This study assesses the cost-effectiveness of reimbursement schemes for community-based distribution (CBD) programs in Tanzania, and answers whether agents who receive monetary incentives perform better and are more cost-effective than those that receive nonmonetary incentives. Fieldwork was undertaken in April and May 1997, and data forming the basis of the analysis was collected from four CBD programs. These programs vary in their remuneration schemes and status of their CBD agents, size, and geographical coverage; the range of activities undertaken by the agents; and supervision and management structures. As noted in this report, CBD agents who receive monetary remuneration see more clients and generate more Couple Years of Protection than those provided with nonmonetary incentives. The program relying on part-time volunteer agents who receive nonmonetary remuneration is the most cost-effective. There are a number of programmatic factors that account for variances in program-output performance and cost-effectiveness. Understanding these factors is important in guiding decision-making about future planning, resource allocation, and technical assistance for CBD programs in Tanzania. These factors and their programmatic recommendations are provided in this report.
Chege, Jane, Naomi Rutenberg, Barbara Janowitz, and Andrew Thompson. 1998. "Factors affecting the outputs and costs of community-based distribution of family planning services in Tanzania." Nairobi: Population Council.
Africa OR/TA Project II