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Expenditure
for Reproductive Health Services in Egypt and Sri Lanka
by Ravi P. Rannan-Eliya, Peter Berman, Eltigani E. Eltigani,
Aparnaa Somanathan and Varuni Sumathiratne
HPP Occasional Paper Series
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Using a national health accounts framework, comprehensive
estimates of expenditures for reproductive health services
and family planning in Egypt and Sri Lanka are derived.
These cost estimates include the full costs of overheads
and non-service delivery costs. Reproductive health service
expenditures are defined as expenditures for family planning,
prenatal and postnatal care, childbirth, infant care, and
obstetric and gynecological services. In nominal terms,
total expenditures were found to be $5.29 per capita in
Egypt in 1994/95, and $3.10 in Sri Lanka in 1997. These
expenditures are comparable, once standardized for differences
in income levels, birth rates and women who are married,
with expenditures in Sri Lanka modestly less in per capita
terms ($4.94 versus $5.29). The relative contribution of
public and private sources of funding was quite similar
in both countries. Public sources (which includes donor
assistance) accounted for two-thirds of funding in both.
Item-wise, family planning and MCH services accounted for
the smallest share of costs (less than 22%). The largest
cost components were childbirth and general obstetric and
gynecological care, which accounted for a quarter and a
third of total expenditures each. General gynecological
care in both countries is predominantly privately financed,
indicating a need to rethink policies to fully take into
account private sector contributions. The similarity in
spending levels in the two countries contrasts with the
difference in levels of utilization and access to services.
Sri Lanka achieves almost universal access to key services
with less expenditures. This suggests that efficiency improvements
may offer more potential for expanding services than new
resource mobilization.
Table of Contents:
- Introduction
- Country situations
- Methodology of study
- Results
- Implications
- Annex a: A Review of Egypt population policy
- Annex b: A Review of National Population Policy in
Sri Lanka
- Bibliography
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