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 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 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 Barriers and Strategies for Better Safety Practices: The Case of Construction SMEs in Malaysia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sheila Belayutham ◽  
Che Khairil Izam Che Ibrahim
Keyword(s):  
Construction Industry ◽  
Safety Culture ◽  
Intervention Study ◽  
Safety Training ◽  
Construction Sites ◽  
Safety Practices ◽  
Funding Mechanism ◽  
Implementation Costs ◽  
The Government ◽  
The Cost

Despite the various efforts that have been made by the government and construction authorities to strengthen safety practices among SMEs in Malaysia, the construction SMEs are still unable to demonstrate good safety practices. As part of a wider intervention study to improve the safety practices of the SMEs, this study has taken the first step in identifying the barriers and strategies to improve the safety practices at construction sites in Malaysia. The study has been conducted using various approaches (workshops, site observation and questionnaire survey) that have enabled the triangulation of information. The findings highlighted that the main barriers to good safety practices are the implementation costs, poor safety culture and lack of safety commitment from the client. The proposed solutions include introducing safety as one of the construction KPIs, creating more safety-conscious culture and establishing a funding mechanism to support the cost of safety training. Subsequently, several recommendations have been provided by collating inputs based on the barriers, strategies and drivers through three-party collaboration (authorities, industry and academia) in creating  a collaborative movement towards enhancing safety practices among the SMEs. The fresh insights from this study would enable authorities and SMEs to be more proactive, rather than reactive in improving safety practices in the construction industry.

The cost-effectiveness of insulin analogs and regular insulin for diabetes control: a case study in Iran

2020 ◽  
Vol 33 (4/5) ◽  
pp. 323-331
Author(s):  
Mohsen pakdaman ◽  
Raheleh akbari ◽  
Hamid reza Dehghan ◽  
Asra Asgharzadeh ◽  
Mahdieh Namayandeh
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Regular Insulin ◽  
Diabetes Control ◽  
Diabetic Patients ◽  
Insulin Analogs ◽  
Content Type ◽  
Patients With Diabetes ◽  
The Government ◽  
The Cost

PurposeFor years, traditional techniques have been used for diabetes treatment. There are two major types of insulin: insulin analogs and regular insulin. Insulin analogs are similar to regular insulin and lead to changes in pharmacokinetic and pharmacodynamic properties. The purpose of the present research was to determine the cost-effectiveness of insulin analogs versus regular insulin for diabetes control in Yazd Diabetes Center in 2017.Design/methodology/approachIn this descriptive–analytical research, the cost-effectiveness index was used to compare insulin analogs and regular insulin (pen/vial) for treatment of diabetes. Data were analyzed in the TreeAge Software and a decision tree was constructed. A 10% discount rate was used for ICER sensitivity analysis. Cost-effectiveness was examined from a provider's perspective.FindingsQALY was calculated to be 0.2 for diabetic patients using insulin analogs and 0.05 for those using regular insulin. The average cost was $3.228 for analog users and $1.826 for regular insulin users. An ICER of $0.093506/QALY was obtained. The present findings suggest that insulin analogs are more cost-effective than regular insulin.Originality/valueThis study was conducted using a cost-effectiveness analysis to evaluate insulin analogs versus regular insulin in controlling diabetes. The results of study are helpful to the government to allocate more resources to apply the cost-effective method of the treatment and to protect patients with diabetes from the high cost of treatment.

scholarly journals Protocol for establishing an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) for integrating care of communicable and non-communicable diseases using tuberculosis and diabetes as a case study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041521
Author(s):  
Stellah G Mpagama ◽  
Kaushik Ramaiya ◽  
Troels Lillebæk ◽  
Blandina T Mmbaga ◽  
Marion Sumari-de Boer ◽  
...  
Keyword(s):  
Operational Research ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Learning System ◽  
Management Approach ◽  
African Countries ◽  
Non Communicable Diseases ◽  
Research Outcomes ◽  
The Government

IntroductionMost sub-Saharan African countries endure a high burden of communicable infections but also face a rise of non-communicable diseases (NCDs). Interventions targeting particular epidemics are often executed within vertical programmes. We establish an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) model with three domains; stepwise training approach, integration of communicable and NCDs and a learning system. The model aims to shift traditional vertical programmes to an adaptive diseases management approach through integrating communicable and NCDs using the tuberculosis (TB) and diabetes mellitus (DM) dual epidemic as a case study. We aim to describe the ADEPT protocol with underpinned implementation and operational research on TB/DM.Methods and analysisThe model implement a collaborative TB and DM services protocol as endorsed by WHO in Tanzania. Evaluation of the process and outcomes will follow the logic framework. A mixed research design with both qualitative and quantitative approaches will be used in applied research action. Anticipated implementation research outcomes include at the health facilities level for organising TB/DM services, pathways of patients with TB/DM seeking care in different health facilities, factors in service delivery that need deimplementation and the ADEPT model implementation feasibility, acceptability and fidelity. Expected operational research outcomes include additional identified patients with dual TB/DM, the prevalence of comorbidities like hypertension in patients with TB/DM and final treatment outcomes of TB/DM including treatment-related complications. Findings will inform the future policies and practices for integrating communicable and NCDs services.Ethics and disseminationEthical approval was granted by The National Research Health Ethical Committee (Ref-No. NIMR/HQ/R.8a/Vol.IX/2988) and the implementation endorsed by the government authorities. Findings will be proactively disseminated through multiple mechanisms including peer-reviewed journals, and engagement with various stakeholders’ example in conferences and social media.

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