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How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations
BACKGROUND: In most low- and middle-income countries, health facility regulation is fragmented, ineffective and under-resourced. The Kenyan Government piloted an innovative regulatory regime involving Joint Health Inspections (JHI) which synthesized requirements across multiple regulatory agencies;...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9664811/ https://www.ncbi.nlm.nih.gov/pubmed/36376860 http://dx.doi.org/10.1186/s12913-022-08727-3 |
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author | Chege, Timothy Wafula, Francis Tama, Eric Khayoni, Irene Ogira, Dosila Gitau, Njeri Goodman, Catherine |
author_facet | Chege, Timothy Wafula, Francis Tama, Eric Khayoni, Irene Ogira, Dosila Gitau, Njeri Goodman, Catherine |
author_sort | Chege, Timothy |
collection | PubMed |
description | BACKGROUND: In most low- and middle-income countries, health facility regulation is fragmented, ineffective and under-resourced. The Kenyan Government piloted an innovative regulatory regime involving Joint Health Inspections (JHI) which synthesized requirements across multiple regulatory agencies; increased inspection frequency; digitized inspection tools; and introduced public display of regulatory results. The pilot significantly improved regulatory compliance. We calculated the costs of the development and implementation of the JHI pilot and modelled the costs of national scale-up in Kenya. METHODS: We calculated the economic costs of three phases: JHI checklist development, start-up activities, and first year of implementation, from the providers’ perspective in three pilot counties. Data collection involved extraction from expenditure records and key informant interviews. The annualized costs of JHI were calculated by adding annualized development and start-up costs to annual implementation costs. National level scale-up costs were also modelled and compared to those of current standard inspections. RESULTS: The total economic cost of the JHI pilot was USD 1,125,600 (2017 USD), with the development phase accounting for 19%, start-up 43% and the first year of implementation 38%. The annualized economic cost was USD 519,287, equivalent to USD 206 per health facility visit and USD 311 per inspection completed. Scale up to the national level, while replacing international advisors with local staff, was estimated to cost approximately USD 4,823,728, equivalent to USD 103 per health facility visit and USD 155 per inspection completed. This compares to an estimated USD 86,997 per year (USD 113 per inspection completed) spent on a limited number of inspections prior to JHI. CONCLUSION: Information on costs is essential to consider affordability and value for money of regulatory interventions. This is the first study we are aware of costing health facility inspections in sub-Saharan Africa. It has informed debates on appropriate inspection design and potential efficiency gains. It will also serve as an important benchmark for future studies, and a key input into cost-effectiveness analyses. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08727-3. |
format | Online Article Text |
id | pubmed-9664811 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96648112022-11-15 How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations Chege, Timothy Wafula, Francis Tama, Eric Khayoni, Irene Ogira, Dosila Gitau, Njeri Goodman, Catherine BMC Health Serv Res Research BACKGROUND: In most low- and middle-income countries, health facility regulation is fragmented, ineffective and under-resourced. The Kenyan Government piloted an innovative regulatory regime involving Joint Health Inspections (JHI) which synthesized requirements across multiple regulatory agencies; increased inspection frequency; digitized inspection tools; and introduced public display of regulatory results. The pilot significantly improved regulatory compliance. We calculated the costs of the development and implementation of the JHI pilot and modelled the costs of national scale-up in Kenya. METHODS: We calculated the economic costs of three phases: JHI checklist development, start-up activities, and first year of implementation, from the providers’ perspective in three pilot counties. Data collection involved extraction from expenditure records and key informant interviews. The annualized costs of JHI were calculated by adding annualized development and start-up costs to annual implementation costs. National level scale-up costs were also modelled and compared to those of current standard inspections. RESULTS: The total economic cost of the JHI pilot was USD 1,125,600 (2017 USD), with the development phase accounting for 19%, start-up 43% and the first year of implementation 38%. The annualized economic cost was USD 519,287, equivalent to USD 206 per health facility visit and USD 311 per inspection completed. Scale up to the national level, while replacing international advisors with local staff, was estimated to cost approximately USD 4,823,728, equivalent to USD 103 per health facility visit and USD 155 per inspection completed. This compares to an estimated USD 86,997 per year (USD 113 per inspection completed) spent on a limited number of inspections prior to JHI. CONCLUSION: Information on costs is essential to consider affordability and value for money of regulatory interventions. This is the first study we are aware of costing health facility inspections in sub-Saharan Africa. It has informed debates on appropriate inspection design and potential efficiency gains. It will also serve as an important benchmark for future studies, and a key input into cost-effectiveness analyses. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08727-3. BioMed Central 2022-11-14 /pmc/articles/PMC9664811/ /pubmed/36376860 http://dx.doi.org/10.1186/s12913-022-08727-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Chege, Timothy Wafula, Francis Tama, Eric Khayoni, Irene Ogira, Dosila Gitau, Njeri Goodman, Catherine How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations |
title | How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations |
title_full | How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations |
title_fullStr | How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations |
title_full_unstemmed | How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations |
title_short | How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations |
title_sort | how much does effective health facility inspection cost? an analysis of the economic costs of kenya’s joint health inspection innovations |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9664811/ https://www.ncbi.nlm.nih.gov/pubmed/36376860 http://dx.doi.org/10.1186/s12913-022-08727-3 |
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