An attempt was made to work out the actual costs (ACs) and marginal costs (MCs) of Indias family planning program over the 1956-57 and 1982-83 periods and to identify the long run trends. Additionally the efficacy was examined of reorienting the program during 1966-67 by making it target-oriented and time-bound. Data from the Year Book on the Family Welfare Program pertaining to expenditure performance and impact were used. These data were available from the financial year 1966-67 onwards. Prior to this there were 2 limitations to the available data: the data on performance of various family planning methods and their impact on couple protection births averted and so forth had been given in the form of calendar years from 1956-66. Consequently the performance data given by Bali Ram in regard to sterilization and IUDs for the years 1956-57 to 1965-66 were used. Secondly the performance data on conventional contraceptives were available in aggregated form for 3 years (1963-65). These were split into 3 financial years i.e. 1963-64 1964-65 and 1965-66 on the basis of the proportions of sterilizations during these individual years. 3 measures were used in the analysis: cost per equivalent sterilization; cost per couple protected; and cost per birth averted. Considerable fluctuations were evident in respect to the number of equivalent sterilizations especially between 1968-69 and 1977-78. Some of the variations in the output were directly related to the level of the program expenditure especially between 1972-73 and 1982-83. Program expenditure and the output in terms of equivalent sterilization were strongly correlated supporting the view that the output of the family planning program varies with variations in program expenditure. The MC and AC curves in regard to equivalent sterilizations showed sections of AC curves with MC curves intersecting them at lowest points around 1959-60 and 1967-68. The longterm AC curve seemed to be a shallow U-shaped curve. The cost curves relating to the couple-years effectively protected also showed a similar trend. The cost curves relating to cost per birth averted showed rather different patterns of the long run AC and MC both decreasing over time with the AC decreasing relatively steadily to an apparent minimum in 1979-80. This measure showed less sensitivity to short term changes. The results of the means test of AC of equivalent sterilizations before and after 1966-67 suggest that this measure has been increasingly cost effective.
Read full abstract