Mother-Baby Package Costing SpreadsheetOrigin / Source: Department of Reproductive Health and Research
Technical area: Maternal and Newborn health Basic Description: The Mother-Baby Package Costing Spreadsheet is a spreadsheet tool that estimates the cost of implementing at the district level a package of interventions to reduce maternal and newborn mortality and morbidity. The tool is targeted at district and national level planners and managers. The spreadsheet is based on the interventions identified in WHO's Mother-Baby Package. Country Applications: The tool was tested in Uganda and Bolivia. We actively promote its use in countries, but we are not always involved in the applications of the tool, so we are not in a position to know all of the countries and settings in which it has been used. Language(s) Available: English. Spanish translation is underway. Purpose: Cost estimation Technical Scope/Purpose: The Mother-Baby Package Costing Spreadsheet is used to estimate the cost of implementing a set of interventions at the district level. The model includes a standard set of assumptions representing a hypothetical rural district population. For a rough estimation of cost, based on "standard" treatment, the base inputs can be used with minimal modification. For a more rigorous analysis that better reflects the local situation, the inputs should be more critically examined and modified. Specifically, using locally collected data, the model can be used to estimate the actual cost of current services, as well as the cost of upgrading the district health system to meet the standards in the Mother-Baby Package. The difference between the "current" and the "standard" cost estimates represents the incremental cost of strengthening the health system in the district under study. Included are estimates of total, per capita and per-birth cost for the district. The estimates are further broken down by input (such as drugs, vaccines, salaries and infrastructure), by intervention (such as management of normal birth, haemorrhage, eclampsia and sepsis), and by service location or level (hospital, health centre and health post). Design: Cost estimation model, based on cross-sectional data collected from health facilities. It includes several components including data collection forms, data consolidation forms, cost estimation spreadsheets, graphing packages, and a user guide. Method: Quantitative. Frequency of Administration: The frequency of administration would be decided locally, depending on local needs. It is likely that an analysis based on the Mother-Baby Package Costing Spreadsheet would be an ad hoc activity. Key Users of the Information: The analysis that can be carried out using the spreadsheet and User Guide would be targeted at maternal and newborn health and safe motherhood planners, managers and policy makers at the national and district levels. The results of the analysis might also be of interest to potential programme donors, multilateral and bilateral donor agencies, NGOs or other interested parties. Objectives and Scope of the Tool: See "technical purpose" above. Key Indicators: The Mother-Baby Package Costing Spreadsheet is not typically used to collect indicators of health status. Tool Design: This is a cost estimation model, based on cross-sectional data collected from health facilities. The duration, sampling methodology, and other methodological concerns would be determined locally, in relation to local needs and objectives. These materials have been developed in such a way that a local health economist with experience using spreadsheet software should be able to carry out the analysis with minimal support, apart from assistance in data collection and analysis. Implementation and Training: The materials have been developed in such a way that a local health economist with experience using spreadsheet software should be able to carry out the analysis with minimal or no training. Manuals and Guidelines (if applicable): Part I of the User Guide provides a general overview of the spreadsheet model, the type of data that will be required, the types of cost estimates the model will generate and information on how to use the spreadsheet. Part II follows with a more detailed description of each individual worksheet. Here the user will find more in-depth information on each worksheet, what kind of information it requires and processes and how it interrelates with the other worksheets. It also tells the user where to collect the data needed to complete that particular worksheet, or if the data collection proves difficult, how to arrive at reasonable proxy estimates. Part III of the User Guide provides a closer look at the eighteen interventions of the Mother-Baby Package and how they are implemented in the model. It explains the scope of each intervention and the treatment protocols proposed at the different levels of the health system. It lists all the drugs and medical supplies needed and provides estimates of the clinical staff time required for the individual interventions. For users who are interested in an even deeper insight into the workings of the model a section with technical notes provides detail about the formulae and technical features used in the model. Data Processing and Analysis: The data is processed and analyzed by the computer model, which is delivered in Excel format. The principal investigator would typically carry this work out. Reporting and Dissemination of Results (if applicable): This is typically carried out by the research team. Cost: The resources required to carry out an analysis based on the Mother-Baby Package Costing Spreadsheet will vary depending on the setting in which it is applied, the number of districts studied, and other local factors. Experience has shown that applying the spreadsheet in one district requires approximately one to two months for planning, preparation and adaptation, followed by a week for data collection, and then one to two months analyzing and writing up the results. As additional districts are added, the resources required will increase correspondingly. Lessons from Experience:
The Spreadsheet is based on WHO's Mother-Baby Package. This document describes the clinical interventions that are required to reduce maternal and newborn mortality and morbidity. For more information and download: http://www.who.int/reproductive-health/publications/ Contact Person: |