Client Donations for Contraceptives: An Innovative Approach to Sustainable Financing in Turkey Fahreddin Tatar; Jeffrey Sine (December 2001)  Full Document (English)      Order for free      email to me  Since the 1960s, the Ministry of Health (MOH) of Turkey has enjoyed the benefits of external assistance for its family planning (FP) program especially from the U.S. Agency for International Development (USAID). The MOH has since developed an FP program that operates through a widespread network of facilities across the entire country. Today, the MOH dispenses about 70 percent of all intra-uterine devices (IUDs) and about 30 percent of all oral contraceptives (OCs) and condoms in the country. MOH’s FP service provision has traditionally been based on free and universal access. The only exception has been that some of the facilities have in recent years started to collect donations from better-off IUD clients as a result of spontaneous trend. In 1995, the Government of Turkey (GOT) and USAID signed an agreement whereby USAID’s assistance for the FP program would be phased out in five years. This meant that Turkey would have to develop a self-sustaining financing policy to bridge the resource gap created by the departure of USAID’s assistance. The MOH has since been continuing its efforts to develop and implement a new policy. According to the phaseout plan, USAID would donate 20 percentage points less condoms and OCs in each year of the phaseout period. IUD donations, however, would fully continue until the fourth year, when they would be lowered to 50 percent of the forecasted consumption of that year. In 2000, total responsibility would pass onto the GOT. However, there was a diversion from the original phaseout in the implementation stage. Although this has caused confusion, the MOH was quick to respond to the plan by initiating its first-ever contraceptive commodity procurement in 1996.