Abstract
BackgroundProvision of up-to-date cost information is crucial for not only addressing knowledge gap on the cost of essential health services (EHS) but also budgeting, allocating adequate resources and improving institutional efficiency at public health centers where basic health services are delivered the most.ObjectiveTo analyze the costs of essential health services at public health centers in Jimma Zone.MethodsA facility based cross-sectional study was conducted in public health centers of Jimma zone from April 10, 2018 to May 9, 2018. The study was conducted from a provider perspective using retrospective standard costing approach of one fiscal year time horizon. Step-down allocation was used to allocate costs to final services. All costs for provision EHS were taken into account and expressed in United States dollar (USD). Sixteen public health centers located in eight districts were randomly selected for the study.ResultsThe Average annual cost of providing essential health services at health centers in Jimma zone was USD 109,806.03 ± 50,564.9. Most (83.7%) of the total Annual cost was spent on recurrent items. Nearly half (45%) of total annual cost was incurred by personnel followed by drugs and consumables that accounted around one third (29%) of the total Annual cost. Around two third (65.9%) of the total annual cost was incurred for provision of EHS at the final cost center. The average overall unit cost was USD 7.4 per EHS per year.ConclusionCost providing an EHS at public health centers was low and so, necessitating funding of significant resources to provide standard health care. The variability in unit costs and cost components for EHS also suggest that the potential exists to be more efficient via better use of both human and material resources.
Highlights
Provision of up-to-date cost information is crucial for addressing knowledge gap on the cost of essential health services (EHS) and budgeting, allocating adequate resources and improving institutional efficiency at public health centers where basic health services are delivered the most
Two third (65.9%) of the total cost incurred for provision of essential health services at Health Centre (HC) was on accounted for various essential health services at the final cost center
Among the recurrent cost component, the highest proportion was incurred by Personnel which accounted for United States dollar (USD) 790,508.49 ± 16,831.01
Summary
Provision of up-to-date cost information is crucial for addressing knowledge gap on the cost of essential health services (EHS) and budgeting, allocating adequate resources and improving institutional efficiency at public health centers where basic health services are delivered the most. The aim of Universal Health Coverage (UHC) as per the World Health Organization (WHO) is to ensure that all individuals receive the quality health services they require without facing financial difficulties. Delivering essential health services at a reasonable cost that realizes the ultimate goal of Universal Health Coverage (UHC) is a worldwide challenge [1]. EHS is a package, limited list of services and policy interventions that are cost-effective, equitable, efficient, affordable, and acceptable designed to direct resources to priority areas of health service delivery to reduce disease burdens and ensure equity in health [2]. The global interest in EHS came with the resolution adopted on Universal Health Coverage (UHC) by the 58th World Health Assembly in 2005 [4]
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