Estimating the costs of providing basic community health services in Aceh, Indonesia
Collaborative research between:
- Nossal Institute of Global Health (UoM) : Dr Krishna Hort, Dr Asnawi Abdullah
- Provincial Health Office, Province of Nanggroe Aceh Darussalam: drg T Azwar, Head, Planning and Monitoring Division
This research developed from the reconstruction and re-development response to the Tsunami. The Aceh Provincial Health Office (PHO) identified a need for a model to calculate the costs of providing six basic community health programs to the standard required by the national minimum service standards. This would assist provincial and district health offices in preparing more accurate budgets for operational costs to be submitted to local governments for funding.
During the first phase in 2007, with funding support from World Vision Australia, the researchers developed a model of standard activities and required cost data which calculated costs per population target unit for the six programs. During 2008, this model was field tested in 12 Puskesmas (community health centres) in 3 districts of Aceh. Preliminary estimates are that operational costs range from Rp 56,000 (AUD $7) to Rp 72,000 (AUD $9) per head of population served. The researchers will now work with provincial and district health offices to assist them to use the model for calculation of budget estimates for 2010.
Further study is proposed in 2009 to extend this work to the measurement of efficiency of service provision at community health centre level, using frontier production functions. This aims to improve our understanding of how variations in Puskesmas funding and operations contribute to variations in efficiency, and to identify Puskesmas which are able to operate more efficiently and still deliver services to required levels of population coverage.