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Operational costs

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OPERATIONAL cost components: possible sources of information





NB Information for many categories may be available from the Multi-year plan and/or recent EPI assessments (especially costing and financing studies).



Cost category Source of Information



Vaccines

1. Recommended costing method: Stock levels

Information needed  The vaccine logistics person at the central cold room should have records of all shipments of vaccines at the national level, including

1. Quantities of vaccines invoices and receipts. The number of doses supplied to the national level for routine immunization should be consistent with the

received during the year information reported to the UNICEF-WHO Joint Reporting Form.

2. Stock of vaccines at the  If the vaccines are externally financed, international donors in the country (e.g. UNICEF) will also have records of vaccine supplies,

beginning of the year including unit prices.

3. Quantities remaining in

stock at the end of the

year

4. Vaccine unit prices

2. Alternate costing method: Actual annual vaccine purchases

Information needed  If the vaccines are externally financed, international donors in the country (e.g. UNICEF, JICA…) will have records of vaccine supplies,

1. Total number of doses including unit prices.

supplied  Countries using local procurement systems for vaccines and purchasing directly through the market should have records and invoices on the

2. Price per dose (including purchase of vaccines (including unit prices).

freight)  Countries that have a line item for vaccines in their national budget can get information from government expenditure statements at the

Ministry of Health or Ministry of Finance.

Injection supplies

1. Recommended costing method: Based on immunization practice for each vaccine

Information needed  Information on total annual doses supplied of each vaccine should be available from the vaccines logistics person at the central cold room.

1. Type and cost of syringe This same information is needed to calculate vaccine costs.

for each type of vaccine  Relevant information and unit prices may be available from invoices on the purchase of injection supplies.

2. Total number of doses

administered per

vaccine

3. Cost of safety boxes





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Cost category Source of Information



2. Alternate costing method: Actual annual injection supply purchases

Information needed  The supplies and logistics person at the central level should have records of this information through purchase invoices and receipt of

1. Total number of supplies supplies at the national level.

2. Price per unit of supplies  If injection supplies are externally financed, international donors in the country (e.g. UNICEF, JICA…) will have records of shipments of

(including freight) supplies (quantities and unit costs).

 Relevant information and unit prices may be available from invoices on the purchase of injection supplies.

Personnel

1. Recommended costing method: Actual staff numbers, salaries and time spent on immunization

Information needed  Expenditure records and payrolls in the Ministry of Health or Ministry of Finance will have information on salaries, allowances and salary grids

1. Total number of staff, by type of staff. When collecting information on salaries, it is easy to tabulate the total number of workers by category and grade. Then use

by category (eg health salary grades available at the Ministry of Health and apply these to the different categories of personnel.

workers, supervisor, EPI  International donors often pay per diems for outreach and supplemental immunization activities. The per-diems rates should be available

manager) directly from donor agencies present in the country.

2. Monthly salary  Other allowances, bonuses, per-diems, benefits, incentive payments, overtime etc. can be collected from direct interviews with individuals

(including allowances) of and averaged by category of staff. When allowances and bonuses are not available, a rough estimate can be made by assuming that the ratio

each staff category between salaries and allowances for a relevant subgroup can be applied to each individual.

3. % of time each category

of staff works on

immunization

2. Alternate costing method: Average personnel cost per health facility

Information needed  The planning or building departments of the Ministry of Health will be able to provide the total number of health facilities in the country by

1. Total number of staff type (hospitals, provincial hospitals, district health centres, dispensaries, other fixed site).

per health facility  Information on average salaries and average time spent on immunization is likely to come from direct interviews with the representative

2. Average monthly salary health centres chosen.

(including benefits,

allowances)

3. Average time spent on

immunization activities

(including outreach)

4. Total number of health

facilities in country.







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Cost category Source of Information



Transportation

1. Recommended costing method: Actual expenditure records

Information needed  The logistics person at the central level immunization department of the Ministry of Health may have an itemized listing of all vehicles used

1. Types of vehicles (eg for the national immunization program.

cars, four-wheel drives,  Expenditure records may give some indication of the total cost of operating and maintaining vehicles, but it is likely that interviewing drivers

motorcycles, bicycles) and mechanics and consulting logbooks will be needed to get a sufficiently detailed picture.

2. Cost items per type of  Supply records, invoices and receipts for vehicles purchased by international donors are another source of data.

vehicle including fuel,  Drivers and mechanics at the central motor pool at the Ministry of Health can give estimates of total annual cost of operating and maintaining

tyres, spare parts each type of vehicles.

 The UNICEF-WHO product information sheet will have unit prices for different types of vehicles.

 Cost statements, invoices and receipts can give accurate unit prices for vehicles. These should be available at the Ministry of Health at the

central motor pool at the Ministry of Health.

 If the data described above are not available, a rough approximation to annual vehicle capital cost can be obtained from local rates for hiring

the same type of vehicles. In such a case, the cost of vehicles looks like a recurrent, rather than a capital item, but it should be considered a

capital cost.

2. Alternate costing method: Average costs per vehicle

Information needed  The logistics and transportation personnel at the central level immunization department of the Ministry of Health should have an itemised

1. Total number of vehicles listing of all vehicles used for the national immunization program.

(eg cars, four-wheel  Drivers and mechanics at the central motor pool at the Ministry of Health can give estimates of total annual cost of operating and maintaining

drives, motorcycles, each type of vehicles.

bicycles)  Further information can be obtain through access to expenditure records, invoices for vehicle repairs, fuel bills, etc. These may give some

2. Average cost of indication of the total cost of operating and maintaining vehicles.

operating, maintaining

and repairing vehicles

Building & maintenance

1. Recommended costing method: Average based on representative facility

Information needed  The planning or building departments of the Ministry of Health may be able to provide the total number of health facilities in the country by

3. Total number of vehicles type (hospitals, provincial hospitals, district health centres, dispensaries, other fixed site).

(eg cars, four-wheel  As the Ministry of Health usually finances maintenance and overhead costs, it is not uncommon for each health facility to receive monthly,

drives, motorcycles, quarterly or annual funds from the national or sub-national level to cover all operating costs of the health facilities (salaries, maintenance and

bicycles) overhead).





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Cost category Source of Information



4. Average cost of  Accounts for each type of facility (recorded in their expenditure reports) may be available at the Ministry of Health or Ministry of Finance. This

operating, maintaining is one category where recorded expenditure data is quite adequate. Recurrent costs for building will normally be listed under such headings

and repairing vehicles as “Utilities”, “Maintenance”, “Cleaning”, or “Security”.

2. Alternate costing method: Percentage of capital cost

Information needed  This method requires using the costing information calculated for buildings and cold chain equipment under the capital costing section below.

Capital cost of equipment

Short-term training

 Since training is often externally financed, international donors in the country (UNICEF, WHO…) will have records of the funds provided for

training activities and training materials.

 External donors often provide per diems for training sessions (for routine and supplemental immunization activities). The per-diems rates

should be available directly from donor agencies present in the country and should be applied to the number of health staff that attended

training sessions.

Social mobilisation & Information, Education and Communication (IEC)

 Expenditure statements and/or financing records at the Ministry of Health or from international donors in the country (UNICEF, WHO…) that

are supporting this activity.

Surveillance & Monitoring

 Expenditure statements and/or financing records at the Ministry of Health or from international donors in the country (UNICEF, WHO…) that

are supporting this activity.









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