Abstract
BackgroundThere is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana.MethodsThe study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs) from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD) attendance were estimated.ResultsThe average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC). The cost per OPD attendance was higher at CHPS (US$8.79) than at HCs (US$5.16). The average Internally Generated Funds (IGF) recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS) reimbursement was the main source of revenue accounting for over 90% total IGF.ConclusionsThe average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar studies involving large numbers of primary health facilities in different parts of the country are needed to assess the cost of providing primary health care.
Highlights
There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations
According to World Health Report, Universal Health Coverage (UHC) is defined as all people having full access to needed promotive, preventive, curative, rehabilitative and palliative health care services which should be of a Dalaba et al BMC Health Services Research (2017) 17:742 standard quality without having to suffer any financial hardship or impoverishment [4]
The average population covered by a Community-based Health Planning and Services (CHPS) and Health Centre (HCs) were 2124
Summary
There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana. Primary health care (PHC) is operationally defined as “essential care based on practical, scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation, and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of selfreliance and self-determination” [1]. The government of Ghana in recent times has prioritized the expansion and strengthening of primary health care such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) [5] in order to achieve health targets and UHC
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