Results of Costing Analysis in Bangladesh and Tanzania
Bangladesh | Tanzania | |||
---|---|---|---|---|
PPIUD Initiative | National Scale-Up Model | PPIUD Initiative | National Scale-Up Model | |
Program design | ||||
Number of facilitiesa | 6 | 36 | 6 | 28 |
Setup period, months | 4 | 4 | 4 | 4 |
Implementation period, months | 36 | 36 | 27 | 36 |
Number of PPIUDs inserted | 8,031 | 26,507 | 7,448 | 43,928 |
Costing analysis | ||||
Estimated total cost | US$539,285 | US$1,979,140 | US$1,869,507 | US$6,910,494 |
Estimated cost of direct PPIUD service provisionb | US$1.71 | US$1.71 | US$2.05 | US$2.05 |
Cost per facility per year | US$27,986 | US$17,373 | US$130,697 | US$79,223 |
Main cost driver | Facility staffc (58% total cost) | Facility staffc (53% total cost) | Training (76% total cost) | Training (80% total cost) |
Estimated direct health care costs saved (Impact 2) | US$802,368 | US$2,648,284 | US$1,348,744 | US$7,954,649 |
Estimated total costs after including estimated health care costs saved (Impact 2) | −US$263,083 | −US$669,144 | US$520,763 | −US$1,044,156 |
Abbreviation: PPIUD, postpartum intrauterine device.
↵a Note the facilities included in the national scale-up model include the facilities in the PPIUD initiative plus additional facilities at the equivalent level of the public health care system. For Tanzania, each hospital in the scale-up model is assumed to have 4–6 associated satellite facilities that are trained in postpartum family planning counseling and given IEC materials to distribute and that refer clients to the hospitals, as was done in the PPIUD initiative.
↵b Includes cost of initial insertion, follow-up visit, and eventual removal using weighted averages. Cost of counseling is included for Tanzania but not for Bangladesh (cost of counselors in Bangladesh is included in staff costs, not direct service costs). Government reimbursements paid in Bangladesh are not included here.
↵c Facility staff in Bangladesh include counselors and honorariums in the PPIUD initiative. Counselors only are included in the national scale-up model.