scholarly journals Cost per insertion and couple year of protection for post-partum intrauterine devices and implants provided during service scale-up in Kigali, Rwanda

2018 ◽  
Vol 2 ◽  
pp. 39 ◽  
Author(s):  
Kristin M. Wall ◽  
Rosine Ingabire ◽  
Susan Allen ◽  
Etienne Karita
Keyword(s):  
Post Partum ◽  
Low Cost ◽  
Intrauterine Device ◽  
Scale Up ◽  
High Volume ◽  
Health Facilities ◽  
Doctoral Level ◽  
Implementation Costs ◽  
The Government ◽  
The Cost

Introduction: In two high-volume government hospitals, their two affiliated health facilities, and two additional health facilities, we developed and implemented post-partum intrauterine device (PPIUD) and post-partum (PP) implant promotions and service delivery procedures between May and July 2017 in Kigali, Rwanda. Between August 2017 and July 2018, 9,073 pregnant women received PPIUD/PP implant promotions who later delivered in one of our selected facilities. Of those, 2,633 had PPIUDs inserted, and 955 had PP implants inserted. Methods: Here, we detail the expenditures during the implementation from the payer perspective (including both the implementation costs and the cost of contraceptive methods) and estimate the cost per PPIUD insertion, PP implant insertion, and couple years of protection (CYP) for PPIUD and PP implant users. Research costs for formative work were excluded. Results: A total of $74,147 USD was spent on the implementation between August 2017 and July 2018. The largest expense (34% of total expenses) went toward personnel, including doctoral-level, administrative, data management and nurse counseling staff. Training for PPIUD and implant providers and promoters comprised 8% of total expenses. Recruitment and reimbursements comprised 6% of expenses. Costs of implants to the government comprised 12% of the expenses, much higher than the cost of IUDs (1%). Costs per insertion were $25/PPIUDs and $77/PP implant. Costs per CYP were $5/PPIUDs and $20/PP implant. Conclusion: The PPIUD/PP implant service implementation provided services at a low cost per insertion and CYP. Understanding the cost per PPIUD/PP implant inserted and CYP can help to inform the cost of scaling up PPIUD/PP implant service implementation activities and resource allocation decision-making by the Rwandan Ministry of Health.

scholarly journals Cost per insertion and couple year of protection for postpartum intrauterine devices and implants provided during service scale-up in Kigali, Rwanda

2019 ◽  
Vol 2 ◽  
pp. 39
Author(s):  
Kristin M. Wall ◽  
Rosine Ingabire ◽  
Susan Allen ◽  
Etienne Karita
Keyword(s):  
Intrauterine Device ◽  
Scale Up ◽  
High Volume ◽  
Health Facilities ◽  
System Perspective ◽  
Doctoral Level ◽  
Government Hospitals ◽  
Implementation Costs ◽  
The Government ◽  
The Cost

Introduction: In two high-volume government hospitals, their two affiliated health facilities, and two additional health facilities, we developed and implemented postpartum intrauterine device (PPIUD) and postpartum (PP) implant promotional counseling and service delivery procedures between May-July 2017 in Kigali, Rwanda. Between August 2017 and July 2018, 9,073 pregnant women received PPIUD/PP implant promotions who later delivered in one of our selected facilities. Of those, 2,633 had PPIUDs inserted, and 955 had PP implants inserted. The goal of the present analysis is to detail implementation expenditures and estimate incremental costs per insertion and couple years of protection (CYP) for PPIUD and PP implant users. Methods: We detail the incremental costs during the implementation from the health system perspective (including both the implementation costs and the cost of contraceptive methods) and use of standard methods to estimate the cost per insertion and CYP for PPIUD and PP implant users. In addition to the incremental costs of labor and supplies, the costs of promotional activities are included. Research costs for formative work were excluded. Results: A total of $74,147 USD was spent on the implementation between August 2017 and July 2018. The largest expense (34% of total expenses) went toward personnel, including doctoral-level, administrative, data management and nurse counseling staff. Training for PPIUD and implant providers and promoters comprised 8% of total expenses. Recruitment and reimbursements comprised 6% of expenses. Costs of implants to the government comprised 12% of the expenses, much higher than the cost of IUDs (1%). Costs per insertion were $25/PPIUDs and $77/PP implant. Costs per CYP were $5/PPIUDs and $20/PP implant. Conclusion: Understanding the cost per PPIUD/PP implant inserted and CYP can help to inform the cost of scaling up PPIUD/PP implant service implementation activities and resource allocation decision-making by the Rwandan Ministry of Health.

scholarly journals Cost per insertion and couple year of protection for postpartum intrauterine devices and implants provided during service scale-up in Kigali, Rwanda

2019 ◽  
Vol 2 ◽  
pp. 39
Author(s):  
Kristin M. Wall ◽  
Rosine Ingabire ◽  
Susan Allen ◽  
Etienne Karita
Keyword(s):  
Intrauterine Device ◽  
Scale Up ◽  
High Volume ◽  
Health Facilities ◽  
System Perspective ◽  
Doctoral Level ◽  
Government Hospitals ◽  
Implementation Costs ◽  
The Government ◽  
The Cost

Introduction: In two high-volume government hospitals, their two affiliated health facilities, and two additional health facilities, we developed and implemented postpartum intrauterine device (PPIUD) and postpartum (PP) implant promotional counseling and service delivery procedures between May-July 2017 in Kigali, Rwanda. Between August 2017 and July 2018, 9,073 pregnant women received PPIUD/PP implant promotions who later delivered in one of our selected facilities. Of those, 2,633 had PPIUDs inserted, and 955 had PP implants inserted. The goal of the present analysis is to detail implementation expenditures and estimate incremental costs per insertion and couple years of protection (CYP) for PPIUD and PP implant users. Methods: We detail the incremental costs during the implementation from the health system perspective (including both the implementation costs and the cost of contraceptive methods) and use of standard methods to estimate the cost per insertion and CYP for PPIUD and PP implant users. In addition to the incremental costs of labor and supplies, the costs of promotional activities are included. Research costs for formative work were excluded. Results: A total of $74,147 USD was spent on the implementation between August 2017 and July 2018. The largest expense (34% of total expenses) went toward personnel, including doctoral-level, administrative, data management and nurse counseling staff. Training for PPIUD and implant providers and promoters comprised 8% of total expenses. Recruitment and reimbursements comprised 6% of expenses. Costs of implants to the government comprised 12% of the expenses, much higher than the cost of IUDs (1%). Costs per insertion were $25/PPIUDs and $77/PP implant. Costs per CYP were $5/PPIUDs and $20/PP implant. Conclusion: Understanding the cost per PPIUD/PP implant inserted and CYP can help to inform the cost of scaling up PPIUD/PP implant service implementation activities and resource allocation decision-making by the Rwandan Ministry of Health.

scholarly journals Cost per insertion and couple year of protection for postpartum intrauterine devices and implants provided during service scale-up in Kigali, Rwanda

2020 ◽  
Vol 2 ◽  
pp. 39 ◽  
Author(s):  
Kristin M. Wall ◽  
Rosine Ingabire ◽  
Susan Allen ◽  
Etienne Karita
Keyword(s):  
Intrauterine Device ◽  
Scale Up ◽  
High Volume ◽  
Health Facilities ◽  
System Perspective ◽  
Doctoral Level ◽  
Government Hospitals ◽  
Implementation Costs ◽  
The Government ◽  
The Cost

Introduction: In two high-volume government hospitals, their two affiliated health facilities, and two additional health facilities, we developed and implemented postpartum intrauterine device (PPIUD) and postpartum (PP) implant promotional counseling and service delivery procedures between May-July 2017 in Kigali, Rwanda. Between August 2017 and July 2018, 9,073 pregnant women received PPIUD/PP implant promotions who later delivered in one of our selected facilities. Of those, 2,633 had PPIUDs inserted, and 955 had PP implants inserted. The goal of the present analysis is to detail implementation expenditures and estimate incremental costs per insertion and couple years of protection (CYP) for PPIUD and PP implant users. Methods: We detail the incremental costs during the implementation from the health system perspective (including both the implementation costs and the cost of contraceptive methods) and use of standard methods to estimate the cost per insertion and CYP for PPIUD and PP implant users. In addition to the incremental costs of labor and supplies, the costs of promotional activities are included. Research costs for formative work were excluded. Results: A total of $74,147 USD was spent on the implementation between August 2017 and July 2018. The largest expense (34% of total expenses) went toward personnel, including doctoral-level, administrative, data management and nurse counseling staff. Training for PPIUD and implant providers and promoters comprised 8% of total expenses. Recruitment and reimbursements comprised 6% of expenses. Costs of implants to the government comprised 12% of the expenses, much higher than the cost of IUDs (1%). Costs per insertion were $25/PPIUDs and $77/PP implant. Costs per CYP were $6/PPIUDs and $21/PP implant.  Conclusion: Understanding the cost per PPIUD/PP implant inserted and CYP can help to inform the cost of scaling up PPIUD/PP implant service implementation activities and resource allocation decision-making by the Rwandan Ministry of Health.

scholarly journals A credible pathway for heavy ion driven target fabrication and injection

2002 ◽  
Vol 20 (3) ◽  
pp. 515-520 ◽  
Author(s):  
D.T. GOODIN ◽  
A. NOBILE ◽  
N.B. ALEXANDER ◽  
L.C. BROWN ◽  
J.L. MAXWELL ◽  
...  
Keyword(s):  
Low Cost ◽  
Fusion Energy ◽  
Scale Up ◽  
Development Program ◽  
High Volume ◽  
Heavy Ion ◽  
Current Status ◽  
Target Chamber ◽  
Inertial Fusion ◽  
Inertial Fusion Energy

The Target Fabrication Facility (TFF) of an inertial fusion energy (IFE) power plant must supply about 500,000 targets per day. The target is injected into the target chamber at a rate of 5–10 Hz and tracked precisely so the heavy ion driver beams can be directed to the target. The feasibility of developing successful fabrication and injection methodologies at the low cost required for energy production (about $0.25/target, approximately 104 times less than current costs) is a critical issue for inertial fusion energy. A significant program is underway to develop the high-volume methods to supply economical IFE targets. This article reviews the requirements for heavy ion driven IFE target fabrication and injection, and presents the current status of and results from the development program. For the first time, an entire pathway from beginning to end is outlined for fabrication of a high-gain, distributed radiator target. A significant development and scale-up program will be necessary to implement this pathway for mass production of IFE targets.

scholarly journals Deprivation of Liberty Safeguards in England: implementation costs

2011 ◽  
Vol 199 (3) ◽  
pp. 232-238 ◽  
Author(s):  
Ajit Shah ◽  
Mark Pennington ◽  
Chris Heginbotham ◽  
Cam Donaldson
Keyword(s):  
Average Cost ◽  
Mental Capacity ◽  
Resource Utilisation ◽  
First Year ◽  
Mental Capacity Act 2005 ◽  
Implementation Costs ◽  
The Government ◽  
Mental Capacity Act ◽  
The Cost ◽  
Utilisation Data

BackgroundThe Deprivation of Liberty Safeguards (DoLS), introduced into the Mental Capacity Act 2005, were fully implemented on 1 April 2009 in England and Wales. The government estimated 20 000 assessments for DoLS at a cost of £600 per assessment.AimsTo estimate the costs likely to be incurred with the implementation of DoLS in England.MethodThe cost of conducting a single DoLS assessment was estimated using resource-utilisation data ascertained from 37 professionals, secretarial staff and independent mental capacity advocates involved with DoLS assessments in six diverse local DoLS offices.ResultsThe estimated average cost of a single DoLS assessment was £1277.ConclusionsThe estimated average cost of a single DoLS assessment was significantly higher than the £600 estimated by the government. However, the allocated budget, based on 20 000 estimated DoLS assessments in the first year of its implementation, is likely to be adequate because a significantly lower number of assessments (only 5200) were conducted in the first 9 months after its implementation.

scholarly journals Cost and Impact of Dried Blood Spot Versus Plasma Separation Card for Scale-up of Viral Load Testing in Resource-limited Settings

2019 ◽  
Author(s):  
Brooke E Nichols ◽  
Sarah J Girdwood ◽  
Aaron Shibemba ◽  
Sharper Sikota ◽  
Christopher J Gill ◽  
...  
Keyword(s):  
Viral Load ◽  
Scale Up ◽  
High Volume ◽  
Dried Blood Spots ◽  
Correct Result ◽  
Load Testing ◽  
Plasma Separation ◽  
Resource Limited ◽  
Low Volume ◽  
The Cost

Abstract Background Routine plasma viral load (VL) testing is recommended for monitoring human immunodeficiency virus–infected patients on antiretroviral therapy. In Zambia, VL scale-up is limited due to logistical obstacles around plasma specimen collection, storage, and transport to centralized laboratories. Dried blood spots (DBSs) could circumvent many logistical challenges at the cost of increased misclassification. Recently, plasma separation cards (PSCs) have become available and, though more expensive, have lower total misclassification than DBSs. Methods Using a geospatial model created for optimizing VL utilization in Zambia, we estimated the short-term cost of uptake/correct VL result using either DBSs or PSCs to increase VL access on equipment available in-country. Five scenarios were modeled: (1) plasma only (status quo); (2) plasma at high-volume sites, DBS at low-volume sites; (3) plasma at high-volume sites, PSC at low-volume sites; (4) PSC only; (5) DBS only. Results Scenario 1 resulted in 795 342 correct results due to limited patient access. When allowing for full and partial adoption of dried specimens, access increases by 19%, with scenario 3 producing the greatest number of correct results expected (929 857). The average cost per correct VL result was lowest in the plasma + DBS scenario at $30.90 compared to $31.62 in our plasma + PSC scenario. The cost per correct result of using dried specimens only was dominated in the incremental analysis, due primarily to fewer correct results. Conclusions Adopting the partial use of dried specimens will help achieve improved VL access for patients at the lowest cost per correct result.

scholarly journals Pendampingan Penyusunan Laporan Keuangan dengan Teknik Pembukuan Sederhana pada Pelaku UMKM Scale-Up di Wilayah Tangerang Selatan

Abdimisi ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 25
Author(s):  
Dila Angraini ◽  
Tri Utami ◽  
Dea Annisa ◽  
Zulfa Rosharlianti ◽  
Wiwit Irawati
Keyword(s):  
Community Service ◽  
Scale Up ◽  
Online Training ◽  
Community Empowerment ◽  
Financial Report ◽  
The Government ◽  
The Cost

Community service (PKM) with the Community Empowerment House (RPM) Institute South Tangerang. The purpose of this PKM is to assist in the preparation of MSME financial report bookkeeping with simple techniques using the Ms. program. Excel. The UKM players involved in this PKM maybe 50 people with online training and mentoring on November 26, 2020 through the Zoom Meeting. The methods used in this PKM are counseling or lectures, tutorials, discussions, mentoring, and assessment. The results of the PKM is helping MSME players in understanding the problems of bookkeeping and composing as well as calculating the Cost of Goods Sold and recording and calculating inventory more accurately, assisted by Ms. Excel. UMKM players are precise and disciplined in doing bookkeeping using the Ms. program. Excel. It is hoped that this PKM can be useful for various parties including MSME actors themselves, the Indonesian Accountants Association, the Government, and academics. <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/

scholarly journals PERANCANGAN HUNIAN SEWA UNTUK MILENIAL DI PADEMANGAN

2020 ◽  
Vol 1 (2) ◽  
pp. 1433
Author(s):  
Fanuel Fang ◽  
Rudy Surya
Keyword(s):  
Green Space ◽  
Low Cost ◽  
Rental Housing ◽  
Common Phenomenon ◽  
Green Line ◽  
Cost Of Living ◽  
The West ◽  
Railroad Tracks ◽  
The Government ◽  
The Cost

Urbanization has become a common phenomenon in big cities, with the exception of Jakarta. Urbanites (the name for people who are urbanizing) usually come to Jakarta to get jobs with higher wages than their home regions. Although the cost of living in Jakarta is relatively expensive, large revenues are the main focus for them. This is what has contributed to the emergence of slums in the capital, as happened in Pademangan Barat Village. The majority of migrants dominated by millennials work as shop employees in Mangga Dua and labor convection. They occupy semi-permanent buildings in narrow alleys, even to the extent that they fill along the edge of the railroad tracks that pass in Pademangan, which should be a green line. The existence of such housing makes the West Pademangan Area seem dingy, crowded with buildings, and loses its green space. This is because the rental price is cheap and sufficient to meet the needs of residents who only need a temporary resting place. The government has actually provided low-cost flats in Kemayoran, but it seems influential in reducing these slum dwellings. Vertical rental housing which simultaneously provides shared facilities also plays a role as a green space to compensate for the density of buildings in Pademangan. So that not only intended for residents, but also can be used by the surrounding residents, where analyzed by the author to be located in 10th RW (citizen association) of Pademangan Barat. AbstrakUrbanisasi telah menjadi fenomena yang umum terjadi di kota besar, tanpa terkecuali Jakarta. Kaum urban (sebutan untuk orang yang melakukan urbanisasi) biasanya datang ke Jakarta untuk mendapatkan pekerjaan dengan upah lebih tinggi dibandingkan daerah asal mereka. Karenanya, pengeluaran selama berada di Jakarta diminimalisir sebisa mungkin, termasuk dalam hal memilih tempat tinggal sementara. Hal inilah yang ikut mengakibatkan munculnya pemukiman kumuh di ibukota, sebagaimana yang terjadi di Kelurahan Pademangan Barat. Para pendatang yang didominasi generasi milenial ini mayoritas berprofesi sebagai karyawan toko di Mangga Dua dan buruh konveksi. Mereka menempati bangunan semi dan non-permanen di gang-gang sempit, bahkan hingga memenuhi sepanjang pinggir rel kereta api yang melintas di Pademangan, dimana semestinya merupakan jalur hijau. Keberadaan hunian seperti inilah yang membuat Kawasan Pademangan Barat terkesan kumuh, padat dengan bangunan, dan kehilangan ruang hijaunya. Meski hanya berupa bangunan berbahan triplek kayu yang menumpang di dinding pembatas rel kereta, namun kamar-kamar yang disewakan ini begitu diminati bahkan hingga kelebihan kapasitas. Hal ini dikarenakan harga sewanya yang murah dan cukup untuk memenuhi kebutuhan penghuni yang hanya memerlukan tempat beristirahat sementara. Pemerintah sebenarnya telah menyediakan rumah susun murah di Kemayoran, namun tampaknya berpengaruh dalam mengurangi hunian kumuh ini. Hunian sewa vertikal yang sekaligus menyediakan fasilitas bersama, turut berperan sebagai ruang hijau untuk mengimbangi kepadatan bangunan yang ada di Pademangan. Sehingga tidak hanya diperuntukkan bagi penghuni, namun juga dapat digunakan oleh warga sekitarnya, dimana berdasarkan analisa penulis berlokasi di RW 10 Kelurahan Pademangan Barat.

Chip Last Fan Out as an Alternative to Chip First

2015 ◽  
Vol 2015 (1) ◽  
pp. 000245-000250 ◽  
Author(s):  
Scott Chen ◽  
Simon Wang ◽  
Coltrane Lee ◽  
Adren Hsieh ◽  
John Hunt ◽  
...  
Keyword(s):  
Low Cost ◽  
Smart Phone ◽  
High Volume ◽  
Smart Phones ◽  
Portable Devices ◽  
Wafer Level ◽  
Packaging Technology ◽  
Two Factors ◽  
The Cost ◽  
Technology Nodes

Smart phones & other portable devices have dominated Semiconductor growth, and drive IC packages smaller, lighter & thinner, and they continue to integrate more functions in that smaller volume. Besides SOC solutions driven by design houses or system companies, we have seen more packages of Quad Flat Non-lead (QFN), wafer level CSP (WLCSP), and system in package (SIP) being widely used in these smart phones & mobile devices.. Fan out WLCSP (FOWLP) has great potential to be the next new package for the smart phone mobility application. Two factors have driven fan out WLCSP (FOWLP) package technology in the last few years. The first is the advancing technology nodes which allow the shrinkage of die, allowing more die per wafer. However this comes at the cost of reduced package area for I/Os such as solder ball interconnects. The second and potentially more important factor relates to the demand of the market for more functions. Not all silicon functionality benefits from these advanced nodes, and merely adds to the cost of the die. This has driven the designers to partitioning of desired functionality into multiple die, which in turn requires effective interconnection of these separate die. The packaging technology that has evolved to solve these two situations has been Fan Out Wafer Level Packaging (FOWLP). Up to date FOWLP used chip first processing, in which the bare die was molded into a wafer shaped carrier with die pads exposed. Typically sputtering is used to provide interconnects to the die pad followed by patterned electroplating of redistribution lines (RDL) to “Fan Out” the next level interconnect pads to regions that can extend on to the molded material beyond the die perimeter. These processes require the use of relatively expensive semiconductor front end classes of equipment and are tailored to handle the reconstituted molded plastic wafers. We will describe a new alternative to chip first FOWLP, an alternative which meets the needs of a large percentage of the applications requiring a packaging technology such as FOWLP. This new package has been in production in ASE for over a year, and uses a “Chip Last” approach to the problem of increasing useable interconnect pad area. Die which have been bumped with Copper(Cu) Pillars are mass reflowed onto a low cost coreless substrate, followed by over molding which also serves as the die underfill. The Cu pillars allow direct connection to die pads at 50 μm pitch or below, negating the requirement for RDL formation on the die. The use of embedded traces allows for fine lines and spaces down to 15μm or less, and bonding directly on to the bare Copper. The Cu Pillars are bonded to one side of the Copper trace, and the solderballs or LGA pads are directly on the opposite side of the Copper. This makes the substrate to be effectively only as thick as the Copper used in the traces, and allows the final package to be as thin as 400μm. Since this uses existing high volume packaging infrastructures, more complex assemblies including multiple die, inclusion of passive components, and 3D structures can be easily implemented. We have designated this package structure “Fan Out Chip Last Package (FOCLP)” For higher end applications we will show the ability to use a high density substrate process for use in more demanding chip last fan out packages

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