_t_ _Private sector coverage of the fanmly planning_<sup>_market_</sup> should allow women greater access to interval<sup>procedures. Data on timing of female sterilization-</sup> -following a cesarean section delivery, following a<sup>vaginal delivery, or interval-are available for nine</sup> countries in Latin America. Across the region,<sup>there is no consistent relationship between total</sup> prevalen. s,f female sterilization and timing of<sup>the procedure, suggesting that norms per se are not</sup> a significant determinant of adoption of this<sup>method. The proportional use of cesarean section</sup> procedures is negatively correlated with proportional<sup>use of interval procedures (r = .69, p < .05),</sup> suggesting that norms do affect the timing<sup>of the procedure. Finally, private sector coverage of</sup> sterilization shows a positive relationship with<sup>absolute prevalence of interval sterilizations (r = .81,</sup> p < .01), supporting the hypothesis that less restrictive<sup>sterilization norms encourage or permit</sup> greaier private sector participation.

Ownership of clinical facilitie-s is another<sup>potential factor in private sector coverage of</sup> sterilization, especially under restrictive<sup>norms which encourage inpatient, post-cesarean section</sup> procedures. Within Latin America, Brazil<sup>and Peru show the highest relative rates of sterilization</sup> by cesarean section (65 percent and 51 percent,<sup>respectively, of all female sterilizations). Hospitals</sup> in Brazil are divided almost equally between<sup>the public and commercial sectors; as a result, 42</sup> percent of the users of female sterilization were<sup>operated in commercial sector hospitals. In Peru,</sup> the private sector controls 25 percent of the hospital<sup>facilities, and the commercial sector accounts</sup> for only 29 percent of tubal ligations.

Because of its relative ease of distribution, pills<sup>and other supply methods should be the</sup> most sensitive to market pressures of supply and<sup>demand. In Latin America, oral contraceptives are</sup> well accepted, and there is a strong positive correlation<sup>between absolute pill prevalence and private</sup> sector coverage: those countries with the highest<sup>pill prevalence also show the highest participation</sup> of pharmacies in the pill market (r = .791). In<sup>contrast, pill prevalence in Sub-Saharan Africa is</sup> much lower: with the exception of Botswana and<sup>Zimbabwe, no country shows more than 5 percent</sup> pill prevalence. Pill prevalence in Sub-Saharan Africa<sup>is positively correlated with government share</sup> of the pill market (r = .450) and negatively correlated<sup>with pharmacy coverage (r = -.517).</sup> It could be argued that the pili market in this region<sup>owes its existence to government efforts to</sup> stimulate demand. Whether government influence<sup>can continue to stimulate demand and provide</sup> contraceptives to growing numbers of users or will<sup>act as a cap by not permitting private market</sup> activity remains to be seen. Asia/North Africa<sup>shows no correlation between pill prevalence and</sup> either govermment or pharmacy share of the<sup>pill market.</sup> Within the private sector, the relative contributions<sup>of private practitioners, pharmacies,</sup> and NGOs are also varied and influenced by method<sup>mix. This can be illustrated by comparing</sup> Brazil and Colombia, two "advanced" developing<sup>countries characterized by high prevalence and low</sup> government involvement in family planning. The<sup>balance between the commercial sector and NGOs</sup> is shifted towards NGOs in Colombia and towards<sup>the commercial sector in Brazil. In Colombia one</sup> NGO, Profamilia, accounts for 32 percent of all<sup>modern method users and the commercial sector for</sup> 40 percent. In contrast, in Brazil, the entire NGO<sup>sector accounts for 1 percent of modern method</sup> users, whereas the commercial sector accounts<sup>for 69 percent.</sup> Part of this difference may be due to differences in<sup>method mix: pill and IUD prevalence</sup> are 14 and 12 percent, respectively, in Colombia,<sup>compared with 25 and less than 1 percent in</sup> Brazil. The commercial sector is the major supplier<sup>of pills in both countries: 75 percent in</sup> Colombia and 94 percent in Brazil. NGOs accounts<sup>for 32 percent of IUD use in Colombia, while</sup> IUD use in Brazil is an insignificant part of the contraceptive<sup>market. Time series data from Mexico</sup> also show the impact of method mix on market<sup>segmentation. Private sector coverage of all modern</sup> method users decreased from 47 to 38 percent<sup>between 1982 and 1987, which coincided with a</sup> relative decline in the use of pills (available from<sup>pharmacies) from 30 to 18 percent of modorn</sup> method users, while the use of IUDs and<sup>female sterilization (available primarily from public</sup>