Costing: Informing National Health Policies and Global Advocacy for Increased Resources
Accurate and up-to-date information on the costs of reproductive, maternal, newborn and child health (RMNCH) programs and interventions are needed to raise "more health for the money" and to inform the formulation of national health policies, strengthen arguments for the required investments to achieve national health targets, and help countries and their partners to plan, budget and monitor the delivery of essential services to ensure the health of women, adolescent girls, newborn, and children.
Many methods exist to determine costs and financing gaps related to RMNCH. Estimates may depend on the choice of costing tool, which services are included, how the services are delivered, and the projected time-scales. Recent estimates are summarized in the recently published PMNCH Knowledge Summary: Cost and Fund RMNCH Programs. The most recent estimate of the funding gap for women's and children's health were produced by the Finance Working Group of the Global Strategy for Women's and Children Health. It estimated that the overall financing gap for the health MDGs is US$26 billion per year in 2011 (US$19 per capita) and US$42 billion in 2015 (US$27 per capita) for 49 low-income countries. The direct costs of programs relating to reproductive, maternal, newborn and child health (including malaria and HIV/AIDS), and the proportional health systems costs to support their delivery, account for almost half of the estimated funding needed: from US$14 billion in 2011 (US$10 per capita) up to US$22 billion in 2015 (US$14 per capita), which amounts to US$88 billion in total in 2011-2015.
To meet the funding gap, the Finance Working Group recommends four actions:
- The 49 lowest-income countries should ensure that growth in GDP leads to more investment in the health of women and children
- Bilateral and multilateral donors should meet their current commitments
- Foundations and civil society organizations should make significant additional contributions of financial and human resources
- The private sector should contribute through increased corporate giving and reduction of product prices
A number of costing tools have been developed to help shape national health policies, strengthen advocacy for increased investments to achieve health targets, and inform national planning and budgeting processes. The estimates of the Finance Working Group are based on the average result of the outputs of two costing approaches: WHO normative costing and the Marginal Budgeting for Bottlenecks tool developed by UNICEF and the World Bank. These are but two costing tools. To help policy makers, technical staff, technical assistance agencies, and non-governmental organizations decide which costing tool to use based on their particular objectives, an Interactive Online Costing Tool Guide was recently launched. The Guide leads users through a short series of questions to help select an appropriate costing tool and understand the different parameters to consider before undergoing a costing exercise. Video tutorials on the use of the guide are provided along with details about the tools, including how to access the tools. The Guide is based on a Technical Review of 13 Costing Tools for the Health MDGs that is highlighted in the Costing Tools Website hosed by the Partnership.