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. 2017 Nov 17;17(1):742.
doi: 10.1186/s12913-017-2676-3.

Cost of delivering health care services at primary health facilities in Ghana

Maxwell Ayindenaba Dalaba  1 , Paul Welaga  2 , Chieko Matsubara  3
Affiliations

Cost of delivering health care services at primary health facilities in Ghana

Maxwell Ayindenaba Dalaba et al. BMC Health Serv Res. .

Abstract

Background: There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana.

Methods: The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs) from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD) attendance were estimated.

Results: The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC). The cost per OPD attendance was higher at CHPS (US$8.79) than at HCs (US$5.16). The average Internally Generated Funds (IGF) recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS) reimbursement was the main source of revenue accounting for over 90% total IGF.

Conclusions: The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar studies involving large numbers of primary health facilities in different parts of the country are needed to assess the cost of providing primary health care.

Keywords: Community-based Health Planning and Services; Cost; Ghana; Health centre; Primary health care; Upper West Region.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the Navrongo Health Research Centre Institutional Review Board (Approval ID: NHRCIRB232) and the National Center for Global Health and Medicine (NCGM), Japan (Approval ID: NCGM-G-0020510-00). Permission was also sought from the regional health directorate of the Upper West Region, district health directorate of Wa West, Nadowli and Sissala East as well as the heads of the health facilities included in the study.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Sampling strategy
See this image and copyright information in PMC

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References

    1. Hixon AL, Maskarinec GG. The declaration of Alma Ata on its 30th anniversary: relevance for family medicine today. Fam Med. 2008;40:585–588. - PubMed
    1. Alam K, Ahmed S. Cost recovery of NGO primary health care facilities: a case study in Bangladesh. Cost Eff Resour Alloc CE. 2010;8:12. doi: 10.1186/1478-7547-8-12. - DOI - PMC - PubMed
    1. Sakeah E, McCloskey L, Bernstein J, Yeboah-Antwi K, Mills S, Doctor HV. Is there any role for community involvement in the community-based health planning and services skilled delivery program in rural Ghana? BMC Health Serv Res. 2014;14:340. doi: 10.1186/1472-6963-14-340. - DOI - PMC - PubMed
    1. WHO. WHO | What is universal coverage? [Internet]. 2017. Available from: http://www.who.int/health_financing/universal_coverage_definition/en.
    1. Awoonor-Williams JK, Sory EK, Nyonator FK, Phillips JF, Wang C, Schmitt ML. Lessons learned from scaling up a community-based health program in the upper east region of northern Ghana. Glob Health Sci Pract. 2013;1:117–133. doi: 10.9745/GHSP-D-12-00012. - DOI - PMC - PubMed