World Development Report 1984
World Development Report 1984
World Development Report 1984
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measuring social acceptability, or easy formula for the amount spent by its formal layers of governensuring<br />
it. ment-central, provincial, prefectural, and<br />
county-on providing contraceptive supplies free<br />
Financing family planning to users; reimbursing service fees for sterilization,<br />
abortion, and IUD insertion; and providing train-<br />
Public family planning programs, like programs in ing and information on family planning. These<br />
education and health, are heavily subsidized, and costs amount to $213 million annually, about $0.21<br />
services are often offered free of charge. Although per capita. In addition, the rural collective system<br />
the private sector makes a significant contribution finances the family planning staff at the commune<br />
to providing services in some countries, public or brigade level (at an estimated cost of $0.34 per<br />
finance will continue to be critical, especially in capita) and pays incentives, in the form of food<br />
low-income countries and in backward regions, supplements and reimbursement of travel costs, to<br />
where contraceptive demand is limited and health holders of one-child certificates ($0.25 per capita)<br />
services are weak. and to individuals undergoing sterilization ($0.15<br />
per capita). Finally, additional time is spent by<br />
Ptiblic spending barefoot doctors on family planning work (though<br />
not much: in Shandong Province they allocate an<br />
China and India-the two most populous coun- average of 1.5 percent of their time to family plantries<br />
in the developing world, with approximately ning, valued at approximately $3 million). Health<br />
half its population-spent roughly $1.00 and $0.30 workers and midwives probably spend more time<br />
per capita, respectively, on population programs in on family planning. Adding all these contributions<br />
1980. In most of three dozen developing countries together produces a figure for family planning<br />
for which rough estimates are available, spending expenditure in China of nearly $1 per capita.<br />
fell within this range (see Table 7.4). If other devel- Although governments finance a large share of<br />
oping countries with programs were spending their population programs, the amounts spent are<br />
equivalent amounts, the total spent on population still trivial-both in absolute terms and in relation<br />
activities in all developing countries in 1980 must to other government outlays (see Box 7.7). In<br />
have been about $2 billion. China the state budget for the family planning pro-<br />
Practically all spending on population in China, gram absorbs only 0.4 percent of total current<br />
and close to 80 percent of the total in India, is spending, compared with 5.2 percent for health<br />
financed from domestic resources. For all other and 13.1 percent for education. In India and<br />
developing countries combined, government and Mauritius spending on family planning in 1981<br />
foreign donors each contribute about 50 percent. accounted for only 0.5 percent of total government<br />
The government share tends to rise the longer a expenditure. The figures are even lower in Korea<br />
program has been in existence. Three out of four (0.2 percent) and in Malaysia (less than 0.1<br />
countries with programs less than five years old percent).<br />
were contributing less than 10 percent of the costs Foreign donors spent an estimated $491 million<br />
of their programs, in contrast to an average of 54 for population programs in developing countries<br />
percent among twenty-seven countries with pro- in 1981; about two-thirds of this amount was for<br />
grams at least ten years old. Nepal is one of the family planning and related programs. In realrare<br />
exceptions: the share of domestic government terms, population assistance grew at almost 6 perfinancing<br />
fell from 80 percent of its spending on cent a year during the 1970s but fell 3 percent inpopulation<br />
in 1975 to 40 percent in 1980. 1980 and 6 percent in 1981. The prospects for<br />
Even among well-established programs there is increased assistance are not good: UNFPA, a major<br />
wide variation in government spending. Domestic channel for population assistance, expects its,<br />
budgetary outlays in 1980 are estimated to have spending to rise by barely 1 percent over the next<br />
been $0.42 per capita in Sri Lanka, about $0.71 per four years. Population assistance from donors is<br />
capita in Korea, and $1.45 per capita in Costa Rica. discussed further in the next chapter.<br />
But these estimates probably understate the true<br />
government contribution. The cost of health work- Private spending<br />
ers, whose functions often include family planning,<br />
is not always imputed to the population pro- Important constraints limit the growth of private<br />
gram-nor are contributions by local government. suppliers of family planning, especially in rural<br />
The estimate for China of $1 per capita includes areas. The most severe constraint is the need for<br />
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