Figures & Tables
Figures
- FIGURE.
CORE Plus Costing Tool Scenarios to Calculate the Recurrent Cost of Primary Health Care Services in Afghanistan
Tables
- TABLE 1.
Average Population and Services Per Facility by Level of Care in 2018, Afghanistan
MHTs HSCs BHCs CHCs DHs Sampled number of facilities 7 15 15 15 15 Catchment population 7,500 6,561 13,201 30,123 59,237 Range 1,500–12,062 4,320–11,662 5,117–37,590 12,376–49,912 8,182–153,000 Types of service in BPHS package 79 81 83 86 155 Types of BPHS services provided 45 55 56 62 113 Range 42–47 49–61 50–65 57–66 99–130 Non-BPHS services provided 6 2 4 6 6 Range 5–7 1–3 2–5 4–7 4–8 Percentage of BPHS services provided 57 68 67 72 73 Range 53–59 60–75 60–78 66–76 63–83 Number of BPHS services 29,920 18,840 28,547 51,876 125,518 Range 13,794–67,259 5,124–38,207 15,985–46,478 22,828–124,938 39,181–226,515 Number of non-BPHS services 3,623 132 2,200 4,201 1,745 Total number of services 33,542 18,971 30,747 56,077 127,264 Total BPHS services per capita 3.99 2.87 2.16 1.72 2.12 Total non-BPHS services per capita 0.48 0.02 0.17 0.14 0.03 Total services per capita 4.47 2.89 2.33 1.86 2.15 Range 1.1–7.6 0.7–8.0 1.2–5.5 0.7–3.7 0.5–5.3 Abbreviations: BPHS, Basic Package of Health Services; BHC, basic health center; CHC, comprehensive health center; DH, district hospital; HSC, health sub-center; MHT, mobile health team.
- TABLE 2.
Average Actual and Required Expenditure for Services by Level of Care in 2018, Afghanistan
MHTs HSCs BHCs CHCs DHs Catchment population 7,500 6,561 13,201 30,123 59,237 Number of BPHS services 29,920 18,840 28,547 51,876 125,518 Number of non-BPHS services 3,623 132 2,200 4,201 1,745 Total number of services 33,542 18,971 30,747 56,077 127,264 Actual total BPHS expenditure, US$ 102,031 63,103 93,632 163,483 393,478 Actual total non-BPHS expenditure, US$ 79,843 288 3,135 15,970 40,170 Actual total expenditure, US$ 181,874 63,391 96,767 179,453 433,648 Actual required BPHS expenditure, US$ 112,646 73,776 138,878 329,353 921,816 Actual required non-BPHS expenditure, US$ 82,131 1,143 18,279 107,457 239,843 Actual required expenditure, US$ 194,777 74,919 157,157 436,810 1,161,659 Actual cost per service, US$ 5.42 3.34 3.15 3.20 3.41 Required cost per service, US$ 5.81 3.95 5.11 7.79 9.13 Actual cost per capita of BPHS, US$ 13.60 9.62 7.09 5.43 6.64 Required cost per capita of BPHS, US$ 15.02 11.25 10.52 10.93 15.56 Actual cost per capita of non-BPHS services, US$ 10.65 0.04 0.24 0.53 0.68 Required cost per capita of additional services, US$ 10.95 0.17 1.38 3.57 4.05 Actual percentage of required cost for all services, % 93 85 62 41 37 Actual number of technical staff 4 4 5 11 30 Required number of technical staff 6 6 12 21 24 Abbreviations: BPHS, Basic Package of Health Services; BHC, basic health center; CHC, comprehensive health center; DH, district hospital; HSC, health sub-center; MHT, mobile health team.
MHT HSC BHC CHC DH Total Number of facilities 309 1,009 877 433 85 Population 31,526,403 31,526,403 31,526,403 31,526,403 31,526,403 31,526,403 Number of BPHS services 9,245,148 19,009,294 25,035,427 22,462,452 10,669,062 86,421,383 Number of non-BPHS services 1,119,385 132,859 1,929,517 1,819,033 148,348 5,149,143 Total number of services 10,364,533 19,142,153 26,964,944 24,281,485 10,817,410 91,570,525 Average actual BPHS expenditure, US$ 102,031 63,103 93,632 163,483 393,478 Total actual BPHS expenditure 31,527,546 63,670,750 82,115,485 70,788,094 33,445,637 281,547,511 Average actual total expenditure, US$ 181,874 63,391 96,767 179,453 433,648 Total all actual expenditure, US$ 56,198,962 63,961,736 84,864,581 77,703,151 36,860,122 319,588,552 Average required BPHS expenditure, US$ 112,646 73,776 138,878 329,353 921,816 Total required BPHS expenditure, US$ 34,807,723 74,440,032 121,796,105 142,609,747 78,354,352 452,007,959 Average required total expenditure, US$ 194,777 74,919 157,157 436,810 1,161,659 2,025,323 Total all required expenditure, US$ 60,186,137 75,593,546 137,827,110 189,138,736 98,741,024 561,486,553 Per capita actual BPHS expenditure, US$ 1.00 2.02 2.60 2.25 1.06 8.93 Per capita required BPHS expenditure, US$ 1.10 2.36 3.86 4.52 2.49 14.34 Actual as percentage of required BPHS expenditure, US$ 91 86 67 50 43 62 Per capita BPHS utilization, US$ 0.29 0.60 0.79 0.71 0.34 2.74 Per capita actual total expenditure, US$ 1.78 2.03 2.69 2.46 1.17 10.14 Per capita required total expenditure, US$ 1.91 2.40 4.37 6.00 3.13 17.81 Actual percentage of required total expenditure, % 93 85 62 41 37 57 Per capita total utilization, US$ 0.33 0.61 0.86 0.77 0.34 2.90 Abbreviations: BPHS, Basic Package of Health Services; BHC, basic health center; CHC, comprehensive health center; DH, district hospital; HSC, health sub-center; MHT, mobile health team.
- TABLE 4.
Cost Comparisons for Actual and Optimal Service Utilization for Sampled Dykundi Health Centers in 2018, Afghanistan
HSC BHC CHC Catchment population 8,275 5,117 21,942 Types of service in BPHS package 79 79 80 Types of BPHS services provided 55 56 62 Percentage of BPHS services provided 70 71 78 Types of non-BPHS services provided 2 4 6 Total number of actual services utilized 11,811 18,230 43,373 Total optimal number of services utilized 28,681 17,173 94,042 Number of services per capita actually utilized 1.4 3.6 2.0 Optimal number of services per capita 3.5 3.4 4.3 Actual expenditure, US$ 43,470 65,272 183,210 Required expenditure, US$ 53,539 100,946 396,115 Required expenditure for optimal number of services, US$ 128,674 95,955 610,434 Actual expenditure per capita, US$ 5.25 12.76 8.35 Required expenditure per capita, US$ 6.47 19.73 18.05 Required expenditure per capita for optimal number of services, US$ 15.55 18.75 27.82 Actual number of technical staff 3 5 11 Required number of technical staff 4 6 18 Required number of technical staff for optimal number of services 8 6 27 Actual percentage of optimal number of services, % 41 106 46 Actual percentage of required expenditure, % 81 65 46 Actual percentage of required expenditure for optimal services, % 34 68 30 Abbreviation: BPHS, Basic Package of Health Services; BHC, basic health center; CHC, comprehensive health center; HSC, health sub-center.
- TABLE 5.
Top 10 Actual Services at Dykundi CHC Ranked by Total Normative Cost for 2018, Afghanistan
Service Number of Services (%) Total Cost, US$ (%) Average Cost Per Service, US$ Average Cost Per Capita, US$ Severe acute asthma and COPD 600 (1.4) 62,756 (16.0) 104.59 2.86 Severe acute malnutrition in children aged younger than 5 years 380 (0.9) 40,165 (10.0) 105.70 1.83 Early childhood development 2,857 (6.6) 35,385 (9.0) 12.39 1.61 Urinary tract infection 3,218 (7.4) 33,282 (8.0) 10.34 1.52 First antenatal visit 754 (1.7) 27,836 (7.0) 36.92 1.27 Prehospital care 612 (1.4) 20,013 (5.0) 32.70 0.91 Normal delivery at facility 339 (0.8) 18,459 (5.0) 54.45 0.84 Peptic disorder 2,566 (5.9) 16,500 (4.0) 6.43 0.75 First postnatal visit 606 (1.4) 9,755 (2.0) 16.10 0.44 PCV 13 vaccination 1,606 (3.7) 8,943 (2.0) 5.57 0.41 Abbreviations: CHC, comprehensive health center; COPD, chronic obstructive pulmonary disease; PCV, pneumococcal conjugate vaccine.
Supplemental material
- Supplement -
Supplement
- Supplement -
