Community Health Planning and Costing Tool


MSH, through funding and technical contributions from the United Nations International Children's Emergency Fund (UNICEF), developed the Community Health Planning and Costing Tool to support the planning and costing of effective community health community health services (CHS) packages. The results can be used to evaluate program performance, plan for future programming, and develop investment cases for introducing or expanding community health services.

Based on inputs provided by the user, this tool calculates key results on the costs and required financing for the introduction, maintenance, or scale-up of comprehensive CHS programs at the national or sub-national levels. All costs and financing elements are linked to the key aspects of a CHS package including start-up costs, service delivery, training, supervision, and management at all levels of the health system. The tool’s financing element can be used to show and project the financing sources of the CHS program as well as gaps in funding.

The tool has the ability to include up to 100 health interventions and six cadres of community health workers (CHWs). At the service delivery level, it is a bottom-up activity-based costing tool, in which unit costs per service are built up by type of resource (e.g. medicines) and multiplied by the total estimated numbers of services. Other costs, such as supervision and training, are allocated using a top-down methodology. The tool uses standard treatment protocols for the CHS services to determine the standard costs of treatment.

To date, the tool has been used in Madagascar, Malawi, Sierra Leone, South Sudan, Togo and Mozambique.

Intended Users: Community health program managers, planners, and policy makers.

Advantages: The user-friendly, open-source, spreadsheet-based tool is designed for use in low- and middle-income countries. The dynamic nature of the tool allows the user to easily modify key variables (e.g. target populations, incidence rates, and service delivery platforms) and immediately determine the changes in program costs for up to 10 projection years.

Results: The tool automatically produces the following key results:

  • Total program costs for baseline year and ten-year projections;
  • Costs per capita, per CHW, per contact, per program, and per resource type;
  • Incremental costs and financing (start-up and recurrent);
  • Key drivers of costs and cost categories as a percent of total costs; and
  • Ten-year projections of financing (and financial gaps) with sources of funding.

The results can be used for the following types of analysis:

  • Planning and budgeting a new package, additions or changes to a package or geographical expansion of a package;
  • Comparing cost efficiency and effectiveness of different service delivery platforms;
  • Calculating reimbursement rates for results-based financing or insurance;
  • Costing “What-if” scenarios to model a package in line with financing limitations;
  • Understanding what bottlenecks exist and their impact, options for removing them and ranges of costs required for removing them;
  • Developing investment cases and lobby for support (funding and otherwise) from donors and partners.

To request a copy of the tool, please e-mail