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Equity and financing for sexual and reproductive health service delivery: current innovations
  1. Dominic Montagu, MBA, DrPH, Assistant Professor1 and
  2. Maura Graff, MPH, Researcher2
  1. Global Health Sciences, Global Health Group, University of California, San Francisco, CA, USA
  2. School of Public Health, University of California, Berkeley, CA, USA
  1. Correspondence to Dr Dominic Montagu, Global Health Sciences, Global Health Group, University of California, San Francisco, 50 Beale Street, Suite 1200, San Francisco, CA 94105-1823, USA. E-mail: montagud{at}globalhealth.ucsf.edu

Abstract

National and international decisions on financing for sexual and reproductive health (SRH) services have profound effects on the type, unit costs and distribution of SRH commodities and services produced, and on their availability and consumption. Much international and national funding is politically driven and is doing little for equity and quality improvement. Financing remains a significant challenge in most developing countries and demands creative responses. While no “one-size-fits-all” solution exists, there are numerous ongoing examples of successful innovations, many of which are focusing on resource pooling and on purchasing or subsidising SRH services.

In this article we have used interviews, grey literature and presentations made at a range of recent public fora to identify new and innovative ways of financing SRH services so as to increase equity in developing countries. Because SRH services are often of low value as a personal good but high value as a public good, we summarise the issues from a societal perspective, highlighting the importance of financing and policy decisions for SRH services. We provide a structured overview of what novel approaches to financing appear to have positive effects in a range of developing countries. Targeting, government payment mechanisms, subsidy delivery and co-financing for sustainability are highlighted as showing particular promise. Examples are used throughout the article to illustrate innovative strategies.

  • developing countries
  • equity
  • finance
  • service delivery
  • sexual and reproductive health
  • Accepted October 23, 2008.

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