4272.0: Tuesday, November 14, 2000 - 4:30 PM

Abstract #12447

A costing tool for achieving greater equity and efficiency

David Collins, MA and Vishal Brijlal. Equity Project, South Africa, Management Sciences for Health, Bisho, South Africa

To rectify the inequities of access to health care inherited from the apartheid system, the South African government has committed to making a package of primary health care services available to all citizens. While the elements of the package have been determined, the mechanisms used to deliver services in each province may vary depending on the cost of services and the amount of available funding.

The Equity project is using the Tool for Cost and Revenue Assessment (CORE) to estimate the cost of providing a package of primary health services to different populations in the Eastern Cape and elsewhere in South Africa. This paper presents the results of this work in the form of a case study.

The analysis suggests that the current service delivery model is appropriate for relatively large and dense populations. Per capita costs rise sharply, however, as catchment populations decrease. The implications of this result are analyzed from the perspective of equity. Should an equity strategy be to apply similar delivery models in both urban and rural areas, or should the strategy be to provide the best possible service for equal expenditure? Given that per capita health expenditure is generally less, not more, for rural populations, the paper suggests that equal per capita expenditure for primary care services may be a useful target.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will have: 1) A greater knowledge of health disparities in South Africa 2)A greater knowledge of how the Equity project is estimating the cost of a primary health services package to various populations in South Africa

Keywords: Access to Health Care, Cost Issues

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: USAID (funding of the EQUITY Project supporting health systems development in South Africa); Management Sciences for Health (technical assistance under the EQUITY Project)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment with MSH

The 128th Annual Meeting of APHA