_45_ _Appropriate policies to support private sector services_ _a. Price subsidies for contraceptive products._<sup>Some areas may have well-developed</sup> commercial retail networks, but prices of commercial contraceptives<sup>are beyond the reach of many</sup> consumers. Social marketing programs can provide<sup>subsidies to keep retail prices low enough to be</sup> affordable to consumers while still guaranteeing<sup>an acceptable profit margin for distributors and</sup> retailers.

b. _Support to NGOs._ While donors usually explicitly<sup>refuse to cover recurrent costs</sup> (other than commodities) in the public sector, recurrent<sup>cost support to NGOs is the rule rather than</sup> the exception. This paper does not advocate eliminating<sup>NGO support, but it does suggest</sup> reexamining the bases for initiating and continuing both<sup>commodity and financial support.</sup> NGOs are thought to have a competitive advantage<sup>in serving hard to reach populations</sup> and in providing non-clinic-based family planning<sup>services. Therefore, before initiating support to</sup> an NGO, the donor should ascertain that the organization<sup>is, in fact, physically located in an</sup> unserved area and that it will provide methods<sup>previously unavailable to the target population.</sup> Creating brand-new single-purpose family planning<sup>NGOs should be a very low priority. Continuing</sup> funding should be based on demonstrated impact and efficiency,<sup>not just total production or cost per</sup> CYP, but geographic coverage or contribution to method<sup>and total prevalence. Management support</sup> should be provided to improve organizational accountability<sup>to the user population and operational</sup> efficiency. Support to NGOs which do not contribute<sup>to prevalence should be phased out.</sup> Successful NGOs should be expected to cover greater<sup>portions of their operating expenses through</sup> local sources, including user fees, cross-subsidization,<sup>and/or local donors.</sup> 3. Tax breaks for employers and health<sup>care financiers who</sup> underwrite family planning Tax breaks for financing family planning are attractive<sup>because they do not require any</sup> cash outlay. Many countries already exempt charitable<sup>contributions or health care expenses. Firms</sup> could be encouraged not only to provide family planning<sup>for employees and dependents, but also to</sup> make cash and/or in-kind contributions to family planning<sup>NGOs.</sup>

# 4. Sharing public sector facilities with the private<sup>sector</sup>

In many countries, public sector facilities stand vacant<sup>many hours of the day, especially</sup> in the late afternoon, evenings, or weekends. Local<sup>directors should be encouraged to permit private</sup> organizations, especially NGOs, to operate after-hours<sup>family planning clinics and wherever feasible,</sup> to charge for services rendered.

# 6.3. Pilot studies and coordinated evaluation<sup>activities</sup>

Even the best-planned program will present unforeseen<sup>opportunities for program</sup> expansion. Donors should reserve funds to<sup>be able to respond to these opportunities though</sup> designing and implementing self-contained, limited-scope<sup>pilot projects. The private sector will often</sup> be best-suited for these projects, although decentralized<sup>public systems may allow local outlets</sup> enough autonomy to undertake such ventures<sup>as well.</sup> Process evaluation should be built into every program<sup>and pilot project.</sup> Impact evaluation is often beyond the means of individual<sup>projects because of limitations on funding, staff,</sup> or time. Large-scale data collection efforts, such as<sup>national prevalence surveys, should include</sup>