As international donor support for population activities in developing countries appears to be stalled, voices have called for increasing user fees. This research measures the extent of global reliance on international aid for family planning services and donated contraceptives. It can also provide a gauge of the potential for cost recovery. I present a national measure of consumers ’ ability to pay for contraception for 103 countries that demonstrate some need for outside assistance. I construct the measure of ability to pay using estimates of the cost of family planning, income distributions and an assumption that only one percent of income can go towards family planning. As a test of the validity of this measure, I compare the results to an index of contraceptive choice (Ross and Stover 2001), an estimate of actual consumer spending on family planning (Conly, Chaya et al. 1995) and the percent of contraception coming from public sources. The results show that while quite a large portion of aid-dependent nations is unable to independently afford contraception, the area of greatest shortfall is sub-Saharan Africa. The percent unable to pay the full price of contraception is 84 % overall, 98 % in is sub-Saharan Africa, 89 % in Asia, 65 % in Arab States and E. Europe and 54 % in Latin America. I include the measure of ability to pay in an Easterlin-type synthesis model of contraceptive prevalence. Ability to pay is positively associated with contraceptive prevalence, implying that cost is a barrier to usage. This research would suggest that caution be exercised in relying on cost recovery programs, implying a continued key role for donors
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