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Costing and Sustainability Planning

Challenge

Given the unprecedented funds flowing into the global health sector, countries, programs, and organizations increasingly need information on the costs of services provided to make informed decisions about resource allocation. More recent economic events have highlighted the need to focus on two key questions. The first is “What is the value for money?” That is, what are governments and donors getting for their investment? The second question is “Are these programs sustainable?” Over the course of the project, Health Systems 20/20 has observed a significant increase in the number of project activities related to costing and sustainability analyses, reflecting the desire of health sector partners at all levels to understand the value for money that they are producing or receiving. While the majority of these activities are related to HIV programming, maternal and child health program costs have also been examined.

Approach

Health Systems 20/20 is actively working to improve the understanding of how to estimate value for money. In practical terms, this means devising appropriate methodologies for estimating costs at the level of service delivery and designing intuitive ways to look at these costs and use them to improve the efficiency of service delivery programs. Often, financial and monitoring and evaluation data are collected for every program, but are presented and used separately. Understanding value for money requires combining these two types of data where appropriate into metrics that provide information on how much it costs to deliver a service. Realizing that this must be a consistent effort rather than a one-off evaluation of a program, Health Systems 20/20 is working to actively ensure that both regional and local organizations participate in all costing activities. This will strengthen their capacity to both collect and analyze data as well as to make recommendations from the analyses.

Health Systems 20/20 and Costing and Sustainability Planning brief