Article type
Year
Abstract
Background: Cost information is essential to improve the economic efficiency of healthcare systems and costing studies play a major role in this regard. However the methods used across different economic evaluation studies are diverse, and it is it is imperative to understand these methods and their applicability in different settings.
Objectives: We undertook a review to evaluate various cost scale-up evaluations from regional, national and multinational scale-up studies for Reproductive, Maternal, Newborn and Child Health (RMNCH) interventions to identify the major methods used for estimating the costs. We also aimed to compare the features of each costing method using an evaluation matrix based on peer review and publication quality.
Methods: Peer-reviewed literature search was conducted for studies on scale-up costing for RMNCH. A data abstraction table was created to extract details on the objective and components of the method, as well as the areas of application for each method. Scale-up methods were then categorized and tabulated.
Results: We included 24 studies focusing on regional, national or multi-country scale-up of RMNCH interventions. Table 1 summarizes the components of the evaluation matrix from each of these studies. Cost scale-up projections for RMNCH interventions are difficult, however various methods have been used to estimate the scale-up costs for evidence-based decision making. Different cost concepts and costing methodology are being used depending upon the purpose for which cost data are being used, the perspective of the study, the type and complexity of the health service, the precision required, the requirements of generalizability and representativeness and the availability of reliable and valid data.
Conclusions: Large scale regional and global cost scale-up analysis mostly relies on scenarios of how results vary under certain situations or on averaging the results from a set of models. There is a need for a standardized costing methodology, if all stakeholders, including providers, purchasers and policy makers, are to make informed decisions. Accurate costing can contribute to the efficient allocation of resources.
Objectives: We undertook a review to evaluate various cost scale-up evaluations from regional, national and multinational scale-up studies for Reproductive, Maternal, Newborn and Child Health (RMNCH) interventions to identify the major methods used for estimating the costs. We also aimed to compare the features of each costing method using an evaluation matrix based on peer review and publication quality.
Methods: Peer-reviewed literature search was conducted for studies on scale-up costing for RMNCH. A data abstraction table was created to extract details on the objective and components of the method, as well as the areas of application for each method. Scale-up methods were then categorized and tabulated.
Results: We included 24 studies focusing on regional, national or multi-country scale-up of RMNCH interventions. Table 1 summarizes the components of the evaluation matrix from each of these studies. Cost scale-up projections for RMNCH interventions are difficult, however various methods have been used to estimate the scale-up costs for evidence-based decision making. Different cost concepts and costing methodology are being used depending upon the purpose for which cost data are being used, the perspective of the study, the type and complexity of the health service, the precision required, the requirements of generalizability and representativeness and the availability of reliable and valid data.
Conclusions: Large scale regional and global cost scale-up analysis mostly relies on scenarios of how results vary under certain situations or on averaging the results from a set of models. There is a need for a standardized costing methodology, if all stakeholders, including providers, purchasers and policy makers, are to make informed decisions. Accurate costing can contribute to the efficient allocation of resources.