Human Development Department, Japan International Cooperation Agency (JICA), 3rd floor, Nibancho Center Building, 5-25 Niban-cho, Chiyoda-ku, Tokyo, 102-8012, Japan; Department of Global Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW, 7th floor, Washington, DC, 20052, USA.
Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung, Dong Da district, Hanoi, Viet Nam.
Public Health. 2018 Mar;156:124-131. doi: 10.1016/j.puhe.2017.12.018. Epub 2018 Feb 20.
In Vietnam, there are three major home-based records (HBRs) for maternal and child health (MCH) that have been already nationally scaled up, i.e., Maternal and Child Health Handbook (MCH Handbook), Child Vaccination Handbook, and Child Growth Monitoring Chart. The MCH Handbook covers all the essential recording items that are included in the other two. This overlapping of recording items between the HBRs is likely to result in inefficient use of both financial and human resources. This study is aimed at estimating the magnitude of cost savings that are expected to be realized through implementing exclusively the MCH Handbook by terminating the other two.
Secondary data collection and analyses on HBR production and distribution costs and health workers' opportunity costs.
Through multiplying the unit costs by their respective quantity multipliers, recurrent costs of operations of three HBRs were estimated. Moreover, magnitude of cost savings likely to be realized was estimated, by calculating recurrent costs overlapping between the three HBRs.
It was estimated that implementing exclusively the MCH Handbook would lead to cost savings of United States dollar 3.01 million per annum. The amount estimated is minimum cost savings because only recurrent cost elements (HBR production and distribution costs and health workers' opportunity costs) were incorporated into the estimation. Further indirect cost savings could be expected through reductions in health expenditures, as the use of the MCH Handbook would contribute to prevention of maternal and child illnesses by increasing antenatal care visits and breastfeeding practices.
To avoid wasting financial and human resources, the MCH Handbook should be exclusively implemented by abolishing the other two HBRs. This study is globally an initial attempt to estimate cost savings to be realized through avoiding overlapping operations between multiple HBRs for MCH.
在越南，有三种主要的家庭为基础的母婴健康记录（HBR）已经在全国范围内推广，即《母婴健康手册》（MCH 手册）、儿童疫苗接种手册和儿童生长监测图。《母婴健康手册》涵盖了其他两个手册中包含的所有基本记录项目。这三种 HBR 之间记录项目的重叠可能会导致财务和人力资源的低效利用。本研究旨在通过实施《母婴健康手册》来终止其他两种手册，估计预计可实现的节省成本规模。
对 HBR 制作和分发成本以及卫生工作者机会成本的二次数据收集和分析。
通过乘以单位成本乘以各自的数量乘数，估计了三种 HBR 的运营经常性成本。此外，通过计算三种 HBR 之间重叠的经常性成本，估计了可能实现的节省成本规模。
据估计，仅实施《母婴健康手册》每年将节省 301 万美元。这一估计是最低的节省成本，因为仅纳入了经常性成本要素（HBR 制作和分发成本以及卫生工作者的机会成本）。通过减少卫生支出，还可以预计进一步的间接成本节省，因为使用《母婴健康手册》将通过增加产前保健访问次数和母乳喂养实践来预防母婴疾病，从而有助于减少卫生支出。
为避免浪费财务和人力资源，应通过废除其他两种 HBR 来专门实施《母婴健康手册》。这项研究是全球首次尝试通过避免母婴健康多种 HBR 之间的重叠操作来估计可实现的节省成本。
