Community Health Planning and Costing Tool

Tool

Recognizing the need for improving the long-term planning of community health services, MSH, in partnership with the United Nations Children's Fund (UNICEF), developed the Community Health Planning and Costing Tool. Initially developed in 2016, the tool was revised in 2020, based on user feedback, and is now available in both English and French. New features of the Community Health Planning and Costing Tool Version include:

  • Pre-loaded, global standard treatment guidelines to reduce data collection
  • Integration of the User Guide directly into the Excel Tool, to help users navigate data entry
  • Ability to add different cadres of community health workers (CHWs) and supervisors.
  • Video tutorial available in French and English

The Community Health Planning and Costing Tool is designed to cost packages of community health services and produce results to help assess performance, plan future services, and prepare investment cases. The user-friendly, open-source, spreadsheet-based tool is designed to be used by health system managers and policy makers. It allows users to calculate the costs of all elements of comprehensive community health services packages, including start-up, training, and community-level service delivery costs, as well as support, supervision, and management costs at all levels of the health system. The tool also has a financing element that can be used to show program financing sources and gaps in current and future funding. The tool can be tailored for either national or sub-national programs and can project costs for up to five years.

The tool has the ability to include up to 100 health interventions and six cadres of community health CHWs. At the service delivery level, it is a bottom-up, activity-based costing tool, in which unit costs per service are built up by type of resource (e.g. medicines) and multiplied by the total estimated numbers of services. Other costs, such as supervision and training, are allocated using a top-down methodology. The tool uses standard treatment protocols for the community health services to determine the standard costs of treatment.

Initially developed and piloted in Malawi and Sierra Leone in 2016, the tool has since been revised based on feedback following its use by governments and nongovernmental organizations in Angola, Burkina Faso, Comoros, Liberia, Madagascar, Malawi, Mali, Mozambique, Sierra Leone, Somalia, South Sudan, Tanzania, Togo, and Zanzibar.

Intended Users: Community health program managers, planners, and policy makers.

Advantages: The user-friendly, open-source, spreadsheet-based tool is designed for use in low- and middle-income countries. The dynamic nature of the tool allows the user to easily modify key variables (e.g. target populations, incidence rates, and service delivery platforms) and immediately determine the changes in program costs for up to five projection years.

Results: The tool automatically produces the following key results:

  • Total program costs for baseline year and five-year projections
  • Costs per capita, per CHW, per contact, per program, and per resource type
  • Incremental costs and financing (start-up and recurrent)
  • Key drivers of costs and cost categories as a percent of total costs
  • Five-year projections of financing (and financial gaps) with sources of funding

The results can be used for the following types of analysis:

  • Planning and budgeting a new package, additions, or changes to a package or geographical expansion of a package
  • Comparing cost efficiency and effectiveness of different service delivery platforms
  • Calculating reimbursement rates for results-based financing or insurance
  • Costing “What-if” scenarios to model a package in line with financing limitations
  • Understanding what bottlenecks exist and their impact, options for removing them, and ranges of costs required for removing them
  • Developing investment cases to persuade policy makers, government funding agencies (e.g., Ministries of Finance), and donors of the benefits of community health services and advocate for the sufficient allocation of resources

Download the Handbook (English and French)

To request a copy of the tool, please e-mail fintools@msh.org.

For additional resources, including country investment cases and reports carried out using the tool, click here.