RED Working papper 31
Costs of Providing Maternal, Newborn and Child Healthcare: Estimates from BRACís IMNCS Programme in Rural Bangladesh
July 30, 2012

Mohammad Nasir Uddin Khan, Zahidul Quayyum, Tasmeen Quayyum, Hashima-E-Nasreen, Shah Noor Mahmud, Tim Ensor

Abstract

Community level healthcare activities are important in low income countries like Bangladesh where the coverage of formal healthcare systems is low. Keeping pace with the national strategies and MDG targets, BRAC, has initiated a programme for improving maternal, neonatal, and child survival (IMNCS) in the rural areas of Bangladesh. The objective of the study is to provide information on economic costs of providing maternal, neonatal and child health services in this intervention. The study was conducted in two IMNCS intervention districts (Nilphamari and Gaibandha) and one control district (Netrokona) where there is BRAC Essential Health Care (EHC) intervention. All resources mobilized by the programme for service delivery were identified, quantified and valued combining top-down and bottom-up approach. Market value approach was applied to capture the opportunity cost of free resources and volunteer time. The average economic cost of any ANC provided by IMNCS programme was BDT 79.2 (USD 1.1). The average cost of four ANCs along with the pregnancy identification in the IMNCS programme was BDT 337.5 (USD 4.9). The average cost of home delivery was BDT 1,457 (USD 21.1). The average cost of PNC was BDT 1,14.7 (USD 1.7). The average cost of a referral case during maternal complication was BDT 1,275.9 (USD 18.5). Spending more money in programmes like IMNCS, BRAC can produce more heath services and contribute greater benefit to the community compared to EHC programme. Besides, the findings can have implications for programme budgeting sustainability and scaling up the similar programme. The differences in economic and financial unit costs of services are useful lessons for BRAC health programme and other NGOs in the country for planning and scaling up such programmes. The success of the programmes and minimizing the unit cost will largely depend on mobilizing community members to contribute their volunteer time.

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