Costing tools

Integrated Healthcare Technology Package

World Health Organization, Medical Research Council (South Africa)1

Graph illustration

iHTP is a resource planning and costing tool developed by WHO/HSS/HDS to provide guidance on the optimal mix of resource inputs (human resources, medical devices, pharmaceuticals and facilities) required for any particular health intervention or their selected set that is specific to the local needs and conditions. iHTP integrates healthcare needs, disease profiles; patient demographics; clinical practice; human resource and technology requirements, availability and constraints; associated capital and recurrent costs; links these to a defined set of health services, and via software simulation, computes the resource requirements necessary to provide these services.

The health interventions resource planning and costing calculations are taken from graphical representations of clinical practice guidelines, called "iHTP scenarios". iHTP scenarios depicting WHO clinical practice guidelines for the areas of maternal, newborn, and child health; sexual and reproductive health; malaria; tuberculosis; HIV/AIDS; essential and emergency surgical care, and other key interventions within the typical district health package are either completed or are in the final stages of development. Following the initial iHTP piloting in China, Kyrgyzstan, Mozambique and Namibia, it is currently applied for a variety of broad policy and specific technical purposes in DRC, Mexico, South Africa and Ukraine, as well as is at the initial stages of implementation in a number of other countries in all WHO regions2. iHTP is now also available in French.


Roger Schmitt
Ole Doetinchem

Summary of main features

Purpose Planning for the optimal resource mix (HR, devices, drugs, facilities) for a defined set of health interventions; qualifying, quantifying and costing resource requirements; defining the HR skills sets; assessing resource availability and constraints, and resource GAPs analysis; resource sharing between "vertical" programs; modelling of resource requirements and associated costs for scaling up health coverage or health services; changing/improving clinical practice.
Health MDGs addressed 4, 5, 6
Scope of interventions Generally, any defined set, package or program (user selects/deselects interventions according to local needs). Covers all MNH interventions included in WHO IMPAC clinical guidelines, as well as most of IMCI, SRH, HIV/AIDS, TB, malaria, and typical district health package interventions. Database contains 11,000 procedures, of which 6,000 are pre-linked to resource requirements.
Type of software Custom; .Net Framework
User manual available Yes
Potential users National planners, decision-makers, managers, clinicians at any level; development, technical assistance and donor agencies
Skills required Depending on application. Generally, team should include clinical experts, and those who can provide information on epidemiology and costs. Basic computer skills for all.
Type and length of training required Training workshop; 3-5 days to become familiar with software; resource kit available for post-training support. Workshops can be at any level as required - intercountry, national, sub-national, institutional.
Costing strategy and methods Based on standard costs, country specific adjustments, user-directed target coverage scale-up; bottom up, ingredient approach (quantities and prices)
Level of aggregation Any (individual facility, facility network, district, national)
Program/system costs included Partially, currently being incorporated
Time-frame Any as required (short-, medium-, long-term planning)
Modeling of intervention impact or interactions on epidemiology or demography Yes
Output Cost per input, procedure, intervention, service package, facility, facility network, level of care, resource type, plus a variety of non-cost outputs (resource type/quantity/optimal mix, HR skills mix/competences, technology criticality, technology reusability, resource sharing across programs, etc.)
Automatic generation of reports Yes
Country applications Variety of on-going and planned/requested applications in many countries in all WHO regions

1 South African Medical Research Council in the late 1990s-early 2000s was the initial WHO's partner in designing the original iHTP concept and methodology, but is no longer involved in its development and implementation.

2 The current technical review focused on the Making Pregnancy Safer (MPS) module of iHTP. The services included in the iHTP-MPS module are taken from the WHO recommended interventions menu, which is part of the Integrated Management of Pregnancy and Childbirth clinical guidelines and tools. iHTP-MPS scenarios/algorithms have been developed for each of 22 maternal and 8 newborn interventions, at primary and referral levels. iHTP-MPS implementation is under way in Malawi; with Botswana, Kenya, Tanzania and Uganda having had the initial training, and two more countries from other regions to be selected shortly for testing and training of trainers.