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

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than it is to increase from 9% to 10%. Table 10 shows the baseline and outcome rates of the targetedbehaviors, together with the cost per new acceptor.Table 10: Comparison of Baseline and Outcome Behavior Rates and Cost Effectiveness(In US$) North CenterSouthIndicatorIndicatorBaselineRateIndicatorOutcomeRateCost perNewAcceptorIndicatorBaselineRateIndicatorOutcomeRateCost perNewAcceptorIndicatorBaselineRateIndicatorOutcomeRateLAM User Rate 1.53% 8.30% $28 5.52% 9.98% $49 6.67% 9.94% $98Cost perNewAcceptorAcross all three regions, lower baseline rates are associated with a lower cost per new acceptor – forexample the North region has the lowest baseline rate and the lowest cost per new acceptor for LAMUser Rate. The data for LAM User Rate costs and outcome suggests there is a direct relationshipbetween higher baseline rates of LAM User Rate and lower cost effectiveness, which can beexplained by increasing marginal costs for behavior change at higher LAM User Rate levels.One of the interpretations of this analysis is that LINKAGES may be able to improve its costeffectiveness of its LAM interventions by targeting areas with low behavior change rates. It should benoted that these results relate to LAM interventions only and these data alone do not allow us to drawconclusions about the cost effectiveness of other behavior change indicators.6.3. What Would It Cost to Replicate These Activities and Is it CostEffective?Overall Finding: The total cost per beneficiary to replicate this set of activities is$1.56. The total cost per new LAM acceptor is $29.836.3.1. Cost to Replicate Package of LINKAGES and Partner ActivitiesDetermining the replication costs entailed a review of all activities included in this study andclassification of those activities as start-up/development activities, ongoing implementation activities,and monitoring and evaluation activities. Start-up or development activities are one-time activitiesthat would not be replicated, such as the development of IEC materials and mass media messages,initial assessment visits, the one-time lactation management training for project counterparts, etc.Implementation activities are an ongoing part of the program and include training workshops,facilitation of mother-to-mother support groups, advocacy meetings, production of IEC materials, andradio broadcasts. Monitoring and evaluation activities are aimed only at assessing outcomes from theinterventions.Disaggregating costs associated with implementation activities provides the most accurate estimate ofthe costs of replicating activities. To calculate the cost of replication, only the costs of implementationactivities are included, because start-up activities would not be incurred again, and evaluation costsdo not produce behavior change and are therefore not included in LINKAGES’ cost effectivenessstudies.22 6. Findings LINKAGES Project/AED
Table 11 shows the classification of all behavior change activities conducted by LINKAGES and itspartners.Table 11: Classification of LINKAGES and Partner Activities from December 2001 – December 2002ACTIVITIESIEC Materials (development, production, dissemination)Advocacy sessions and meetingsCourses on BF and LAM for health workersTraining of trainers on BF and LAMMother-to-mother support groups (MTMSG) training of trainersFacilitation of MTMSGInitial visits to establish MTMSGLactation management course for master trainersSession on LAM for trainees from PHCI project1-day Workshops to discuss BF, LAM, M&E and MTMSGRefresher workshops on BF and LAMIEC and Monitoring and Evaluation workshopMonitoring and supervision visitsDesign of Quantitative Baseline Survey on IF and LAM in North SentinelSite (preparation phase)Monitoring health provider knowledge (phone survey)M&E workshop for MCH midwife supervisorsStart-up, Implementation, orMonitoring/EvaluationStart-up/ImplementationImplementationImplementationImplementationImplementationImplementationStart-upStart-upImplementationImplementationImplementationImplementation /Monitoring andEvaluationImplementationMonitoring and EvaluationMonitoring and EvaluationMonitoring and EvaluationThe costs associated with implementation activities to promote LAM are shown in Table 12. Theseactivities target antenatal and postpartum women with infants less than 6 months old, and can begrouped together to estimate replication costs per woman. Total implementation costs for this subsetof activities were $22,308 in the North, $32,358 in the Center, and $13,737 in the South. Theimplementation cost per beneficiary was $1.56 across all regions, $1.26 in the North, $1.61 in theCenter, and $2.27 in the South.Table 12: Costs of Replicating LAM Promotion Activities, LINKAGES and Partner ImplementationCosts OnlyNorth Center South TotalLINKAGES Costs (US$) 16,954 25,702 11,896 54,552Partner Costs (US$) 5,354 6,656 1,841 13,851Total Costs of LAM PromotionActivities (US$)22,308 32,358 13,737 68,403Total Beneficiaries 17,693 20,065 6,042 43,800Cost per Beneficiary (US$) 1.26 1.61 2.27 1.56Linkages Project/AED 6. Findings 23
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 and 32: 6. FindingsThe findings presented a
Page 33 and 34: Table 6: Relationship Between Costs
Page 35: 6.2.3. Cost Effectiveness and Targe
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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