How Much Does it Cost to Treat Malaria?

How Much Does it Cost to Treat Malaria?

My recent field visit has given me a great perspective on one of MSH’s major activities - the costing of health services. MSH has extensive costing experience in East Asia & Pacific, Latin America & the Caribbean, Southern Africa, and West Africa.

MSH developed and has helped manage multiple applications of the CORE Plus (Cost and Revenue Analysis Tool Plus). CORE Plus is a tool that helps managers and planners estimate the costs of individual services and packages of services in primary health care facilities as well as total costs for the facilities. The cost estimates are based on norms and can be used to determine the funding needs for services and can be compared with actual costs to measure efficiency.

Costing of health care services is a powerful exercise whose data and results can be used for a number of things. When the cost of a package of services is determined, the analysis can be used for practical purposes, such as planning and prioritization or allocation of funds based on known cost figures. Results from a costing study can also be used to set appropriate user fees or other prices linked to provision of services. Finally, results of a costing study can be used as an advocacy tool to ensure that appropriate funds are allocated for the package of services.

Extensive data collection is required for a thorough CORE Plus analysis. This data includes national health plans and strategies, a list of services to be costed, essential drugs and medical supplies required to provide those services, costs of those drugs and supplies, national service utilization figures from the health management information system, staffing information, catchment populations, operating costs for facilities, and standard treatment guidelines for each service being costed.

Costing of health care services is a complex process that requires a substantial amount of information. The period of analysis for CORE Plus is preferably for one full year. I have recently completed the data collection for a costing of the package of services provided at the Health Center level in Malawi. Malawi is currently providing an Essential Health Package (EHP) of services that covers a wide range of interventions including maternal and child health, HIV services, TB services, and other primary health care services. Completing this exercise requires flexibility, problem solving, and persistence.

Preparing for Costing Analysis in Malawi

Much of the information in Malawi is in hard copy, and often not routinely kept in duplicate. Information and commodities follow different paths from the central level to the district level to the health center level, which makes tracking down information even more complex. We will be returning to the US with much of our data captured by digital photograph, cataloged and sorted by district, health facility, and village clinic. The success of this exercise has been the result of collaboration with the Ministry of Health, as well as their commitment to this exercise.

Understanding the cost of services, especially of packages of services, is crucial to their continued provision at appropriate levels and with high efficiency. The next steps require data entry and analysis, and then the production of a report for the Ministry of Health. This report will arm them with appropriate cost figures so they can adequately plan, budget, and advocate for the EHP.

Kate Dilley, MPH is an Administrative Coordinator at Management Sciences for Health.