Cost and Funding Projections for the Minimum Package of Activities for Health Centers: Ministry Of Health, Royal Government of Cambodia

February 2009

The primary objective of this study was to model the costs and funding requirements of the Ministry of Health’s Minimum Package of Activities (MPA), which covers services provided by health centers. The resulting cost and funding estimates are intended to support the planning and implementation of the Health Strategic Plan, 2008-2015 (HSP2), specifically to assist in the preparation of district and provincial service delivery plans and budgets and in the development of business plans for health centers and Operational Districts (ODs). They should also assist the MOH to coordinate and harmonize external assistance.

This cost modeling builds on work done previously to estimate the cost of implementing the Child Survival Strategy (CSS) and complements that work by producing detailed costs of the CSS interventions within the context of the MPA. It also produces costs for other key interventions such as TB and HIV/AIDS.

The model uses incidence and prevalence rates together with catchment population figures to estimate the number of each type of service needed for different levels of coverage (overall utilization of a facility by the community). The model analyzes and estimates the costs and revenues using a bottom-up, or micro-costing, approach. It determines the standard costs associated with the delivery of a particular health service, taking into account the staff time, drugs, medical supplies and tests required. Operating costs and indirect staff costs are distributed proportionally across the health services in accordance with direct staff costs. The model determines the unit cost for each service, which is used to allocate actual costs across services or to project costs under different scenarios. The model also includes standard fees for service and other types of funding and uses those figures to assess actual revenues and funds received and to estimate income under the different scenarios.

All the major assumptions used in the model can be changed easily by the user. These include the catchment population, need norms, overall utilization rate, standard quantities and prices of Drugs and supplies, standard staff times, staff pay levels and standard operating costs. Any new services added to the MPA list of services can also be included.