Costing tools

The OneHealth Tool

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An Inter-Agency Working Group (IAWG) on Costing, composed of UNICEF, World Bank, WHO, UNFPA, UNDP, and UNAIDS, has been working since January 2008 on the harmonization of costing and impact assessment tools used for health sector planning. The IAWG has reviewed existing planning, costing and budgeting tools for the health sector and has developed a joint UN model, the OneHealth Tool.

The OneHealth Tool is a software tool designed to strengthen the development of national strategic health plans, by facilitating health system analysis, costing and financing scenarios at the country level. Its primary purpose is to assess public health investment needs in low and middle income countries. For the first time, planners have a single framework for planning, costing, impact analysis, budgeting and financing of strategies for all major diseases and health system components.

The work is supported by the six participating IAWG agencies, as well as the Global Health Workforce Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria and UNWOMEN.

The development of the OneHealth Tool leverages the best components of previously existing tools and is designed in a modular fashion allowing for program specific costing as well as health sector wide costing.

The first version of the tool was released in May 2012 and to date (November 2013) over 25 countries have explored use of the tool to support national planning and costing processes. Updated versions of the OneHealth Tool are regularly released on the Futures Institute website (

Purpose Inform strategic health planning: determine the financial costs associated with activities and targets outlined in a health plan, along with assessment of estimated health impact; support scenario analysis
Health MDGs addressed 1,4,5,6 + non-MDGs (non communicable diseases, mental health, etc)
Scope of interventions Health systems strengthening; Promotive, preventive and curative health interventions; programme activities
Type of software Custom software, module in Spectrum
User manual available? Yes
Potential users Health sector planners, program managers, consultants and academics
Skills required Knowledge of strategic planning. Degrees in public health, epidemiology, economics are useful but not necessary. Essential is a familiarity with determining appropriate and local data inputs regarding the health services and activities to be costed.
Type and length of training required Four- to five day courses are organized by the tool developers to support capacity building.
Costing strategy and methods Driven by target intervention coverage; ingredients approach (separate quantities and prices at level of inputs for activities and interventions)
Level of aggregation National / Sub-national
Program/system costs included? Yes
Time-frame Medium-term
Modeling of intervention impact or interactions on epidemiology or demography? Health impact is estimated through impact models directly linked to the targets and strategies identified by the user within the tool. Three sub-models within OneHealth Tool that draw upon UN epidemiological reference group models, a recognized gold standard, are fully incorporated as part of the software:
The Lives Saved Tool (LiST)  estimates impact for a range of child and maternal health interventions, including malaria interventions.
The AIDS Impact Model (AIM) model projects health impact for HIV/AIDS interventions
The Family Planning (FamPlan) model computes the relationship between family planning and total fertility rate.  The output is then communicated to the population projection parts of the tool.
A newly developed tuberculosis (TB) model projects impact on TB health targets.
Additional work is ongoing to support development of impact models for Non-Communicable diseases, expected to be ready in 2014.
Output: Stream of inputs and costs by year, by intervention in USD or National Currency Unit (NCU); estimated health impact; comparison of programme/intervention demands on the health system with planned health system capacity
Automatic generation of reports? Yes
Country applications Over 25 countries to date (November 2013), most of which in Sub-Saharan Africa
For more information