Qalys Health Economics, Middenweg 239 I, 1098AP, Amsterdam, Netherlands.
Nijmegen International Center for Health Systems Research and Education (NICHE), Department of Primary and Community Care, Radboud University Nijmegen Medical Center, 9101, Nijmegen, 6500HB, Netherlands.
Cost Eff Resour Alloc. 2013 Aug 1;11(1):17. doi: 10.1186/1478-7547-11-17.
Policy-makers who are making decisions on sexuality education programs face important economic questions: what are the costs of developing sexuality education programs; and what are the costs of implementing and scaling them up? This study responds to these questions by assessing the costs of six school-based sexuality education programs (Nigeria, Kenya, Indonesia, India, Estonia and the Netherlands).
Cost analyses were carried out in schools that were fully implementing a SE program, as this best reflects the resources needed to run an effective program. The costs were analyzed from the program perspective, meaning that all costs borne by the governmental and (international) non-governmental organizations supporting the program were included. Cost analyses were based on financial records, interviews and school surveys.We distinguished costs in three consecutive program phases: development, update and implementation. Recommendations on the most efficient program characteristics and scale-up pathways were drawn from results of three fully scaled up programs (Estonia, Nigeria and the Netherlands), scale-up scenarios of two pilot programs (Kenya and Indonesia), and an implementation plan (India), The costs of the programs were compared by converting cost per student reached in US dollars (US$) to international dollars (I$).
Findings revealed a range of costs and coverage of sexuality education programs. Costs per student reached were; US$7 in Nigeria, US$13.50 in India, US$33 in Estonia and the Netherlands, US$50 in Kenya, and US$160 in Indonesia.
Intra-curricular sexuality education programs have, because of their compulsory nature, the most potential to be scaled up and are therefore most efficient. Extra-curricular sexuality education programs have lower potential to be scaled up and are therefore less efficient. In terms of class size and number of lessons, countries need to strike a balance between the quality (demanding smaller classes and many lessons) and the costs (demanding larger classes and fewer lessons). Advocacy was a significant cost component.
制定性教育计划政策的决策者面临着重要的经济问题：开发性教育计划的成本是多少；实施和扩大规模的成本是多少？本研究通过评估六项基于学校的性教育计划（尼日利亚、肯尼亚、印度尼西亚、印度、爱沙尼亚和荷兰）的成本来回答这些问题。
在全面实施 SE 计划的学校中进行成本分析，因为这最能反映运行有效计划所需的资源。从项目角度分析成本，即包括支持项目的政府和（国际）非政府组织承担的所有成本。成本分析基于财务记录、访谈和学校调查。我们将成本分为三个连续的项目阶段进行区分：开发、更新和实施。从三个全面扩大规模的项目（爱沙尼亚、尼日利亚和荷兰）、两个试点项目的扩大方案（肯尼亚和印度尼西亚）和一个实施计划（印度）的结果中得出了关于最有效项目特征和扩大规模途径的建议。通过将每个学生的成本转换为美元（美元）到国际美元（I$）来比较项目成本。
研究结果揭示了性教育计划的一系列成本和覆盖范围。每个学生的成本为：尼日利亚为 7 美元，印度为 13.50 美元，爱沙尼亚和荷兰为 33 美元，肯尼亚为 50 美元，印度尼西亚为 160 美元。
课程内的性教育计划由于其强制性，具有最大的扩大规模潜力，因此效率最高。课外性教育计划扩大规模的潜力较低，因此效率较低。就班级规模和课程数量而言，各国需要在质量（要求小班和多节课）和成本（要求大班和少节课）之间取得平衡。倡导是一个重要的成本组成部分。
