All of these instruments require information to be introduced in the calculations, especially those related to the type of interventions that it was chosen, and those related to basic coverage and the broader final coverage, to epidemiological and demographic data, information on the health system (number of installations of services and human resources) local prices of medicines and salaries.
Some of these instruments contain prices for drugs and presumed salaries in cases where this type of information does not exist locally. We are continuing work to harmonize these instruments. TABLE IV.2 Summary of some relevant program instruments that include cost calculations WHO costsCalculate operating costs for varying coverage levels for interventions selected for child survival
Can be used in medium term planning
at national and national levels sub-national as soon as the strategy is conceivedOnly for child health, but subject to expansionCurrently not including system costs or general costsCosts and resources (human resources, facilities, medicines and materials, equipment) Spreadsheets in EXCEL Very simple to use and can be built with support, in a few weeksObjectiveUsageCompetitiveness of SME Competencies
- Calculation of Reproductive Health Costs UNFPACalculate costs of exploration and / or improvement of servicesCan be used to finance and
- create budgets for existing sector strategies and plans (eg. oRoteiro) at country level or district level Reproductive and maternal health Costs of activities
- and improvements to the health system (training, equipment, referral system, etc.) Costs of providing an essential package of productive health interventions
(family planning, ANC and childbirth assistance, COE, managements IST / HIV) EXCEL spreadsheets Very simple to use and can be built with support in a few weeks Marginal budget for foreigners (Uments (UNICEF, World Bank, WHO) Compare the expected number of lives saved with the marginal costs of interventions with varying coverage levels, as an objective of overcoming the main supply and demand bottlenecks that oppose increased coverage.
It can be used to guide the definition and phasing of priorities in the context of national or regional planning and policy dialogue. Maternal, newborn and child health, malaria, vaccinations, HIV / AIDS. activities and improvement s of the health system needed to overcome specific constraints for improving servicesCalculating the impact of the lives of mothers, newborns and saved children
Calculated costs (per capita) to extend coverage
of consensual SMNIC intervention packagesComparison of various interventions, service delivery methods and phasing options, with costs of improving the health system.The calculation sheets in EXCEL will be customized for application Technically complex, with a series of hypotheses, requires training and expertise to be used and time-consuming
African countries, the salaries and other incentives offered by ARV therapy programs have been much higher than those offered by other programs, which leads to the abandonment of staff. routine health services and slowing improvements in other high-impact interventions. Malawi has made a concerted attempt to create a comprehensive human resources plan (Box IV.5). A vast human resources plan is therefore essential and should include strategies for FORMING, HOLDING.30 BOX IV.
- Essential Health Technology Package (PETS-EHTP) Planning human and material resources) necessary to provide aselected sets of health interventionsCan be used in the
- detailed planning and logistics of a program that uses defined interventions Reproductive and child healthCurrently does not include system costs or general costs
Tanzania found that less than 10 percent of its basic obstetric care facilities met predicted standards, largely because no one could perform vacuum extraction. Consequently, national regulations are being revised to allow midwives to carry out that operation. It is very frequent that the difficulties of human resources are solved in a piecemeal manner that merely serves to prolong the existing crisis. For example: while promoting increased acceptance of antiretroviral therapy is crucial in many
Countries and programs that have achieved high service
coverage have focused on selected interventions and packages, rather than trying to do everything at the same time. Although there is a strong justification for fewer interventions, but high quality, the other ingredients of success are often lacking: leadership, management and effective use of the data necessary for decision making.
If there are already shortages of midwives, how is it possible that your time will be occupied primarily to perform specialized tasks such as childbirth assistance? Eliminating administrative tasks from midwifery functions can increase job satisfaction and efficiency. In some cases, this will require changes to legislation that support the delegation of responsibilities. In a recent survey of COE services, for example,
- Over time, interventions that require greater specialization, and more expensive materials and products, can be added to essential packages. For
- example: doing tests and treating pregnant women for asymptomatic urinary infections is based on the evidence, but it is more complex and expensive than
- simple ANC interventions. However, as skills increase, or perhaps in referral services, this intervention can be added to the essential package.
When running a program, the essential questions to ask are: What? Essential interventions • Where? At home or in a basic health service, depending on the intervention With what? Materials, products, equipment and medicines Who? Who has the necessary skills and who is highlighted for this When? Through an integrated service delivery strategy, during pregnancy, childbirth and the postnatal period
Global guidelines should be adapted at national level and include task aids for in-service training, monitoring and regulation. Regular audits are a powerful tool for improving quality.8Improving supplyWhere and with what? Infrastructure, materials, products and goods Despite the fact that assistance to newborns is often associated with advanced technologies,