Cost of provision of essential health services in public health centers of jimma zone, south west Ethiopia

Abstract

Introduction: - Improvement of universal coverage of essential health service through the use of cost-effective strategies continues to be a challenge, particularly in Ethiopia. There is a paucity of knowledge on the cost of essential health services that poses a challenge in the cost analysis of these services. Generation of up -to-date information on the costs of essential health service (EHS) is therefore crucial for budgeting and allocation of adequate resources to health centers. Objective:-To analyze the costs of essential health services at public health centers in Jimma Zone. Methods and participants: - A facility based cross-sectional study was conducted in public health centers of Jimma zone from April 10 to may 9, 2018. Sixteen selected health centers located in eight districts of the zone were included. The cost study was conducted from a provider perspective using retrospective, standard costing approach. A checklist developed by Management Sciences for Health (MSH) was adopted to collect relevant cost data. Unit cost of each service was calculated by dividing the costs of inputs incurred by the total number of output of the respective services during the base year. Step-down allocation (SDA) was used to allocate costs to final services. Data were coded and entered in EPI-DATA and exported to Ms-excel 2016 and SPSS version 20 for descriptive analysis to display frequency, percentage, total cost, and unit costs essential health services. Results: The Average annual cost of providing essential health services at health centers in Jimma zone was USD 109,806.03 with standard deviation of USD 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. Similarly, around two third (65.9%) of the total annual cost was incurred for provision of essential health services at the final cost center. The average overall unit cost was USD 7.4 per EHS services per year. Conclusion: - With carefully attentive effort, health center costing is possible in our settings and cost of essential health services can be estimated. Cost of Essential health services provision at health centers were low and so, necessitating funding of significant resources to provide standard health care services. 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