Cost Study of Maternal Health ServicesName:Cost Study of Maternal Health Services Purpose: The tool is used to collect data for estimating the unit cost of services across levels and between health facilities and among community providers. Type of Design: facility-specific, cross sectional and retrospective Sample Size: 4 facilities in each district; four to eight districts/provinces Where Used: Africa, but could be adapted to Asia or Latin American setting Tool 29 BASIC INFORMATIONName: PHR Maternal Health Costing Tool Origin / Source: Ann Levin, Mark McEuen, and Tania Dmytraczenko of Partnerships for Health Reform (PHR) Technical Area: Maternal Health Basic Description: Tool contains nine instruments for collecting data on maternal health costs. The first seven instruments are for health facilities, the latter two for community service providers. Country Applications: Africa: Uganda, Malawi and Ghana. Languages available: English Purpose: The tool is used to collect data for estimating the unit cost of services across levels and between health facilities and among community providers. Technical Scope / Purpose: Tool is used to collect information on costs, quality indicators, and effectiveness of maternal health care services. Design: facility-specific, cross sectional and retrospective Method: quantitative Frequency of Administration: Once per facility or community provider Key Users of the information: Program managers, policymakers and international community Objectives and Scope of the Tool: The main objective of the study is to better understand the structure of maternal health costs through estimating costs of key maternal health services in facilities, to determine the factors that affect costs and how variations in some of these factors can lead to variations in costs. A second objective is to estimate the cost to consumers of attaining these maternal health services. The final objective is to test a methodology to provide information to policymakers on the actual costs of selected maternal health services at different levels and by different providers from a facility/provider perspective and from a consumer perspective. Key Indicators: Unit costs per service, direct costs, indirect costs, client costs per service Tool Design: The types of information gathered with this tool includes personnel time observation, record review, and observation of selected quality indicators. The unit of analysis is the facility; information can be gathered at different types of facilities and for different services provided. Implementation and Training: The data collection team should be provided with a week of training. This training should include: objectives of study, explanation of data collection methods, role-playing, and pre-test at nearby health facility. The analysis team should receive training on methodology of study and methods of analysis. They are provided with dummy tables and spreadsheets for the study. Manuals and Guidelines: No manuals and guidelines have as yet been developed, although some descriptions of the techniques are provided in the tool. Data Processing and Analysis: Data entry can be done directly into spreadsheets. Local data entry staff edit the data either directly after it has been entered or soon after so that mistakes can be identified quickly. The analysis plan should focus on specific outputs to be obtained: e.g. percentage of time spent on services, weighted averages of drug and supply costs per services, indirect costs, etc. Reporting and Dissemination of Results After the analysis is completed, the results should be disseminated to the Ministry of Health or district officials. A summary report should be produced and disseminated at relevant venues. The results can also be disseminated at other regional and international venues. Lessons from Experience: Because of the complexity of the data collection and analysis and lack of guidelines and manuals, some guidance from authors or other persons experienced in these techniques is suggested. Contact: |