Using the DMPPT: preliminary results of country costing exercises

advertisement
Costing Adult and Adolescent
Male Circumcision in Kenya,
Zambia, Zimbabwe and Uganda
Urbanus Kioko (PHD)
University of Nairobi
Arusha, Tanzania
10 June 2010
Currently offering MMC services
 Meets existing policies for
comprehensive MMC services
 Represents geographic diversity
 Represents diversity of sites where MMC
services will be scaled-up

Country
Kenya
Zambia
Zimbabwe
Uganda
Number of Sites Costed
30
17
4
27
Kenya Hospitals
Fixed
Outreach
Direct Costs
$8.11
Consumables
Personnel
Training
$11.62
$4.60
Subtotal
$24.32
22%
32%
8.68
24.04
21%
57%
13%
67%
0.83
33.55
2%
79%
8%
2.24
5%
13%
7%
4%
1.18
3.61
0.50
3%
9%
1%
2%
1.24
8.76
42.32
378
3%
21%
100%
Indirect costs
Equipment
Maintenance/Utility
$2.92
$4.55
Support personnel costs
Mgmt./supervision costs
$2.44
$1.33
Mobilisation
Subtotal
$0.74
$11.99
TOTAL
# of MC Clients/Yr/Facility
$36.31
845
33%
100%
Kenya Health Center
Fixed Outreach
Direct Costs (US$)
$8.15
Consumables
Personnel
Training
$3.04
$4.36
$9.04
$22.61
$0.64
Subtotal
$15.55
$32.29
Equipment
Maintenance/Utility
$2.28
$2.28
$1.67
$2.00
Support personnel costs
Mgmt. and supervision costs
Mobilisation
Subtotal
$3.82
$0.95
$1.40
$10.74
$2.59
$0.79
$1.67
TOTAL
# of MC Clients/Yr/Facility
$26.30
2044
Indirect costs (US$)
$8.73
$41.02
445
Kenya Dispensaries
Fixed
Outreach
Direct Costs (US$)
Consumables
Personnel
Training
$12.57
$25.99
$2.98
$8.87
$18.57
$0.73
Subtotal
$41.55
$28.17
Indirect costs (US$)
Equipment
$2.93
$1.92
Maintenance/Utility
Support personnel costs
Mgmt and supervision costs
Mobilisation
$2.33
$4.57
$1.13
$1.06
$1.08
$3.24
$0.38
$1.39
Subtotal
TOTAL
# of MC Clients/Yr/Facility
$12.01
$53.56
326
$8
$36.17
530
Zimbabwe
Fixed
%
Outreach
%
Consumables
Non-consumables
Personnel costs
$28.13
$0.96
$19.09
48%
2%
32%
$28.13
$1.01
$19.12
40%
1%
27%
Training costs
Subtotal
Indirect costs
Equipment/capital costs
$ 0.34
$48.43
1%
82%
$0.26
$48.52
0%
69%
$0.45
$3.24
$4.42
$2.28
$10.39
$58.82
9600
1%
6%
8%
4%
18%
100%
$3.56
$12.29
$4.67
$1.25
$21.77
$70.29
4800
5%
17%
7%
2%
31%
100%
Direct Costs
Maintenance/Utility
Support personnel
Indirect Labor/Mgmt.
Subtotal
TOTAL
# of MC Clients
Zambia
Direct Costs
%
Labor
$8.95
16.40%
Materials
$8.54
15.65%
Training
N.A.
Subtotal
$17.49
32.05%
Equipment
$21.27
38.98%
Maintenance/Utility
$13.80
25.29%
Indirect Labor/Management
$2.01
3.68%
Subtotal
$37.08
67.95%
TOTAL
$54.57
100.00%
Indirect Costs
# of MC Clients/Yr/Facility
328
# of MC Clients/Yr
Difficult to capture demand creation,
training and management costs
 Excludes traditional MC
 Does not address question about how unit
costs might change with different
methods of service delivery
 Limitation of the data used for estimating
unit costs—may not be very accurate
 Preliminary data-further analysis/validation
of the unit costs

 The
unit cost of MC varies significantly
particularly due to:
› Scale (# of clients seen at each site)
› Type of site (public, private)
› Location of site (urban, peri-urban, rural)
› Type of service delivery method
(integrated, outreach, mobile)
› Surgical instrument method/kit(disposable
kits, non-disposable kits, etc.)
› Persons responsible for delivery (e.g., nurse,
surgeon, clinical officer)
Likely to generate more accurate data
over time-2-3 yrs
 Need to update the unit costs-2-3 years
after the 1st costing exercise


Disseminate findings from countries
where costing was performed

Repeat costing exercise to update and
validate cost estimates every 2-3 years
Download
Related flashcards

Pediatricians

20 cards

French pediatricians

13 cards

Breastfeeding

14 cards

Create Flashcards