Costing a set of gradient-adjusted maternal and newborn health
Costing a set of gradient-adjusted maternal and newborn health (MNH) bundles of primary health care services
DPD under its managed services workstream was engaged by the Ekiti State Health Insurance Agency to provide 1-year technical support to the scheme to expand its footprint and coverage from 5 LGAs to 171 PHCs across the 16 LGAs of the state. The platform’s consultants were engaged to evaluate the scheme’s activities, re-engineer its processes and re-position it on a path of performance.
Key Objectives
Derive cost estimates for a selected set of maturity adjusted maternal and newborn service bundles across the client’s flagship states in Nigeria for investment planning.
Estimate program costs of funding technical assistance to layer bundles of high impact interventions (HII) on the group ANC model AND to simplify care seeking between basic and comprehensive care centers for high- risk pregnancies.
Methodology
The MNH costing adopted a provider perspective and estimated unit cost of services. The costing of the MNH continuum of care bundles adopted a “nuanced provider” perspective which entailed the costs incurred by the health facility in providing the service. In adopting a “nuanced provider” perspective, we considered only direct and variable costs. This implies costs that can be directly traced to a service but only increase and the number of services provided increases.
This included costs of drugs, medical consumables, laboratory tests and excluded fixed costs such as HRH, Infrastructure costs typically involved in provider costing. This considered only the per woman costs of providing the stipulated services. All costs were in USD and exchanged at N415 to $1. The base year of costing was 2022 and cost data from 2022-2014 was subjected to inflationary and currency adjustment based on the annual government released annual consumer price indices (CPI) and CBN exchange rate respectively.
The programs costing adopted a system lens and modelled out the costs of deploying technical assistance to provide two important program approaches for delivering MNH services.
These TA costs essentially include management costs, such as costs of conducting baseline assessments, landscaping analyses, health facility studies, meetings, trainings, supervision, and other management costs. It also leveraged the per woman costs and the service quantities derived from the MNH gradient costing.