2. Costing Approach
Calculation of the cost per case (Unit Cost) for:
(1) Counselling and testing
(2) PMTCT
(3) TB-HIV
(4) ART
(5) LAB SERVICES
(6) CARE AND SUPPORT
Note: Unit cost to be calculated separately and total cost will be arrived at by
multiplying with the number of persons receiving the intervention
(Typically for one year)
2
3. 3
Pre Requisites for an Intervention
Target population [person covered
under the Intervention (PCI)] – That is
done through a Typical Course of
Events (TCE)
Resource requirements that are in the
form of Infrastructure, Fixed and
Variable cost (Units of measurement
differ for the type of resources used)
4. Typical course of events
4
Persons entering into
the Intervention tree for
Counselling and testing
from H2H
1. OPD, IPD-Wards, Haematology,
Voluntary blood donors, self referrals
to H2H Center
2. ANC Clinics
3. TB-Clinics
+Ve -ve Persons entering into
the Intervention tree for
Counselling and testing
from ANC clinics
Branched out
- Ve
+ve
ART Clinic Registration and
Meeting the doctor
Rx Pharmacy
Not
eligible
for Rx.
7. What is Health infrastructure
and what it produces
The infrastructure available at different level of
facilities that are directly or indirectly used for
the patient care
The health infrastructure produces different type
of services i.e., HH visit, OPD, Diagnostic and
Lab services, Hospitalisations, surgeries,
specialist consultations etc.. (The unit of
measurement of the infrastructure is PCI)
7
8. Program Fixed Cost
The specific costs are usually techno
managerial outfits to plan, execute,
monitor and evaluate the program.
Example: Cost of Program Managers
Cost of refresher training of Lab
technicians and other staff
8
9. Program Variable Cost
These are the recurring expenses such as,
medicines, consumables and other supplies
for the test.
This cost is linked to the utilisation of the
facilities and therefore linked to the PCI
9
10. Calculation of Infrastructure Cost-
Information requirements and source
The infrastructure for our program
include (a) Building (b) Equipment (c)
Manpower
Sources:
(1) Program experience
(2) Rapid assessment/Time and motion study –
information on duration of counselling and test,
waiting time etc.
(3) Expert opinion
10
11. Cost of Building Space
Assumption:
1. One comprehensive site on an average
need to have 282 square meter of space
(study by Steve) – assume it as 280 square
meter
2. Distribute the space for different sites (ANC
clinic/TB clinic/H2H center/ Counselling and
testing room etc...)
11
12. Cost of Building Space
3. Calculate the present cost of construction value
for 282 sq. meter.
4. Take the Life span of the building as 25 years
and on the basis of actual number of years back
the facility was constructed depreciate it and
find out the annual cost of the building.
5. Cost per day / hour can be calculated by further
division and sub divisions
12
13. Cost of equipment
1. Divide the equipment in different categories (Categories
are already specified by Steve) FHI Nigeria Asset
classification 110510.xls
2. Under each category there are various instruments
3. Methodology: Step -1
E1=(e11, e12, e13, …,e 1n)
E2=(e21,e 22, e 23,…, e 2n)
……………………….
……………………….
Em= (em1, em2, em3,…, emn)
13
14. Cost of Equipment
Where, and eij, represents jth type of instrument within ith
category of equipment
or i = 1, 2, …,m and j = 1, 2, …, n. If pij represents the price
vector for the same, then the cost of instruments under
equipment category 'i' ( CEi) equals:
CEi = m
i =1n
j =1 eijpij
14
15. Cost of Equipment
Step 2:
Annual cost of ith category of equipment (ACEi)
equals: ACEi = [m
i =1n
j =1 eij pij'] [m
i =1n
j =1
LEij], where, LEij is the life expectancy of
instrument 'j' within ith category.
Cost per day = ACEi / 365 (assuming that the
equipments are used throughout the year)
Cost per Hour = Cost per day / Number of hours
the equipment functions Maintenance costs
160410.xls 15
16. Costing the Manpower
List out the staff under each sub-category and find out
the range of their salary [(max+min)/2].
The salary of each sub-category of staff per day / hour
could be arrived at by dividing the total monthly salary
with the number of working days / hours in a month.
Further desegregations could be made by appropriate
division / multiplication with time.
The cost contribution of each category of staff could be
arrived at by adding the unit (hourly / daily) cost of each
sub-category under respective categories.
16
17. Costing the Manpower
Look at the functional specificity of various categories and
sub-categories of staff, and allocate their cost on the
basis of functions carried out by them at different service
points.
The monetary values of the time spent for different
activities in a day could be arrived at on the basis of
percentage of time devoted by them for different
activities.
Typical Example Manpower cost.xlsx
17
18. Components of Infrastructure
and Unit of Measurement
Services Unit of Measurement
OP Contact Number
Lab tests (all types) Number
X-Ray type tests Number
Manpower Time (including all) Hours
Time for the Machine Hours
Vehicle time Hours
Building Space Cost/Sq. Feet
18
19. Calculation of Program fixed
cost
Program Fixed Cost Unit of measurement
Managerial Time Hours
Technical staff time Hours
Equipment Hours
19
20. Program Variable cost
20
Cost Components Unit of measurement
Operational cost Naira
Cost of training Naira
Travelling expenses Naira
Fuel and maintenance Naira
21. Future Course of Action
Sl No Time Plan
Completion of Data collection template – 30% Finished 17th May
Pretesting the data collection tool 20th May
Finalisation of the tool 22st May
Collection of data from one comprehensive site, analysis and
presentation
30th May
21
