Table 6.
Breakdown of costs by facility utilization
|
Item |
Facility utilization level |
||
|---|---|---|---|
| Low utilization (Fewer than 7,000 outpatient visits) | Middle utilization (7,000 to 14,999 outpatient visits) | High utilization (Over 15,000 outpatient visits) | |
| Number of health centres |
6 |
13 |
5 |
| of which CHAM |
4 |
2 |
2 |
| Population served (average) |
18,345 |
24,372 |
36,071 |
| Estimated Children U5 (average) |
3,385 |
4,597 |
6,561 |
|
Outputs (Children U5) |
|
|
|
| Inpatient admissions (average) |
71 |
82 |
338 |
| Outpatient visits (average) |
4,446 |
10,507 |
18,961 |
| FIC (average) |
495 |
1,013 |
1,165 |
| Child outpatient utilization rate |
1.31 |
2.29 |
2.89 |
| Proportion of caretakers reporting over 1 hour travel time to facility (95% CI)* |
67% |
60% |
56% |
| (52 – 81%) |
(47 – 73%) |
(41 – 71%) |
|
|
Inputs (Children U5) |
|
|
|
|
Variable |
|
|
|
| Staff remuneration |
47% |
23% |
29% |
| Average number of clinical staff |
3.7 |
3.8 |
5.8 |
| Outpatient visits per clinical staff |
1213 |
2732 |
3269 |
| Average number of staff (all) |
37.2 |
29.8 |
45.6 |
| Outpatient visits per staff (all) |
120 |
352 |
416 |
| Training |
5% |
8% |
6% |
| Vehicle operation & Field visits |
6% |
7% |
20% |
| Non-medical supplies |
1% |
2% |
3% |
| Medical Supplies |
8% |
7% |
5% |
| Pharmaceuticals |
18% |
42% |
22% |
| Average pharmaceutical spending per visit ($) |
1.4 |
2.6 |
1.3 |
| Proportion of drugs out of stock |
0.19 |
0.32 |
0.28 |
| Proportion of children correctly medicated |
0.59 |
0.82 |
0.81 |
|
Subtotal: Variable costs |
87% |
94% |
92% |
|
Fixed |
|
|
|
| Building & Equipment (incl. lab/x-ray) |
8% |
5% |
5% |
| Vehicles |
5% |
1% |
3% |
| Subtotal: Fixed costs | 13% | 6% | 8% |
*Based on 229 exit interviews of caretakers at facilities; 60 respondents for low utilization facilities, 128 respondents for middle utilization facilities, and 41 respondents for high utilization facilities. Difference between low utilization and high utilization facilities is statistically significant (p<0.05) in logit regression when controlling for district (data not shown).