In almost all developing countries, family planning services are provided by both the public and private health care sectors. But because services offered through private clinics or doctors are expensive, most people receive family planning care from government-funded facilities, which offer services for free or at low cost.

The expense of providing this care is skyrocketing as populations in developing countries grow and the demand for family planning services increases, according to the U.S. Agency for International Development (USAID). Between the years 1995 and 2015, costs associated with providing family planning care in developing countries are expected to jump from $8 billion to $22 billion.

At the same time, though, public-sector funds tagged for family planning in the developing world are expected to stay the same-or decrease. By the year 2015, USAID estimates that donors to and governments of developing countries will supply only half of the anticipated $22 billion needed.

Help for family planning services in the developing world may come from a surprising source-the private sector. In 1998, USAID's Center for Population, Health, and Nutrition designed a five-year, $80 million project to encourage private-sector involvement in work traditionally performed by the public sector. The project is called Commercial Market Strategies (CMS).

Administered by the consulting firm Deloitte Touche Tohmatsu, the project is targeting 20 developing countries where the private sector can be mobilized to assume more responsibility for family planning services. National governments, with support from international donors, will provide services for those who can't afford to seek care elsewhere. CMS encourages for-profit enterprises like private practices, pharmacies, and insurance companies to venture into family planning services by offering profit incentives.

In the Philippines, for instance, CMS has extended business loans to midwives who offer family planning services. In Jordan, it has conducted market research for Blue Circle, a contraceptive manufacturer. In Uganda, CMS has advised three businesses offering employees health insurance for the first time.

But the project's most impressive success has been franchising clinics. A prototype franchise in Bolivia helped the nonprofit organization PROSALUD create a network of clinics catering to low- and middle-income clients. The franchise helped PROSALUD eliminate "the bad service and outmoded equipment of the public sector," says Director Carlos Cueller, "and the high costs and interest in high margin of profit of the private sector."

In order to effect partnerships between the public and private sectors, the project draws on the expertise of specialists within the field of public health. In March 2000, CMS asked AVSC International to function as a resource, citing its half century of reproductive health experience around the world.

Besides helping CMS design global clinic-based training programs, AVSC will also participate in specific country contracts. AVSC's first contract will involve Ghana, where a large corporation wants to establish its own reproductive health clinic. Other contracts in Cambodia, India, and Nepal are likely.

"We welcome the opportunity to share our expertise in furthering this initiative," says Sara Warren Gardner, AVSC Deputy Director of Programs. "As the universal recognition of the importance of family planning continues to increase," she adds, "the marrying of private- and public-sector initiatives may be a more familiar sight."

Elizabeth Uphoff is a program associate in Development at AVSC.