Issues in costing cross cutting hss interventions in
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Issues in costing cross cutting hss interventions in Presentation Transcript

  • 1. Issues in costing cross cutting HSS interventions in GFATM proposals Afghanistan experience Najibullah Safi, MD, MSc. HPM
  • 2. Health system building blocks
    • Health services
    • Health workforce
    • Health information system
    • Medical products, vaccines and technologies
    • Health financing
    • Leadership and governance
  • 3. Areas covered under HSS
    • Globally * :
      • Human resources
      • Infrastructure and equipments
      • Communication
      • Training
      • Health product
      • Procurement
      • Monitoring and evaluation
      • Management
      • * Activities supported under GFATM R8
  • 4. Areas covered under HSS cont.
    • Afghanistan:
      • Expansion of lab network (R8 &R10)
      • Training
        • Long term programs (community nursing program (R8 &R10), FETP (R8), female community health supervisor (R10 ))
        • Short term programs
      • Revision of HMIS (R8)
      • Technical support
      • Research
      • Salary support
  • 5. Measuring unit costs
    • Unit cost:
      • Relationship between financial investments and outcomes
    • Required development of tools for standardized unit costing e.g.
      • Cost per person-year of ART (variations)
      • Cost per DOTS patient treated (variations)
      • Cost per LLIN distributed (is this practical?)
    • Routine unit costing is expected to:
      • Improve budgeting, planning, and target setting
      • Optimize resource allocation
    • Is this practical to calculate unit cost for HSS interventions?
  • 6. Issues in costing, Afghanistan experience
    • Lack of local expertise
    • HSS cover wide range of services (make it difficult to use standardized procedures/tools for costing)
    • Unavailability of costed national strategies and standard procedures for costing
    • Difficult to properly link inputs (investment) with outcome/impact
    • Inadequate preparation for proposal writing/costing
    • Significant proportion of budget goes to salaries (less structured)
  • 7. Issues in costing, Afghanistan experience cont.
    • Lack of required data for planning
      • Estimation of the required quantities/number
      • Geographical distribution (cost varies)
      • Estimation of the unit cost (e.g. FETP, BHC labs)
    • Too much assumptions
    • Duplication with the supported programs by other donors
    • Inflated budget
  • 8.