CEMOPLAF, a private, nonprofit Ecuadorian family planning organization, was founded in 1974 by a group of professional women who wanted to provide much-needed health and family planning services within Ecuador. These women were committed to the initiation of a self-reliant and self-financing organization. Since it's inception CEMOPLAF has received many donor grants, but as a matter of policy, it has always generated a significant percentage of its revenues from the sale of services.
In 1988, when it appeared likely that donor funding would be phased down, CEMOPLAF was generating 42 percent of its revenues from the national Ecuadorian market and was receiving 58 percent from international donors. Anticipating both lower international revenues and increased demand for its services, CEMOPLAF embarked on an intensive effort to make itself sustainable. The organization identified sustainability as having three interrelated organizational qualities:
The first step CEMOPLAF took was to preparation of a strategic plan. The strategic plan became the catalyst for generating organizational commitment to sustainability and resulted in the development of objectives, strategies, and activities to promote sustainability.
Organizational Survival
The leadership of CEMOPLAF had vision and the ability to share that vision with the whole organization. They worked carefully and skillfully to generate participation and ownership of the new philosophy. Each of the 22 clinics carried out its own strategic planning process and determined how it could best serve its clinic population and generate revenues. Supply and demand were analyzed and services were structured to meet demand. Staff were provided with additional training, and quality and excellence were rewarded.
Continuing Services to Low-Income and Underserved Populations
CEMOPLAF studied the needs and preferences of its current and potential clients, including rural underserved communities. It strengthened its client focus, began a user continuity program, and strengthened quality assessment and assurance programs. CEMOPLAF established and implemented strategies for demand generation in populations traditionally hostile to family planning, and opened new clinics in underserved areas.
Increased Self-Financing
Targets were set for levels of self-financing. CEMOPLAF determined what volume of services would be necessary to generate the desired revenues. The costs of all services and products were determined. Pricing policies were established on the basis of costs, prices in the market, and the client's ability to pay. Strategies for cross-subsidizing between services, clinics, and clients were developed and implemented. New financial systems for planning and controlling were developed.
Within two years, the results of this effort were apparent and extremely rewarding. CEMOPLAF expanded services by 44 percent, including significant expansion in poor and underserved areas. The level of self-financing had risen from 42 percent to 52 percent. Quality had been improved. CEMOPLAF was on its way to becoming a sustainable organization.