Bahuguna Pankaj, Khanduja Puneet, Prinja Shankar
School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Community Med. 2019 Apr-Jun;44(2):147-151. doi: 10.4103/ijcm.IJCM_253_18.
We estimated the unit costs for implementing postpartum intrauterine contraceptive device (PPIUCD) services from the perspective of both health system and development agencies.
Seven districts from two Indian states, i.e., Uttarakhand (UK) and Madhya Pradesh (MP), were selected to study the cost of PPIUCD service. Data on costs incurred both by health system and development agencies for PPIUCD service were collected. Unit costs were estimated for providing PPIUCD and IUCD services by state and district level of care in public health-care system. We also estimated unit cost per couple-year protected (CYP) by the level of the health facility.
We found that the unit cost per PPIUCD insertion including all costs, i.e., for service delivery and program support, was INR 522 ($8.7) and INR 502 ($8.4) in MP and UK, respectively. Similarly, the unit costs per interval IUCD insertion were INR 287 ($4.8) in UK and INR 281 ($4.7) in MP. Development partners have a share of >50% in overall costs. From a health system's perspective, PPIUCD and interval IUCD cost per CYP at the level of district hospital were INR 440 ($7.3) and INR 449 ($7.5), respectively.
In India, PPIUCD, being a low-cost procedure, should be considered as a primary strategy targeted toward pregnancy spacing over other contraceptory methods.
我们从卫生系统和发展机构的角度估算了实施产后宫内节育器（PPIUCD）服务的单位成本。
从印度的两个邦，即北阿坎德邦（UK）和中央邦（MP）选取了7个地区，研究PPIUCD服务的成本。收集了卫生系统和发展机构在PPIUCD服务上产生的成本数据。估算了在公共卫生保健系统中，按邦和地区护理级别提供PPIUCD和宫内节育器（IUCD）服务的单位成本。我们还按卫生设施级别估算了每对夫妇年保护（CYP）的单位成本。
我们发现，包括所有成本（即服务提供和项目支持）在内，MP邦和UK邦每次PPIUCD插入的单位成本分别为522印度卢比（8.7美元）和502印度卢比（8.4美元）。同样，UK邦每次IUCD间隔插入的单位成本为287印度卢比（4.8美元），MP邦为281印度卢比（4.7美元）。发展伙伴在总成本中所占份额超过50%。从卫生系统的角度来看，地区医院级别每CYP的PPIUCD和IUCD间隔成本分别为440印度卢比（7.3美元）和449印度卢比（7.5美元）。
在印度，PPIUCD作为一种低成本程序，应被视为相对于其他避孕方法而言针对生育间隔的主要策略。
