Effect of introducing an 'afternoon pay clinic' on service utilization and cost recovery (Nepal)

An operations research study was initiated with financial and technical assistance from the FRONTIERS program to examine whether introducing an afternoon clinic at the Chhetrapati Family Welfare Center (CFWC) in Nepal with a substantially higher registration fee could improve cost recovery by adding more to program revenues than to program costs. The study showed, however, that premium pricing of afternoon services generated very little additional demand for services. Even with a premium price, the afternoon clinic could reach its cost recovery goal only if the volume of afternoon clients were to increase significantly. However, client perceptions about the ability of CFWC providers to provide non-family planning services needs to change in order for the utilization of the CFWC afternoon clinic to increase. Among the report’s conclusions is that family planning program sustainability without external support would not be feasible in the near future.