Context: The principles endorsed by delegates to the 1994 International Con
ference on Population and Development expanded on the areas typically inclu
ded in reproductive health. Yet implementation of more comprehensive reprod
uctive health programs has been slow, and the impediments to program expans
ion need to be identified
Methods: The elements of a reproductive health care program were identified
, and in 1995, the disaggregated costs of providing some of these services
were gathered from a program of the Zimbabwe National Family Planning Counc
il (ZNFPC) and from MEXFAM, a nongovernmental organization in Mexico affili
ated with the International Planned Parenthood Federation. These data were
used to estimate and compare the costs (in U.S. dollars) of various compone
nts of reproductive health care per visit (or per diagnosis and treatment)
in the two countries.
Results: The costs of providing contraceptive methods, particularly surgica
l ones, as well as gynecologic and general health services, varied between
ZNFPC and MEXFAM. Whereas tubal ligation cost $70 and oral contraceptives $
3 at ZNFPC, a tubal ligation cost $269 and oral contraceptives $4 at MEXFAM
. During a gynecologic visit, the cost of treatment fora sexually transmitt
ed disease was $19 at ZNFPC and $29 at MEXFAM. The cost of providing an ado
lescent with a routine examination and iron supplement was $5 at ZNFPG and
$4 at MEXFAM. At ZNFPC, providing a Pap smear, screening for a reproductive
tract infection and checking an IUD during a single visit cost $4, compare
d with $6 when the procedures were performed separately.
Conclusions: Costing reproductive health programs requires breaking service
components into individual cost elements. This process can help managers u
nderstand both the financial and programmatic implications of alternative i
mplementation strategies.