United States General Accounting Office

GAO Report to Congressional Requesters

April 1997 FOREIGN

ASSISTANCE

Impact of Funding

Restrictions on

USAID’s Voluntary

Family Planning

Program

GAO/NSIAD-97-123

GAO United States

General Accounting Office

Washington, D.C. 20548

National Security and

International Affairs Division

B-276613 

April 25, 1997

The Honorable Benjamin A. Gilman

Chairman

The Honorable Lee H. Hamilton

Ranking Minority Member

Committee on International Relations

House of Representatives

For fiscal year 1996, Congress placed funding restrictions on the U.S.

Agency for International Development’s (USAID) voluntary family planning

program that (1) reduced its appropriation from the previous year,

(2) delayed the release of funds for 9 months, and (3) required that funds

be apportioned over 15 months. For fiscal year 1997, Congress also

delayed the release of funds and required that they be apportioned at a

rate not to exceed 8 percent per month.1

As you requested, we have reviewed the impact these restrictions have had

on USAID’s family planning program and are likely to have in fiscal year

1998. Specifically, we sought to determine

• what has been the effect of the fiscal year 1996 and 1997 funding limits and

delayed release of funds on USAID’s voluntary family planning program,

• what would be the effect of current funding restrictions if they were

imposed in fiscal year 1998, and

• whether a relationship exists between USAID’s family planning program and

a reduction in abortions.

Background Since 1965, the United States has provided voluntary family planning

services to (1) support the right of couples to determine the number and

spacing of their children, (2) reduce unintended pregnancies, (3) promote

maternal and child health, and (4) stabilize world population. The United

States contributes almost one half of all donor funding to family planning

programs in more than 60 countries with a combined population of

2.7 billion people. The Congressional Research Service reported that USAID

has expended over $5 billion on international family planning during the

past 30 years. Since the 1970s, legislation has prohibited the use of USAID

1

Section 518A of the fiscal year 1996 Foreign Operations Appropriations Act (P.L. 104-107, Feb. 12,

1996) and section 518A of the fiscal year 1997 Foreign Operations Appropriations Act (P.L. 104-208,

Sept. 30, 1996).

Page 1 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

funds to perform abortions as a method of family planning and to motivate

or coerce anyone to have an abortion.2

USAID’s Office of Population manages a substantial portion of the Agency’s

family planning program. USAID awarded about 65 percent of its annual

family planning funding through contracts, grants, and cooperative

agreements to about 30 cooperating agencies that work primarily with

USAID field staff and host government agencies on centrally managed

family planning programs. USAID overseas missions and regional bureaus

manage the remaining 35 percent of annual funds in bilateral or

government-to-government programs, often using the centrally managed

programs in support of their country-specific programs.3

 See appendix I

for a list of countries receiving family planning assistance and

participating cooperating agencies.

Appropriations to the family planning program generally increased from

the start of the program in 1965 through fiscal year 1995. Congress

appropriated $356 million in fiscal year 1996, a 35-percent decrease from

the $545 million appropriated in fiscal year 1995. In addition, Congress

imposed funding restrictions that (1) delayed release of fiscal year 1996

funds until July 1, 1996 (9 months into the fiscal year), and (2) required

that the funds be evenly apportioned over a 15-month period at a rate not

to exceed 6.7 percent of the appropriated amount in fiscal year 1996

($23.7 million per month). Congress appropriated $385 million in fiscal

year 1997, an 8-percent increase from fiscal year 1996, but continued to

include funding restrictions. The 1997 appropriations act delays the

release of funds until July 1, 1997, and requires that they be apportioned at

a rate not to exceed 8 percent per month, unless the President determines

that the delay is having a negative impact on the proper functioning of the

family planning program and Congress approves the determination. In that

event, the funds may be released on March 1, 1997, at 8 percent per month

($30.8 million per month).4

2

The current restriction, included in section 518 of the fiscal year 1997 Foreign Operations

Appropriations Act, prohibits (1) using funds to pay for the performance of abortion or involuntary

sterilization as a method of family planning or to motivate or coerce any person to practice abortions

or undergo sterilization and (2) funding any research that relates to the methods or performance of

abortion or involuntary sterilization as a means of family planning.

3

Congress legislated this split of family planning funds beginning with the fiscal year 1996 Foreign

Operations Appropriations Act and continued it in the fiscal year 1997 Foreign Operations

Appropriations Act.

4

See section 518A of the fiscal year 1996 Foreign Operations Appropriations Act and section 518A of

the fiscal year 1997 Foreign Operations Appropriations Act. This monthly apportionment is known as

“metering.”

Page 2 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

The President submitted a Presidential Determination to Congress on

January 31, 1997, certifying that the funding delay from October 1996 to

July 1997 was having a negative impact on the proper functioning of the

family planning programs. In February 1997, Congress approved the

determination that allowed for the release of the funds on March 1, 1997.

Results in Brief USAID took steps to minimize the impact of fiscal year 1996 and 1997

funding cuts and the delayed release of funds on its family planning

program. It did not have to drop any countries from the program or

terminate any contracts, grants, or cooperative agreements. USAID was able

to maintain the structure and scope of its family planning program

because it (1) consolidated programs and cut activities in 1995 in

anticipation of fiscal year 1996 governmentwide cuts, (2) supplemented its

fiscal year 1996 appropriation with carryover funds, and (3) drew funds

from its family planning pipeline.5

 For the first 5 months of fiscal year

1997, USAID managed its program with fiscal year 1996 funds and pipeline

funds. However, to maintain the scope of its current programs,

cooperating agencies and missions had to delay or cut back some program

elements and could not implement some planned expansion.

The delay in releasing funds reduced USAID’s family planning pipeline 

44 percent, from an estimated $745 million as of October 1, 1995, to an

estimated $414 million as of October 1, 1996. During this time frame, the

development assistance pipeline, which includes such programs as child

survival and democracy, increased about $500 million, or 39 percent.6

 As a

result, some centrally managed and bilateral projects operated with

pipelines close to levels considered disruptive by USAID.

7

 With the release

5

Carryover funds are unobligated balances brought forward from prior years. USAID family planning

funds are 2-year monies; that is, they can be obligated over a 2-year period rather than the standard 1

year in which they are appropriated. The pipeline is the difference between the funds that USAID

obligates to its various activities and the amount it has spent on them. A USAID official told us that as

of December 31, 1996, USAID’s aggregate pipeline totaled $6.4 billion, consisting of funds for

Development Assistance (including family planning), the Development Fund for Africa, the Economic

Suport Fund, Support for East European Democracy, assistance for the New Independent States of the

former Soviet Union, and Special Assistance Initiatives.

6

Family planning funds were subtracted from the development assistance account for purpose of this

pipeline comparison.

7

USAID officials believe that 4 months of pipeline funding is the minimum level at which missions and

cooperating agencies can satisfy existing commitments without disrupting program implementation.

They also stated that mission and cooperating agency subagreements with U. S.-based and host

country institutions; research subcontracts; materials, supplies, and bulk purchase contracts; and

staffing contracts are usually premised on long-term funding availability. As pipelines decrease to the

4-month level, these officials stated that missions or cooperating agencies must end or renegotiate the

terms of their agreements, limit bulk purchases, distribute layoff notices, and arrange for employee

repatriation.

Page 3 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

of fiscal year 1997 funds in March 1997 rather than July 1997, USAID should

have sufficient resources to cover its fiscal year 1997 requirements.

Our analysis shows that if the fiscal year 1998 funding level remains at

$385 million, a 9-month delay (until July 1998) in releasing funds occurs,

and funds are metered on a monthly basis, most of USAID’s bilateral

projects would be in serious jeopardy of running out of funds sometime

during fiscal year 1998 and the centrally managed projects would have

minimal levels of funding available by September 1998. For example, by

September 1998, the average bilateral pipeline would have no funds and

the centrally managed pipeline would have an average of 6 months of

funding in contrast with the 12- to 18-month level recommended in Agency

forward-funding guidelines. USAID officials stated that under this funding

scenario, USAID would not have access to sufficient funds to satisfy

program needs, and certain bilateral family planning programs would have

to be terminated. On the other hand, our analysis shows that if fiscal year

1998 funding is available in October 1997, rather than July 1998, the

current bilateral and centrally managed programs will not be in jeopardy,

even if the funds are metered.

Some studies have shown a correlation between increased use of modern

contraceptives and a reduction in abortion. A recent Demographic and

Health Surveys project conducted by Macro International, Inc., indicated

that in countries where USAID is the primary family planning service funder

and contraceptive use increases, fertility rates have dropped significantly,

and abortion rates have declined. For example, in Almaty, Kazakstan,

contraceptive use increased at USAID-supported clinics by 59 percent from

1993 to 1994, while abortions declined by 41 percent over the same period.

However, because of the lack of accurate and reliable data, researchers

have been unable to prove conclusively that a statistically based causal

relationship exists between increases in the use of modern family planning

methods and decreases in abortion in developing countries.

Impact of Funding

Cuts

USAID minimized the impact of funding cuts on its family planning program

by consolidating programs and cutting activities in 1995 in anticipation of

governmentwide fiscal year 1996 budget reductions. USAID’s Office of

Population directed its field support staff, missions, and cooperating

agencies to plan for a 35-percent reduction in funding. USAID reported that

its downsizing activities included

Page 4 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

• a consolidation of worldwide programs such as training, policy

development, breastfeeding, and data collection and evaluation;

• cuts in social science research, contraceptive development, publications,

and regional activities; and

• reductions in staff and freezes in hiring by cooperating agencies.

The January 1997 Presidential Determination reported that funding for

multilateral programs was cut, and smaller projects were designated for

phaseout without renewal. However, USAID placed a high priority on

service delivery programs and worldwide contracts for contraceptives and

protected them relative to other program components. USAID staff stated

that the advance planning for funding cuts, the metering of fiscal year 1996

funds for 3 months, the availability of fiscal year 1995 carryover funds, and

unexpended pipeline funds enabled USAID to preserve the structure and

scope of the family planning program in fiscal year 1996. During fiscal year

1997, USAID will use the fiscal year 1996 funds available and the 7 months of

fiscal year 1997 funds metered from March through September to cover

expenditures. The pipeline will recover $21 million of the $328 million

depleted in fiscal year 1996 by September 30, 1997, because available

funds will exceed estimated expenditures. (See fig. 1.)

Figure 1: USAID Family Planning Program by Funding Source (dollars in millions)

Pipeline funds

FY 1996 Funds

FY 1995 Funds

 Pipeline recover

Fy 1996 funds

FY 1997 funds

54.6%

41.4%

Pipeline depletion ($328)

Fiscal year 1996 funds ($71)

Fiscal year 1995 carryover funds ($81)

Pipeline recovery ($21)

Fiscal year 1996 funds ($285)

Fiscal year 1997 funds ($216)

Fiscal year 1996 Fiscal year 1997

Source: USAID and GAO.

Page 5 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

USAID did not drop any countries from the program or terminate any

contracts, grants, or cooperative agreements during fiscal year 1996 or the

first 5 months of fiscal year 1997. However, cooperating agencies and

missions had to delay or limit some program elements to maintain their

current scope and could not implement some planned expansion. For

example, a USAID official stated that successful educational pilot projects

for birth spacing, maternal health, and the use of contraceptives were not

expanded into countrywide activities. Further, the USAID mission in

Mozambique reported that a cooperating agency would not be able to

initiate a child-spacing project in additional districts as planned.

Impact of Delayed

Funding and Metering

The 9-month delay in releasing fiscal year 1996 family planning funds

reduced bilateral and centrally managed pipelines. For example, the

combined bilateral-centrally managed pipeline declined from an average of

19 months as of September 30, 1995, to 10 months as of September 30,

1996—a decrease of 47 percent. In contrast, the pipeline for the

development assistance account increased from 17 months as of

September 30, 1995, to 21.9 months as of September 30, 1996—an increase

of about 29 percent. (See fig. 2.)

Page 6 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

Figure 2: Comparison of USAID’s

Development Assistance and Family

Planning Pipelines (1995-1996)

1995 1996

0

5

10

15

20

25

17

21.9

19

10

Months of pipeline

Development assistance Family planning

Note: The development assistance account includes programs such as child survival,

democracy, and the environment. We subtracted family planning funds from the development

assistance account for the purposes of this comparison. Projections for the development

assistance account were not available for 1997 and 1998.

Source: USAID and GAO.

USAID attempted to minimize the impact of delayed funding and metering

on the family planning projects by developing a metering plan. The plan

incorporated program priorities and project funding needs into a timing

schedule for each project so that funds were provided in the month that

the project was calculated to fall close to or below a 4-month minimum

level.8

 According to USAID officials, these actions, along with those

8

USAID officials stated that they did not anticipate that funding restrictions would continue in fiscal

year 1997. Such knowledge might have changed their input into the development of the fiscal year 1996

metering plan, resulting in different funding levels and timing for each project.

Page 7 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

associated with funding cuts, carried the bilateral and centrally managed

projects through fiscal year 1996 and minimized the impact of the funding

delays. A Deputy Director of the Office of Population told us that the

delayed release of fiscal year 1996 funds, in combination with metering,

had the most significant adverse impact on the bilateral and centrally

managed pipelines. USAID missions and cooperating agencies reported

some incidents of program delays or cuts. For example, the mission in

Mozambique reduced its level of contraceptive commodities, and the

mission in Nepal reported that it was unable to work with a

nongovernmental organization to establish a new family planning and

maternal health facility. In addition, a USAID official indicated that up to 19

research contracts, including clinical trials of new contraceptives, were

delayed or interrupted because of the delayed release of funds.

Pipelines were further reduced by the 5-month funding delay and the

$385 million appropriated for fiscal year 1997. USAID projected that without

an early release of funds, the pipeline would average 6 months for

centrally managed projects and 6 months for bilateral projects by June 30,

1997. USAID further projected that 12 centrally managed and 8 bilateral

projects were in urgent need of funds.9

 For example, Pathfinder

International, a participating cooperating agency, reported that if available

funds were stretched past March 1997, it would have to cut its

nurse/midwife training programs in Uganda. Additionally, CARE, another

cooperating agency, reported that it would have to phase out its medical

training program in maternal and reproductive health in Peru if funds were

delayed until July 1997. USAID projected that without the March release of

funds, it would have been about $40 million short in meeting its urgent

funding requirements between March and June 1997.

Because funds were released in March 1997 rather than July 1997, USAID

said it will be able to meet its urgent requirements during this time frame.

USAID will have $123 million in fiscal year 1997 funds and $95 million in

fiscal year 1996 funds available to support its urgent needs between March

and June 1997 as well as other projects approaching the 4-month minimum

level. USAID officials indicated that while the funding release in March is

beneficial, USAID must develop a fiscal year 1997 metering plan.10 The

Director of the Office of Population also said that continued metering will

9

A USAID official stated that the questionable accuracy of bilateral pipeline data (due to delayed

posting of expenditures) led USAID to do a detailed pipeline review and, more importantly, to obtain

information from the missions and cooperating agencies about their projects’ funding levels. As a

result, USAID identified the 20 projects in urgent need of funds.

10USAID expects to complete the plan by May 1997.

Page 8 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

adversely impact programs because it reduces USAID’s flexibility and its

ability to respond to emergency needs.

USAID staff also stated that the current funding restrictions have associated

administrative and program costs. They provided information showing

that designing and implementing the metering plan for the legislated delay

in funding cost $1.5 million and involved up to 143 people on a part-time

basis in Washington and the missions. In addition, the Presidential

Determination stated that the number of separate actions to fund USAID

family planning programs is nearly triple what would be required without

the metering.

Cooperating agencies have also cited the increased administrative costs

incurred as a result of the funding restrictions. For example, AVSC

International, USAID’s second largest cooperating agency, stated that the

legislatively mandated delays and metering “required us to increase the

paperwork, staff time, and administrative expense associated with

providing family planning and reproductive health services overseas. For

every dollar intended to provide access to these services last year, a

smaller quantity of services was actually provided.”

Impact of Funding

Restrictions on

USAID’s Fiscal Year

1998 Needs

Our analysis shows that if fiscal year 1998 funding parallels the fiscal year

1997 level of $385 million, Congress delays the release of funds for 

9 months, and funds are metered, USAID’s family planning program will

have an average 3-month pipeline as of September 1998, 1 month below

the 4-month minimum level. The bilateral programs will have no funds in

the pipeline, and the centrally managed programs will have about a

6-month pipeline on average. (See fig. 3.)

Page 9 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

Figure 3: USAID’s Projected Pipeline

(June 30, 1997, Through Sept. 30, 1998)

Bilateral projects Central projects All projects

0

2

4

6

8

10

12

7

8 8

7

10

9

1

6

4

0

6

3

Months of pipeline

6/30/97 9/30/97 6/30/98 9/30/98

Source: USAID and GAO.

If actual expenditures vary significantly from the estimates, pipelines will

expand or contract accordingly. USAID staff noted that actual expenditure

rates can vary significantly from month to month, depending on a variety

of factors, including the stage and type of a family planning project. In

addition, missions such as Nigeria reported that USAID’s financial

management information systems do not always accurately report all

actual mission expenditures on a timely basis.

USAID officials stated that with the funding scenario shown in figure 3,

some bilateral programs would be delayed or shut down. For example, the

mission in Indonesia reported that if the funding restrictions were to

Page 10 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

continue in fiscal year 1998, it would be forced to suspend its integrated

family planning and reproductive health activities midway through

completion, jeopardizing maternal health and child health programs as

well. Moreover, the Kenyan mission reported that it may have to delay

implementation of family planning programs and concentrate instead on

sexually transmitted disease programs. USAID staff also stated that the U.S.

government would lose the long-standing confidence of other donor

countries, cooperating agencies, and host governments if bilateral and

contractual agreements are compromised. Although other donors have

increased their level of funding for family planning programs, USAID

officials told us that these donors are not able to provide the full range of

program support, such as contraceptive development and operations

research; logistics management; training; demographic and health surveys;

and the provision of contraceptives, which is unique to USAID’s family

planning program.

USAID staff also stated that if fiscal year 1998 funding levels parallel fiscal

year 1997, the release of funds is delayed, and funds must be metered,

many of the adverse program impacts that would have occurred with a

July 1997 release of funds, as cited in the January 1997 Presidential

Determination, would be realized in fiscal year 1998. Likely consequences

include the indefinite deferral of training programs and the suspension of a

range of service delivery programs. They also indicated that they would

have to implement alternative funding strategies, such as shifting funds on

a temporary basis among selected family planning and other development

programs, terminating programs, and asking other donors to meet urgent

program needs. USAID officials believe that all mitigating measures carry

risks that are unacceptable or undesirable for proper program

management. For example, they believe that shifting funds from selected

programs on a temporary basis to those with a “dangerously low” pipeline

is not prudent management and would only exacerbate the problem when

the programs “borrowed from” need funds.

Our analysis shows that if the release of funds is not delayed and funds are

made available in October 1997, USAID would not be forced to curtail

projects and other activities within its family planning program and

project pipelines would exceed USAID’s 4-month minimum level. The

bilateral pipeline would average 6 months, and the centrally managed

pipeline would average 14 months as of September 30, 1998. According to

a Deputy Director of the Office of Population, an October 1997 release of

funds, rather than a delayed release, is preferable, even if the funds are

metered on a monthly basis.

Page 11 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

Family Planning and

Abortion

USAID believes that its family planning programs have been a primary factor

in reducing abortion rates among its clients. A recent Demographic and

Health Surveys project conducted by Macro International, Inc., indicated

that where USAID is the primary family planning provider and contraceptive

use increases, fertility rates have dropped significantly, and abortion rates

have declined. For example, it reported that in Almaty, Kazakstan, where

USAID has provided assistance to train doctors and nurses and to increase

contraceptive supplies, contraceptive use increased by 59 percent from

1993 to 1994; at the same time, abortions declined by 41 percent. In

addition, the Ministry of Health in Ukraine reported an 8.6-percent

decrease in abortions between January and June 1996, which it directly

attributed to the women’s reproductive health program that began in 1995

with USAID funding.

The researchers we spoke with stated that a statistically based causal

relationship between increases in the use of modern family planning

contraceptives and decreases in abortions cannot be conclusively proven

in developing countries. Representatives of the Alan Guttmacher Institute,

Princeton University, and the University of North Carolina have reported

that the inability to obtain accurate data on the incidence of abortion is the

primary difficulty in assessing the impact of modern family planning and

contraceptive use on abortion. Data is considered most reliable in

countries where abortion is legal and medical organizations maintain

records. Data is also considered reliable in countries where abortion has

been used as a means of contraception, for example, in the former Soviet

Union and Eastern Europe. Data is more suspect in developing countries,

where few resources exist to collect and analyze statistics, and in

countries where most, if not all, abortions are illegal and not reported.

Agency Comments In commenting on a draft of this report, USAID indicated that it agreed with

the report’s conclusion that USAID’s management actions, combined with

congressional action to release fiscal year 1997 funds in March rather than

July 1997, had minimized the negative impact of funding cuts and other

congressional restrictions on its family planning program to date. USAID

also indicated that its family planning program would be in “serious

jeopardy of running out of funds” if there is a repetition of the fiscal year

1996 and 1997 restrictions in fiscal year 1998. USAID also provided

additional examples of program impact that we did not verify. Appendix

III contains the full text of USAID’s comments.

Page 12 GAO/NSIAD-97-123 Foreign Assistance
B-276613 

See appendix II for information on our scope and methodology. We

performed our work from December 1996 to March 1997 in accordance

with generally accepted government auditing standards.

As arranged with your office, unless you publicly announce its contents

earlier, we plan no distribution of this report until 30 days after the date of

this letter. We will then send copies of this report to the Administrator of

USAID and other appropriate congressional committees. We will provide

copies to others upon request.

Major contributors to this report were Ron Kushner, Barbara Schmitt,

Michael Zola, Joan Slowitsky, Jose Pena, and Thomas Melito. Please

contact me on (202) 512-4128 if you have any questions on the information

in this report.

Jess T. Ford, Associate Director

International Relations and

 Trade Issues

Page 13 GAO/NSIAD-97-123 Foreign Assistance
Contents

Letter 1

Appendix I 

Recipients of Family

Planning Assistance

and Participating

Cooperating Agencies

16

Recipients of USAID Family Planning Assistance in Fiscal Year

1997

16

Participating Cooperating Agencies in Fiscal Year 1997 17

Appendix II 

Scope and

Methodology

19

Appendix III 

Comments From the

Agency for

International

Development

21

Figures Figure 1: USAID Family Planning Program by Funding Source 5

Figure 2: Comparison of USAID’s Development Assistance and

Family Planning Pipelines

7

Figure 3: USAID’s Projected Pipeline 10

Abbreviations

USAID U. S. Agency for International Development

Page 14 GAO/NSIAD-97-123 Foreign Assistance
Page 15 GAO/NSIAD-97-123 Foreign Assistance
Appendix I 

Recipients of Family Planning Assistance

and Participating Cooperating Agencies

Recipients of USAID

Family Planning

Assistance in Fiscal

Year 1997

Albania

Armenia

Bangladesha

Belarus

Benin

Boliviaa

Botswana

Brazil

Cambodiaa

Colombia

Cote d’Ivoire

Dominican Republica

Ecuadora

El Salvadora

Egypta

Eritreaa

Ethiopiaa

Georgia

Ghanaa

Guatemalaa

Guinea

Guinea-Bissau

Haitia

Hondurasa

Indiaa

Indonesiaa

Jamaicaa

Jordana

Kazakstan

Kenyaa

Kyrgyzstan

Madagascara

Malawia

Malia

Mexico

Moldova

Moroccoa

Mozambiquea

Nepala

Nicaraguaa

Page 16 GAO/NSIAD-97-123 Foreign Assistance
Appendix I 

Recipients of Family Planning Assistance

and Participating Cooperating Agencies

Nigera

Nigeria

Oman

Paraguaya

Peru

Philippinesa

Romania

Russia

Senegala

South Africaa

Sri Lanka

Tajikistan

Tanzaniaa

Turkmenistan

Turkey

Ugandaa

Ukraine

Uzbekistan

Yemena

Zambiaa

Zimbabwea

aDenotes country with bilateral program; remaining countries receive assistance through centrally

managed program.

Participating

Cooperating Agencies

in Fiscal Year 1997

AVSC International (Access to Voluntary and Safe Contraception)

Basic Health Management International

CARE

Center for Development Activities

Centers for Disease Control

Deloitte and Touche

Durex International (formerly known as Aladan, Inc.)

East-West Center

Eastern Virginia Medical School

Family Health International

Finishing Enterprises, Inc.

The Futures Group International

Georgetown University

International Planned Parenthood Federation/London

International Planned Parenthood Federation/Western Hemisphere Region

Johns Hopkins University

Page 17 GAO/NSIAD-97-123 Foreign Assistance
Appendix I 

Recipients of Family Planning Assistance

and Participating Cooperating Agencies

John Snow International

Leiras Oy

Macro International

Management Sciences for Health

National Academy of Sciences

Ortho Pharmaceuticals

Pathfinder International

Panalpina, Inc.

Pharmacia & Upjohn

Planning and Learning Technologies

Population Reference Bureau

The Population Council

University of Michigan School of Public Health

University of North Carolina

Western Consortium for Public Health

U.S. Bureau of the Census

Wyeth-Ayerst International

Page 18 GAO/NSIAD-97-123 Foreign Assistance
Appendix II 

Scope and Methodology

To obtain information on the impact of funding cuts, delays, and metering

on USAID’s family planning programs, we interviewed and obtained

documents from officials in USAID’s Center for Population, Health, and

Nutrition, including the Office of Population, Office of Field and Program

Support, Division for Policy and Evaluation, and Division for

Contraceptives and Logistics Management; the Bureau for Management,

including the Office of Budget and the Office of Procurement; the Bureau

for Latin America and the Caribbean; the Bureau for Europe and the New

Independent States; and the Bureau for Asia and the Near East. We

analyzed USAID’s fiscal year 1995-98 family planning pipeline data, the

metering plan, and the contraceptives procurement plan and reviewed its

studies and analyses of program performance.

We also interviewed and obtained studies and analyses from officials of

the following organizations: AVSC International; Durex, a subsidiary of

London International Corporation (formerly known as Aladan, Inc.);

Centers for Disease Control; Carolina Population Center; Christian

Coalition; International Planned Parenthood Federation; Population

Action International; Population Council; Population Reference Bureau;

and the Rockefeller Foundation. We were unsuccessful in our attempts to

obtain the views of the National Right to Life Committee and the

Population Research Institute.

We did not conduct field visits to overseas locations for this review; rather,

we relied on USAID’s and other organizations’ studies and analyses and our

interviews.

To project the impact of continued funding restrictions in fiscal year 1998,

we evaluated family planning project pipelines to determine when these

pipelines would fall below the USAID-determined 4-month minimum level.1

We assumed that the fiscal year 1998 funding restrictions would be the

same as those that Congress imposed in 1997; that is, a $385 million

funding level, a 9-month delay in release of funds,2

 and metering at

8 percent per month. We also assumed that expenditure and obligation

patterns would remain constant over time. Based on these assumptions,

1

USAID officials stated that their current reporting systems include pipeline information by funding

account (economic support fund, development assistance, etc.) and country. They indicated that their

reporting systems are currently not capable of computing pipeline amounts at the program level—the

pipeline for the family planning program was manually computed. USAID officials indicated that when

the new management system is fully operational it will be capable of readily identifying program

financial data, such as rate of obligations and expenditures, and level of pipeline.

2

We assumed a July 1998 release of funds in fiscal year 1998.

Page 19 GAO/NSIAD-97-123 Foreign Assistance
Appendix II 

Scope and Methodology

we used USAID pipeline projections at June 30, 1997, to establish a baseline

for our projections through September 30, 1998.

The June 30, 1997, baseline was based on pipeline levels that represent

USAID’s bilateral projects and centrally managed projects, including their

respective monthly expenditure rates. Bilateral pipeline levels were based

on PIPE data, one of USAID’s financial management information systems, as

of September 30, 1996. The data was then projected forward by adding

planned fiscal year 1996 family planning funding and subtracting

expenditures based on recent monthly expenditure rates from Mission

Accounting and Control System data. USAID provided us with centrally

managed project pipeline levels that were obtained directly from each

cooperating agency during USAID’s semiannual portfolio review process

and verified against vouchering data. USAID’s Contraceptives and Logistics

Management Division provided us with pipeline levels and expenditure

rates for contraceptives procurement.

To adjust the June 30, 1997, baseline to reflect the March 1997 release of

funds approved by Congress in February 1997, we added 4 months of fiscal

year 1997 funding—March 1 through June 30—and subtracted 4 months of

estimated expenditures based on USAID’s determination of urgent needs.

We then added the remaining fiscal year 1996 funds and fiscal year 1997

funds through September 30, 1997, and subtracted estimated expenditures

to project pipelines to the end of fiscal year 1997. Finally, we added the

remaining fiscal year 1997 and fiscal year 1998 funds through

September 30, 1998, to project pipelines at the end of fiscal year 1998.

We attempted to verify bilateral pipeline data with each USAID mission that

reported pipeline deficits. This exercise revealed inconsistencies between

the bilateral pipeline data provided by USAID’s Management Bureau Budget

Office and data provided by overseas missions due to delayed posting of

expenditures. As a result, some bilateral projects appeared to be running

deficits, when in fact the pipeline exceeded USAID’s 4-month threshold. We

also requested that these missions and cooperating agencies provide

information on the projected impact of funding restrictions on programs in

fiscal year 1998.

To determine the relationship between USAID’s family planning programs

and reductions in abortions, we interviewed and obtained documentation

and studies from officials of the Alan Guttmacher Institute and Princeton

University, in addition to the USAID offices and organizations previously

mentioned.

Page 20 GAO/NSIAD-97-123 Foreign Assistance
Appendix III 

Comments From the Agency for

International Development

Note: GAO comments

supplementing those in the

report text appear at the

end of this appendix.

Page 21 GAO/NSIAD-97-123 Foreign Assistance
Appendix III 

Comments From the Agency for

International Development

Page 22 GAO/NSIAD-97-123 Foreign Assistance
Appendix III 

Comments From the Agency for

International Development

Now on p. 3.

Now on p. 3.

Page 23 GAO/NSIAD-97-123 Foreign Assistance
Appendix III 

Comments From the Agency for

International Development

Now on p. 3.

See comment 1.

Now on p. 4.

Now on p. 4.

Now on p. 3.

See comment 2.

Page 24 GAO/NSIAD-97-123 Foreign Assistance
Appendix III 

Comments From the Agency for

International Development

Now on p. 4.

See comment 3.

Now on p. 11.

Page 25 GAO/NSIAD-97-123 Foreign Assistance
Appendix III 

Comments From the Agency for

International Development

The following are GAO’s comments on USAID’s letter dated March 24, 1997.

GAO Comments 1. While we recognize that USAID minimized negative impacts on the family

planning program, USAID did not provide additional data to demonstrate

that these types of consequences will occur.

2. The report text has been modified to reflect this information.

3. We noted in our report that release of funds in October 1997 rather than

July 1998, even though metered, will enable USAID to continue funding

family planning projects and that pipelines will exceed the 4-month

minimum level. Nonetheless, it is likely that USAID will have to deal with

the administrative burden of metering.

(711240) Page 26 GAO/NSIAD-97-123 Foreign Assistance
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