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  • Title: Another view on Norplant: match method with users.
    Author: Herndon N.
    Journal: Netw Res Triangle Park N C; 1992 Oct; 13(2):24-6. PubMed ID: 12286081.
    Abstract:
    Even though most family planning specialists believe that Norplant has an important role in public sector family planning programs in developing countries, cost studies in 3 developing countries indicate that its overall costs are greater than those for IUDs, sterilization, or oral contraceptives (OCs). Thus, it may be more worthwhile for programs to target Norplant use to the most appropriate candidates. The study in the Dominican Republic finds the yearly cost of providing contraceptive protection via Norplant is US$ 28, compared to US$ 13.55 for the IUD, US$ 15 for sterilization, and US$ 10 for OCs. Thus, public sector programs should target women who want a long-acting method but are contraindicated for the IUD and do not want to be sterilized. The reasons for Norplant having the highest cost are the high cost o purchasing Norplant and the number of years of protection afforded by Norplant when compared with other methods. For example, women who have undergone sterilization are protected from pregnancy an average of 16 years compared to an average of 3.5 years for Norplant. Clinic visits and staff time do not contribute to overall cost differences. Studies in Bolivia and Thailand indicate similar results. USAID is buying 50,000-100,000 Norplant units to distribute to 8 countries. An advantage of Norplant is that it contains a progestin making it tolerable for women who cannot use OCs with estrogen. According to the manufacturer in Finland, the unit price of Norplant for public programs ranks just a bit higher than production costs. The manufacturer is testing an optimal semiautomated assembly method to reduce production costs (the high unit price of $350 in the US is due to malpractice insurance). It is also thinking about moving manufacturing capabilities to Indonesia to reduce costs.
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