Cost and Effective Analysis of the LINKAGES ... - Linkages Project

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Table 4: Total Cost of LINKAGES Activities to Promote LAM and BF in Study RegionsNorth Center South Total As % ofTotal CostTotal Cost 75,540 111,483 60,261 247,284Costs allocated toBF activities47,293 74,405 42,959 164,657 67%Costs allocated toLAM activities28,247 37,078 17,302 82,627 33%6.1.2. Partner CostsTotal costs incurred by the MOH/MCH are shown in Table 5.Table 5: MOH/MCH Costs Allocated by IndicatorNorth Center SouthNumber of 17,693 20,065 6,042BeneficiariesIndicator Total Cost Cost perBeneficiaryTotal Cost Cost perBeneficiaryTotal Cost Cost perBeneficiaryLAM User Rate $5,508 $0.31 $6,831 $0.34 $2,021 $0.33Total partner costs in the North were $5,508, representing $0.31 per beneficiary; in the Center, totalpartner costs were $6,831, representing $0.34 per beneficiary; and in the South, total partner costswere $2,201 representing $0.33 per beneficiary.6.1.3. Package of LINKAGES and MOH/MCH Interventions Compared with OutcomesBased on an analysis of the three regions, there appears to be no relationship between the costsincurred and LAM behavior change outcomes. Table 6 shows the total cost of LINKAGES andpartner LAM activities in each of the three regions compared with behavior outcomes. While the costper beneficiary is the lowest in the North ($1.91), the percentage change in the LAM User Rate is thehighest (6.78%). The reverse pattern is observed in the South, where the cost per beneficiary is thehighest ($3.2) and percent change in the LAM User Rate the lowest (3.28%).The low behavior change rate in the South may be partially explained by a lower intensity ofimplementation activities, primarily fewer training courses. Out of a total of fifteen 5-day trainingcourses on BF and LAM, only two were carried out in the South compared with 7 in the Center and 6in the North. This means there were fewer women who attended MCH centers and were exposed toLAM counseling messages in the South. At the same time, the high cost per beneficiary can beexplained by the lower number of MCH sites located in the South resulting in a lower number ofpotential project beneficiaries. Only 21% of all MCH centers are located in the South region,compared with 42% in the North and 37% in the Center.18 6. Findings LINKAGES Project/AED
Table 6: Relationship Between Costs and Outcomes (LINKAGES and Partner Costs)North Center South17,693 20,065 6,042Number ofBeneficiariesIndicator Cost PerBeneficiaryPCTChg inIndicatorCost PerBeneficiaryPCTChg inIndicatorCost PerBeneficiaryPCTChg inIndicatorLAM User Rate $33,755 $1.91 6.78% $43,909 $2.19 4.47% $19,323 $3.20 3.28%6.2. What are Determinants of Costs and Cost Effectiveness?Overall Finding The cost of training activities and IEC are the key cost drivers. Thekey factors affecting cost effectiveness include baseline and outcome behaviorchange rates and the size of targeted population.Higher total cost or cost per beneficiary does not necessarily imply lower or higher cost effectiveness(defined as cost per new acceptor). Many factors affect total costs and cost effectiveness. Costs aredisaggregated in a variety of ways to examine patterns among different types of costs, and factors thataffect cost effectiveness.6.2.1. Key Cost DriversThe cost patterns in the three regions are similar – costs were concentrated in BF/LAM trainingactivities (60% of costs in the Center, 58% in the North, and 54% of costs in the South region), withIEC, mother-to-mother support group activities, and monitoring and evaluation the next largest costcomponents.Although BF/LAM training is clearly the highest cost activity in all regions, there are regionaldifferences in the cost per beneficiary. Table 7 shows the cost of each activity by region. TotalBF/LAM training cost per beneficiary in the North is $1.06, in the Center $1.32, and in the South$1.73.There is a difference in the proportional distribution of MTMSG activity costs across the regions.They comprise 3% of total costs in the North, 7% in the Center, and 11% in the South. Further, theMTMSG costs per beneficiary were six times higher in South ($0.36) than in North ($0.06), and twicethat of the Center region ($0.16).Another notable difference in the proportionate distribution across the regions can be found in IECcosts. IEC costs represent 20% of the total costs in the North and 13% of costs in the Center. On aper beneficiary basis, the costs in the North ($0.38) were 31% higher than in the Center region($0.29). Even though total IEC costs in the South were lower than in the North and Center regions,cost per beneficiary ($0.54) was 86% higher than in the Central region and 42% higher than in theNorth. This is due to the fact that the coverage population in the North was triple and in the Center3.3 times that in the South.Linkages Project/AED 6. Findings 19
Page 1 and 2: Cost and Effective Analysisof the L
Page 5 and 6: AbstractThis study analyzes cost ef
Page 7 and 8: ContentsExecutive Summary .........
Page 9 and 10: Executive SummaryIntroductionThe La
Page 11 and 12: activities conducted in support of
Page 13 and 14: activities will allow spreading tho
Page 15 and 16: 1. Background to the StudyIn an eff
Page 17 and 18: 3. Description of LINKAGES and Part
Page 19: of MCH services are mostly women of
Page 22 and 23: the administrative and overhead str
Page 24 and 25: activities were implemented. This i
Page 26 and 27: 4.7. Comparability and Applicabilit
Page 29 and 30: 5. Financial Data Collection5.1. LI
Page 31: 6. FindingsThe findings presented a
Page 35 and 36: 6.2.3. Cost Effectiveness and Targe
Page 37 and 38: Table 11 shows the classification o
Page 39 and 40: some portion of the costs are fixed
Page 41 and 42: 7. Discussion and Conclusions7.1. R
Page 43 and 44: Annex A: List of All LINKAGES Activ
Page 45 and 46: LINKAGES' LAM Activity Costs by Ele
Page 47 and 48: Detailed MOH/MCH' LAM Activity Cost
Page 49 and 50: Percentage of Each Activity Allocat
Page 51 and 52: III. LAM Indicator Data by RegionLA
Page 53 and 54: LAM User Rate Calculations - CENTER
Page 55 and 56: 36. Al-Muwaqar37. Al-Faisaliya (Eas
Page 57 and 58: 118. Southern Al-Twa’l (Al-Dayat)
Page 59 and 60: 196. Jiffien197. Izma’lBani Kinan
Page 61 and 62: Kayak Health Directorate276. Al-Rab
Page 63: LINKAGES Project/AEDAnnex B: Detail

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