cost analysis of an llin keep-up channel in ......• itns have since been distributed to...

Table 2. Financial and Economic cost of SNP3 per person year of protection (PYP)

• 494,407 nets were distributed in total by SNP3. • The nets combined provided an ~3 million PYP over the study period. • The �nancial cost per net distributed was ~US$7.54. The economic cost per net distributed was ~US$7.70. • The �nancial cost per person year of protection (PYP) was $1.26. The economic cost per person year of protection (PYP) was $1.28.• The �nancial cost per treated net year (TNY) was $2.51. The economic cost per treated net year (TNY) was $2.57.

Figure 1. Breakdown of �nancial costs by line item

Table 5. Sensitivity Analysis of Selected Parameters

• Changing the exchange rates, discount rate, and useful life of vehicles had a negligible impact on cost per output.

INTRODUCTION• Distributing insecticide-treated nets (ITNs) through schools has been recommended by the WHO as a channel for maintaining universal coverage de�ned as universal access to ITNs. • Little is known about the cost of school-based distribution. • In 2011–2012, Tanzania had reached high levels of coverage (~90%) with ITNs nationwide, • ITNs have since been distributed to schoolchildren in the Southern Zone in Classes 1, 3, 5, and 7 and Forms 2 and 4 once a year as a long-term “keep-up” strategy. • During SNP3, the government distributed 494,407 ITNs through 1,919 schools in 19 districts. • A cost analysis of the School Net Program, Round 3 (SNP3), was implemented in 2015.

METHODS• Intervention description developed based on direct observation, document reviews, and key informant interviews with stakeholders.• The study estimated both economic and �nancial costs from the provider perspective.• The study used a three-year time frame (though all �nancial costs were incurred in a one-year period). • Data on costs collected retrospectively from �nancial and operational records and through stakeholder interviews at the national and regional levels.• The ingredients approach was used. Aggregated expenditure was used as a supplement where necessary. • A survey instrument was used to collect resource use and expenditure information at the district and school levels. • 15 of the 19 districts were sampled, along with two schools from each of those districts.• Average costs for each activity calculated from the sampled districts and schools and applied to those not included.• The primary output measure - number of nets distributed to students. • Person-years of protection (PYP) - calculated assuming that one net can cover two people for a period of three years in the base case scenario.• Treated-net years (TNY) - calculated assuming a lifetime of three years per net in base case scenario.

RESULTSTable 1. Financial and economic cost of SNP3 per treated-net year (TNY)

Table 3. Financial and Economic cost of SNP3 per person year of protection (PYP), paid by international donors

Table 4. Financial and economic cost per treated-net year (TNY), paid by international donors

• The �nancial and economic cost paid by international donor per net distributed were $6.55 and $6.71, respectively.

• The �nancial cost per person year of protection (PYP) was $1.09. The economic cost per person year of protection (PYP) was $1.12.

• The �nancial cost per treated net year (TNY) was $2.18. The economic cost per treated net year (TNY) was $2.24.

CONCLUSIONS• SNP3 delivered ITNs at an economic cost of US$7.70 per net distributed during 2014–2015.

• Of these costs, US$4.33 was for distribution; the remainder was related to the cost of the net itself.

• These costs, as well as the cost per TNY and cost per PYP provided, appear to be reasonable if compared against other continuous ITN distribution systems.

• The most signi�cant cost driver in �nancial terms was the price of ITNs.

• The second most important cost driver was the expenditure on supervision personnel at all levels.

• International donors invested heavily in SNP3, providing ~87% of the �nancial and economic costs, with domestic sources providing ~13%.

• Use of survey instruments can help quantify government resource use at lower levels in the system but should be deployed close to the time of net delivery to minimize information bias and measurement error.

Sara Scates1, Timothy Finn1, Angela Acosta2, Waziri Nyoni2, Renata Mandike3, Ally Mohamed3, Karen Kramer4, George Greer5, Naomi Kaspar5, Joshua Yukich1

1Tulane University School of Public Health and Tropical Medicine, Department of Tropical Medicine and the Center for Applied Malaria Research and Evaluation, New Orleans, LA, United States, 2VectorWorks Project, Johns Hopkins University Center for Communication Programs, Baltimore, MD, United States, 3Tanzania National Malaria Control Program, Dar es Salaam, Tanzania, United Republic of, 4Tanzania National Malaria Control Program,

Swiss Tropical and Public Health Institute, Dar es Salaam, Tanzania, United Republic of, 5U.S. President's Malaria Initiative, Dar es Salaam, Tanzania, United Republic of

Presentation number 1658

COST ANALYSIS OF AN LLIN KEEP-UP CHANNEL IN TANZANIA: THE SCHOOL NET PROGRAM

All Regions

All Regions

Total number of ITNs issued

Person-years protected (PYP)

Financial cost per PYP

Economic cost per PYP

494,407 2,966,442 $1.26 $1.28

All Regions

All Regions

Total number of ITNs issued

Person-years protected (PYP)

Financial cost per PYP

Economic cost per PYP

494,407 2,966,442 $1.09 $1.12

Financial Year 1 Year 2 Year 3 Total

Distribution cost $4.33 $4.33

Financial ITN cost $3.21 $3.21

Total �nancial cost $7.54 $7.54

Number of TNYs 1 1 1 3

Financial cost per TNY $7.54 $0.00 $0.00 $2.51

Economic Year 1 Year 2 Year 3 Total


Economic ITN cost $1.12 $1.12 $1.12 $3.37

Total economic cost $5.45 $1.12 $1.12 $7.70


Economic cost per TNY $5.45 $1.12 $1.12 $2.57

Financial Year 1 Year 2 Year 3 Total


Financial ITN cost $3.21 $3.21

Total �nancial cost $6.55 $6.55


Financial cost per TNY $6.55 $0.00 $0.00 $2.18

Economic Year 1 Year 2 Year 3 Total


Economic ITN cost $1.12 $1.12 $1.12 $3.37

Total economic cost $4.46 $1.12 $1.12 $6.71

Number of TNYs $1.00 $1.00 $1.00 $3.00

Economic cost per TNY $4.46 $1.12 $1.12 $2.24

LLIN Transport

6%

LLIN Storage

2%

SBCC11%

Indirect Costs3%

personnel and fringe

7%Planning and Coordination

4%Quanti�cation

4%Training and

Microplanning 2%

Supervision17%

M & E1%

LLINS43%

Baseline values

Net usage (89%)

Life expectancy of net (2 years)

Number of people per net (2.25)

25% increase in distribution costs

25% decrease in distribution costs

$1.26

$1.41

$1.88

$1.12

$1.44

$1.08

Fin. cost per PYP

$1.28

$1.44

$1.64

$1.14

$1.46

$1.10

Econ. cost per PYP

$2.51

$2.51

$3.77

$2.51

$2.87

$2.15

Fin. cost per TNY

$2.57

$2.57

$3.85

$2.57

$2.93

$2.21

Econ. cost per TNY

$7.54

$7.54

$7.54

$7.54

$8.62

$6.46

Fin. cost per net

This poster is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the President’s Malaria Initiative (PMI) under the terms of USAID/JHU Cooperative Agreement No AID-OAA-A-14-00057. The contents do not necessarily re�ect the views of PMI or the United States Government.

Contact: Sara Scates, [email protected]

cost analysis of an llin keep-up channel in ......• itns have since been distributed to...

Documents