Market-based family planning : the enterprise program experience

This paper analyzes efforts conducted by the Enterprise Program to increase private sector participation in family planning services in Brazil, Mexico, the Dominican Republic, Haiti, Ghana, Zimbabwe, Egypt, Turkey, India, Thailand, the Philippines, and Indonesia. The report assesses four strategies used by Enterprise: (1) working through umbrella organizations to reach a large number of service providers or retailers; (2) developing fee-for-service clinic arrangements to increase the availability of family planning services; (3) developing innovative managed care or insurance arrangements to increase access to family planning; and (4) designing public policy initiatives to reduce barriers to privatization and to make more cost-effective use of host government resources. The paper concludes that trade-offs frequently need to be made. For example, in some instances it may be better to work through nonprofit rather than for-profit organizations. Donors need to be aware of these trade-offs, and select program strategies and models to maximize specific objectives.