Technical consultation, Senegal, January 2008
To assist countries in the use of costing tools relevant to the health MDGs, international development partners (NORAD, UNFPA, UNICEF, UNAIDS, UNDP, WHO, World Bank, MSH, USAID through the Health Systems 20/20 and Basics projects, and the Partnership for Maternal, Newborn and Child Health) organized in collaboration with the Government of Senegal a technical consultation in Senegal on January 8-10, 2008.
There was a total of 61 participants in the technical consultation, including users of the tools at the country-level, tool developers, two external reviewers, resource persons and steering committee members.
Objectives of the technical consultation
- Obtain feedback from users on their experiences with the tools, criteria that should be considered when selecting costing tools, and how countries can be empowered and supported to manage the process of costing
- Identify possibilities for improvement in the scope and content of the tools and their application, including key features of effective tools and context in which costing is done
- Discuss the development of guidance to assist countries in conducting costing exercises
- To summarize our experience, to hear from the users what they would like to see next, and to discuss the next steps
The full meeting report is available in pdf format as per link below. Please see also below a summary of the recommendations.
1. Accessibility of tools
Participants requested the development of a central location/website or “knowledge center” to assist country costing exercises. Participants suggested that the following information should be included:
- Access to the costing tools
- Contact information for tool developers/focal points
- Help-desk for technical questions
- User manuals and technical documentation
- Technical review reports by Bitran and Associates and PATH
- Technical consultation report of meeting in Senegal
- Guidance in selecting and using appropriate tools (see below)
- Standard data sources and price lists.
Informal Consultation, New York, February 2008
It was agreed that the Partnership for Maternal, Newborn and Child Health (PMNCH) would host the website and begin bringing the pieces together so that country users have one central location where they can access the necessary costing tool information.
2. Guidance on choosing a tool
A key area of interest of the users is additional assistance to support the entire process of costing. It was recommended that the international development partners develop guidelines or a roadmap to help countries take the necessary steps to select the right tool for their purposes. The guidelines would help the user specify the questions to be addressed by the costing exercise, such as through a catalogue of questions, describe the different types of costing, and help the user select the appropriate tool based on the type of costing to be done and the costing question that needs to be answered.
3. Content and use of tools
Many users expressed concern that many of the tools themselves were difficult to navigate, understand and use. Users would therefore like to see several actions taken to assist them with understanding the tool and applying it to their situation:
- The establishment of a help-desk (on the “knowledge center” website) to which people could submit questions electronically and receive responses from a technical person within a certain timeframe.
- Development of more explicit, step-by-step guides that are specific to each tool.
- Efforts should be made to enhance consistency between tools and establish standardized program components within and between the tools, including explanations of assumptions and default values.
- Costing tool output, which should be more aligned with the format and content requirements of national planning and budgeting processes.
- Development of templates for charts and presentations, to assist in the interpretation and presentation of the results to inform policy and planning processes.
4. Process of using tools
Many participants expressed the need for increased involvement of countries in the costing exercise to build national ownership. This includes involving policy-makers from the planning of the costing exercise, which will facilitate the agreement on the key questions that should be addressed by the costing exercises, and to ensure that the tools are visible to the partners in the government who need to use the results. It was recommended that international development partners and countries should take a longer-term approach to capacity building to support a sustainable mechanism for conducting costing analyses, including supporting general training in health economics, with costing integrated as a core competency.
5. Dissemination of meeting findings
It was also recommended that a journal article or editorial should be drafted and submitted on behalf of the meeting participants to share findings of the meeting and to advocate for increased and improved use of costing tools to strengthen national policy-making, planning and implementation processes.