Table 1.
Provider and patient costs (in 2016 US Dollars) for antenatal care in Gaibandha district
| Level of care (n = number of pregnant women) | Community Level (n = 34) | Facility Level (n = 36) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Care setting | Gov’t (n=14) |
BRAC (n=12) |
Smiling Sun (n=8) | Community Clinic (n=10) | Upazila Health Complex (n=10) | Maternal and Child Welfare Center (n=10) | Smiling Sun (n=6) | ||
| Provider costs | Service costs | Staff level | Family Welfare Visitor | Shyastho Kormi | Paramedic | Family Welfare Visitor | Nurse | Family Welfare Visitor | Paramedic & Counselor |
| Staff monthly salary ($) | 182-390 | 78 | 286 | 182-390 | 208-455 | 182-390 | 286 | ||
| Service time per patient (min) | 6 (5-10) | 25 (21-25) | 10 (9-10) | 5 (5-6) | 17 (10-20) | 10 (5-14) | 28 (18-30) | ||
| Total service costs | 0.17 (6%) | 0.18 (21%) | 0.27 (28%) | 0.13 (4%) | 0.55 (16%) | 0.27 (9%) | 0.75 (51%) | ||
| Drug costsa | Iron & Folic acid ($) | 0.32-0.39 | 0.13 | 0.13 | 0.32-0.39 | 0.32-0.39 | 0.32-0.39 | 0.13 | |
| Calcium ($) | 0.45-0.65 | 0.13-0.19 | 0.13 | 0.45-0.65 | 0.45-0.65 | 0.45-0.65 | 0.13 | ||
| Vitamin B Complex ($) | n/a | 0.26-0.47 | 0.45 | n/a | n/a | n/a | 0.45 | ||
| Misoprostol ($) | 1.95 | n/a | n/a | 1.95 | 1.95 | 1.95 | n/a | ||
| Total drug costs | 2.86 (94%) | 0.66 (79%) | 0.71 (72%) | 2.86 (96%) | 2.86 (84%) | 2.86 (91%) | 0.71 (49%) | ||
| Total provider costs | 3.03 | 0.84 | 0.98 | 2.99 | 3.41 | 3.13 | 1.46 | ||
| Average provider costs (USD, 2016) | $1.62 | $2.75 | |||||||
| Patient costsb | Indirect costs | Hourly wagec ($) | 0.58 (0.36-0.71) | 0.52 (0.43-0.69) | 0.88 (0.42-0.10) | 0.48 (0.36-0.92) | 0.52 (0.44-0.84) | 0.62 (0.44-0.84) | 0.66 (0.36-0.66) |
| Travel time (a round trip, min) | 20 (10-55) | 13(6-33) | 10 (10-17) | 10 (10-20) | 48 (41-60) | 120 (70-120) | 40 (25-70) | ||
| Waiting time (min) | 13 (5-56) | 15 (2-30) | 6 (4-17) | 20 (8-30) | 40 (15-105) | 120 (90-210) | 8 (1-10) | ||
| Consultation time (min) | 10 (8-10) | 30 (24-35) | 18 (9-20) | 4 (2-9) | 13 (10-28) | 10 (10-20) | 30 (23-41) | ||
| Pharmacy time (min) | 0 (0-0) | 0 (0-1) | 0 (0-0) | 0 (0-0) | 1 (0-4) | 0 (0-0) | 0 (0-0) | ||
| Total time (min) | 73 (46-114) | 78 (43-97) | 34 (27-44) | 43 (27-52) | 153 (78-182) | 260 (195~292) | 90 (70-106) | ||
| Total wage loss (total time x hourly wage) | 0.70 (0.48-0.96) (100%) | 0.49 (0.31-1.03) (43%) | 0.49 (0.31-0.91) (100%) | 0.44 (0.25-0.61) (77%) | 1.19 (0.69-2.29) (80%) | 2.25 (1.40-5.96) (42%) | 0.81 (0.40-0.94) (53%) | ||
| Direct costs | Admission fee ($) | 0 | 0 | 0 | 0 | 0.04 (0.04-0.04) | 0 | 0 | |
| Medical service fee ($) | 0 | 0.65 (0.65-0.65) | 0 | 0 | 0 | 1.89 (1.20-2.93) | 1.56 (1.02-1.62) | ||
| Transportation ($) | 0 | 0 | 0 | 0.13 (0-0.2) | 0.45 (0.32-0.56) | 0.52 (0.23-0.91) | 0.65 (0.52-0.78) | ||
| Others ($) | 0 | 0 | 0 | 0 | 0 | 0.71 (0.13-1.30) | 0 | ||
| Total direct costs | 0 (0%) | 0.65 (0.65-0.65) (57%) | 0 (0%) | 0.13 (0-0.2) (23%) | 0.49 (0.04-0.56) (20%) | 3.12 (1.27-4.48) (58%) | 2.21 (0.59-1.36) (47%) | ||
| Total patient costs | 0.70 | 1.14 | 0.49 | 0.57 | 1.68 | 5.37 | 3.02 | ||
| Average patient costs (USD, 2016) | $0.78 | $2.66 | |||||||
| Average provider and patient costs (USD, 2016) | $2.40 | $5.41 | |||||||
aProviders’ monthly salary estimates and drug costs are based on interviews with organization managers and drug inventory documents in the facilities. Provision of medicines and supplements may vary depending on government supply in stock. Unit drug cost are slightly different by product brands
bPatient costs are based on direct service observation (n=70) and exit interviews with pregnant women (n = 70) Wage, time, and patient costs data represent median estimates and interquartile ranges (25% and 75%)
cHour wages are estimated based on women/husbands’ reported monthly salaries. Total wage loss was calculated based on multiplying the estimated hourly wage and total time spend to seek care