How much is enough?: estimating requirements for subsidized contraceptives : results from a ten-country analysis

As the number of women of reproductive age grows and as the proportion of those women using modern contraceptive methods increases, total global demand for contraceptive commodities is expected to grow by more than 40 percent by the year 2015. Much of this increase will occur in developing countries, many of which are heavily dependent on multilateral and bilateral donor organizations for commodities distributed through their public sector health systems and through social marketing initiatives. Donor contributions, however, have fallen short of the commitments made at the International onference on Population and Development in 1994, leading some to question whether a crisis is looming in the world's ability to meet future demand for contraceptives.

This paper provides an alternative view to the Ross et al recent estimate of the need for donated contraceptives. Calls for donors to significantly increase funding for procurement and distribution of contraceptives rest on a key assumption: that the current shares of demand met by public and private sector providers will persist into the future. This implicitly assumes that the private sector (and more importantly, the commercial sector) will not successfully engage in strategies to increase its market share. Furthermore, it implies acceptance of the relatively untargeted strategies that characterize most public sector programs. Ensuring that subsidized contraceptives reach those most in need and maximizing the use of limited government budget and donor resources requires that we question these untargeted approaches.

This paper recommends that

• public sector and social marketing programs be encouraged to better direct thedistribution of subsidized supplies to those most in need
• the private sector be encouraged to better serve consumers who can afford to pay for their contraceptives.

In this way, theburden of meeting future demand will not rest so heavily on governments and donor organisations