Strategies Adopted by Caribbean Family Planning Associations to Address Declining International Funding. (Comment)

Article excerpt

In response to high rates of fertility and population growth from the 1950s through the 1990s, many Caribbean countries adopted some form of family planning program. (1) These programs, in combination with increased female educational enrollment and labor force participation, have been successful in reducing population growth: In Barbados, for example, the crude birth rate declined by 22% from 1978 to 1998, while the total fertility rate declined by 19% from 1980 to 1990. (2)

Most Caribbean family planning associations rely on funding from local, national and international sources. One such source, the International Planned Parenthood Federation (IPPF), has implemented a phased reduction in its funding of family planning services in Latin America and the Caribbean. This reduction is mainly the result of two events, a reduction of IPPF funding by the Japanese government and the earmarking of IPPF donations by several contributing countries for use only in Africa and Asia, which occurred in the mid-1990s.

In light of its diminished funds, IPPF has adopted the United Nations Population Fund's prioritization system, which allocates money according to need. Although African and Asian countries have been graded as high-need areas (category A), most Caribbean countries have been designated as areas of midlevel need (category B) and have experienced funding reductions. Two Caribbean countries, the Bahamas and Barbados, have been graded as areas of low-level need (category C) and are slated for an elimination of funding by 2005.

Between 1997 and 1998, IPPF funding for the Family Planning Association of Trinidad and Tobago dropped by 21%, from US$255,961 to US$202,880. Funding for the Grenada Planned Parenthood Association was also cut by more than one-fifth, from US$92,515 in 1997 to US$71,625 in 1998. The Barbados Family Planning Association was hit even harder: It experienced a 20% reduction in unrestricted cash grant funding, from US$96,687 to US$77,471, and a 73% cut in restricted funding, from US$20,709 to US$5,523--an overall reduction of 29%. (Restricted grants are provided for specific purposes, however, and are not usually intended to continue from year to year.) In contrast, IPPF raised its funding for the Jamaican program, FamPlan, from US$144,579 in 1997 to US$174,692 in 1998--an increase of 17%. This increase, however, was offset by the loss of approximately US$30,053 in funding from the U.S. Agency for International Development (USAID); no other country reported decreased funding from USAID.

The reduction of IPPF funding has made it increasingly difficult for Caribbean family planning associations to provide programs and services. Given this situation, as well as the pivotal role played by family planning associations in the fight against HIV in the Caribbean, a look at the funding of Caribbean family planning associations and how that funding affects their ability to provide sexual and reproductive health services is warranted. How have providers weaned themselves from heavy reliance on external funding? Have they been able to obtain more local funding and achieve self-reliance?

THE SURVEY

A questionnaire designed to collect information on services, funding and financial strategies was administered to the family planning associations of five Caribbean countries: Antigua, Barbados, Grenada, Jamaica, and Trinidad and Tobago. The countries were randomly selected from a geographically stratified sample to ensure representation from the broad geographic regions of the Caribbean.

The survey was sent to the executive director of each participating family planning association, and a representative of each program was asked to report on its funding (sources and amounts) for 1997 and 1998, on the potential impact of reduced funding and on the strategies it was implementing or planned to implement to deal with reduced funding. …