a comparison of ovc costs in ethiopia and botswana
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What Does it Cost to Raise an Orphan?. A Comparison of OVC Costs in Ethiopia and Botswana. Daniel Telake , Constance Formson , Steven Forsythe Health Policy Initiate, Task Order 1. Why Cost OVC Programs?. Budgeting for current and future needs Resource allocation - PowerPoint PPT PresentationTRANSCRIPT
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AIDS 2012 - Turning the Tide Together
What Does it Cost to Raise an Orphan?
A Comparison of OVC Costs in Ethiopia and Botswana
Daniel Telake, Constance Formson, Steven ForsytheHealth Policy Initiate, Task Order 1
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Why Cost OVC Programs?
• Budgeting for current and future needs• Resource allocation• Understand what are the cost drivers• Cost-effectiveness analysis
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Background:Comparison of Two Countries
Ethiopia Botswana
Population 82,950,000 2,070,000
GDP per Capita $358 $7,403
Adult (15-49) HIV Prevalence 1.5% 25%
Population per km 72 3
Cost of 1 liter of milk $0.85 $1.63
Children orphaned by all causes 5,450,000 130,000
Orphans per capita 6.6% 6.3%
Total Adult Literacy 30 84
2
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Approach
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Sites Costed
• 19 Sites Costed in Ethiopia• 19 Sites Costed in Botswana
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Location of Costed OVC Sites
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Costing Approach
• Economic Costing – All resources were assigned a value, including
donated items• Initial study not designed to assess
effectiveness of services
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Costing Approach
• All Costs Disaggregated to one of seven OVC Services– Economic Strengthening/Income Generation– Food & Nutrition– Shelter and Care/Clothing and Bedding– Education– Health Care– Psychosocial Support (PSS)– Child Protection/Legal Support
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Results
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Cost per OVC Reached
Ethiopia Botswana$0
$100$200$300$400$500$600$700$800$900
$1,000
$80
$946
Ethiopia
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Median Number of OVC Reached
Ethiopia Botswana0
500
1,000
1,500
2,000
2,500
3,000
2,400
138
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Variation in Unit Cost by Scale
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000$10
$100
$1,000
$10,000
$100,000
Botswana Ethiopia
Number of OVC Reached/Year
Cost
per
OVC
Rea
ched
(US$
)
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Percentage of Children Receiving Each Service
Economic S
trength
ening/I
GA
Food/N
utrition
Shelt
er & Care
Educati
on
Health
Care PSS
Child Protec
tion/Lega
l Support
0%
20%
40%
60%
80%
100%
7%
55%
15%
75%86% 86%
45%
9%
38%
5%
40%
11%
76%
1%
Ethiopia Botswana
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Unit Cost by Service
Economic S
trength
ening/IGA
Food/N
utrition
Shelte
r & Care
Education
Health Care PSS
Child Protecti
on/Lega
l Support
$1
$10
$100
$1,000
$10,000
$181$64
$33 $21
$6 $4
$1
$220$433
$2,388
$512 $331 $220 $189
Ethiopia Botswana
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Distribution of Costs
Ethiopia
Botswana
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
LaborMaterialsEquipmentTransportationOverhead
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Conclusions
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Conclusions
• The cost of the OVC program is substantially higher in Botswana (US$946) than in Ethiopia (US$80).
• Despite the lower cost in Ethiopia, the number of services provided per child is greater in Ethiopia.
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Conclusions (2)• The higher cost in Botswana is in part due to
scale (Ethiopia’s OVC programs are, on average, 17 times larger than those in Botswana).
• The cost components in Botswana and Ethiopia are comparable, although Botswana’s program is more labor-intensive and Ethiopia’s programs have lower overhead costs.
• Some of the cost differences are due to cost of living, geographic and demographic differences.
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Conclusions (3)
• The analysis cannot determine which program is more cost-effective, but this cost analysis is the first step in evaluating cost-effectiveness.