Evaluating Population Programs: International Experience with Cost-Effectiveness Analysis and Cost-Benefit Analysis.

Abstract

This book examines cost-benefit (CBA) and cost-effective analysis (CEA) of the planning and evaluation of population and policy programs particularly in Africa Asia and Latin America. With the general reduction of financial resources throughout the world there is now increasing emphasis on the financial accountability and economic justification for such programs. There are several unsettled questions regarding the application of CBA/CEA to population planning activities. For instance there is no completely satisfactory practical way to measure the impact or outputs of population planning programs. During the past decade there has been extensive work on measuring the fertility impact of family planning programs. The basic question on which there is as yet no general consensus is how much of an observed fertility change should be credited to program efforts as opposed to non-program factors. Input and cost measures raise a series of difficult conceptual and practical issues. The basic input variables are well defined. They include the manpower cost and the cost of supplies facilities and equipment. Problems arise where costs are joint in multi-purpose programs; where the allocation of current costs differs from the timing of their associated outputs; where sources of funds are pooled; where the assignment of values to imported items is based on a system of dual exchange rates; and where actual expenditures are not based on budget allocations. This volume contains 2 parts. The 1st is mainly concerned with methodological and conceptual issues such as the CBA/CEA techniques and their application in the population field or criticism of CBA applications to manpower and population policies. A practical question is whether the application of CBA is appropriate at all levels of program development and how often the exercise should be repeated. A number of authors feel that although attention must be given to CBA on the development planning level more attention should be devoted to the development of cost-effectiveness techniques as a guide for the effective and efficient operation of population planning programs. The focus in CEA is more on program strategy and operation and the findings are of greater relevance to program managers. While the 1st part of this volume is devoted to theoretical and methodological aspects of cost-benefit and cost-effectiveness analysis the 2nd part examines its application to family planning programs. The problems of application revealed include issues of measurement cost estimation and standardization of output measures. It is argued that it is the dialogue between those concerned with conceptual development and those involved with application that provides the unique contribution of this volume.