[Family planning in Latin America: development, costs, and future].
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This study examines, on a per-case basis, the social costs associated with contraceptive failures and resulting term pregnancies. To combat unintended pregnancy and escalating health care costs, the public sector needs to provide greater access to highly effective methods of contraception.
In 1994, federal and state funding for contraceptive services and supplies reached +715 million. Funding totaled +148 million for contraceptive sterilization and +90 million for abortion services. According to a survey of state health, Medicaid and social service agencies, reported spending on contraceptive services and supplies increased by 11% between 1992 and 1994. In the same period, spending under Title X rose by 37%, making it the third largest public funding source for contraceptive services and supplies. The largest source of public funds for family planning services continues to be the joint federal-state Medicaid program. Medicaid family planning expenditures increased by only 4% between 1992 and 1994, a sizable decrease in growth from previous years. State funds continue to be the second largest source, providing almost one-quarter of reported public expenditures in 1994. The maternal and child health and social services block grants remain relatively minor sources of support nationally, although in a handful of states they provide the majority of public-sector funds. State governments were virtually the sole source of public support for the 203,200 abortions provided in 1994 to low-income women. Despite the loosening of federal abortion funding criteria in FY 1994 permitting payment in cases of rape and incest, federally funded abortions numbered only 282.
Contraceptive services became free to patients of general practitioners in the British National Health Service on 1 July 1975. We report the numbers of patients advised in a practice of 6,612 patients during the first three-month period and found that in a sample of 211 women, just over half had received medical advice. The financial implications are discussed.
Just to maintain the admittedly inadequate level of research in reproduction and contraceptive development attained in 1974 would require an investment of $143 million this year--a level that has not been reached. To take advantage of existing knowledge, at least $361 million would be required--increasing to $498 million by 1980. To achieve a high-priority research program--10 percent of health expenditures--would require $500 million this year--rising to $766 million by 1980.