School of Public Health, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
BMC Pregnancy Childbirth. 2018 Oct 3;18(1):390. doi: 10.1186/s12884-018-2019-3.
The main intervention under ReMiND program consisted of a mobile health application which was used by community health volunteers, called ASHAs, for counselling pregnant women and nursing mothers. This program was implemented in two rural blocks in Uttar Pradesh state of India with an overall aim to increase quality of health care, thereby increasing utilization of maternal & child health services. The aim of the study was to assess annual & unit cost of ReMiND program and its scale up in UP state.
Economic costing was done from the health system and patient's perspectives. All resources used during designing & planning phase i.e., development of application; and implementation of the intervention, were quantified and valued. Capital costs were annualised, after assessing their average number of years for which a product could be used and accounting for its depreciation. Shared or joint costs were apportioned for the time value a resource was utilized under intervention. Annual cost of implementing ReMiND in two blocks of UP along and unit cost per pregnant woman were estimated. Scale-up cost for implementing the intervention in entire state was calculated under two scenarios - first, if no extra human resource were employed; and second, if the state government adopted the same pattern of human resource as employed under this program.
The annual cost for rolling out ReMiND in two blocks of district Kaushambi was INR 12.1 million (US $ 191,894). The annualised start-up cost constituted 9% of overall cost while rest of cost was attributed to implementation of the intervention. The health system program costs in ReMiND were estimated to be INR 31.4 (US $ 0.49) per capita per year and INR 1294 (US $ 20.5) per registered women. The per capita incremental cost of scale up of intervention in UP state was estimated to be INR 4.39 (US $ 0.07) when no additional supervisory staffs were added.
The cost of scale up of ReMiND in Uttar Pradesh is 6% of annual budget for 'reproductive and child health' line item under state budget, and hence appears to be financially sustainable.
ReMiND 项目的主要干预措施包括一个移动健康应用程序，由社区卫生志愿者（称为 ASHAs）用于为孕妇和哺乳期妇女提供咨询。该项目在印度北方邦的两个农村地区实施，旨在提高医疗质量，从而增加母婴保健服务的利用率。本研究旨在评估 ReMiND 项目的年度和单位成本及其在北方邦的扩大规模。
从卫生系统和患者的角度进行了经济成本核算。在设计和规划阶段使用的所有资源，即应用程序的开发；以及干预措施的实施，都进行了量化和评估。资本成本在评估产品的平均使用年限并考虑折旧后，按年摊销。共享或共同成本按资源在干预措施下使用的时间价值进行分配。估计了在北方邦的两个街区实施 ReMiND 的年度成本以及每位孕妇的单位成本。在两种情况下计算了在整个州实施干预措施的扩展成本：第一，如果不雇用额外的人力资源；第二，如果州政府采用与该项目相同的人力资源模式。
在 Kaushambi 区的两个街区推出 ReMiND 的年度成本为 1210 万印度卢比（191894 美元）。启动年度成本占总成本的 9%，其余成本归因于干预措施的实施。ReMiND 的卫生系统项目成本估计为每人每年 31.4 印度卢比（0.49 美元），每位登记妇女 1294 印度卢比（20.5 美元）。当不增加额外的监督人员时，北方邦扩大干预措施的人均增量成本估计为 4.39 印度卢比（0.07 美元）。
北方邦扩大 ReMiND 规模的成本占州预算中“生殖和儿童健康”项目年度预算的 6%，因此在财务上似乎是可持续的。
