Costing tools


Management Sciences for Health

Graph illustration

Spreadsheet-based tool developed by MSH with USAID and other funding to help determine projected and actual costs of individual interventions and total costs of integrated services provided by a primary health facility. It is a "bottom-up" costing tool that allows the user to estimate a standard cost for each intervention, broken down by drugs, tests, medical supplies and staff. The standard costs are multiplied by the number of each type of interventions to build the total direct costs for a facility or group of facilities, to which are added indirect costs. It includes a demographic component that allows users to project estimated service utilization and compare it with actual service utilization and compare costs for different numbers of patients and different service delivery models. It also includes a component for comparing revenue with costs and for setting fee levels.

The strength of the tool is that it can predict the cost of different interventions, such as child survival, within the context of an integrated PHC system, and the impact of changes in those interventions on the cost of the system as a whole. The tool has been used in many countries, including South Africa, where it was used to estimate the total cost of the primary health care package for the Ministry of Health. CORE Plus has the same costing platform as a previous tool called CORE. CORE Plus is available in English (a French version can also be provided) and is accompanied by a detailed manual.


David Collins

Summary of main features

Purpose Planning, costing and budgeting for individual interventions and integrated services provided by a primary health facility
Health MDGs addressed All, but only at the primary health care facility level.
Scope of interventions Integrated primary health care services
Type of software Excel
User manual available Yes
Potential users Planners and service and finance managers at any level
Skills required Epidemiology, service delivery standards, spreadsheet
Type and length of training required Small group – 3 days
Costing strategy and methods Based on standard or actual costs. Bottom-up, based on mix of standard and actual costs
Level of aggregation Facility, network of facilities, district, national
Program/system costs included Yes
Time-frame Any – e.g. monthly, quarterly, annual
Modeling intervention impact or interactions on epidemiology or demography Includes a component that predicts utilization of each service based on the catchment population.
Output Cost by intervention, package of services, facility, resource type.
Automatic generation of reports No
Country applications CORE Plus has been used in South Africa, Rwanda and Haiti. CORE has been used in Afghanistan, Bangladesh, Ethiopia, Haiti, Kenya, Madagascar, Mexico, Rwanda, South Africa, Tanzania, Zimbabwe, Senegal, Guatemala, Bolivia, Honduras, Nicaragua and the USA.