a comparison of ovc costs in ethiopia and botswana
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What Does it Cost to Raise an Orphan?. A Comparison of OVC Costs in Ethiopia and Botswana. Daniel Telake , Constance Formson , Steven Forsythe Health Policy Initiate, Task Order 1. Why Cost OVC Programs?. Budgeting for current and future needs Resource allocation - PowerPoint PPT PresentationTRANSCRIPT
AIDS 2012 - Turning the Tide Together
What Does it Cost to Raise an Orphan?
A Comparison of OVC Costs in Ethiopia and Botswana
Daniel Telake, Constance Formson, Steven ForsytheHealth Policy Initiate, Task Order 1
Why Cost OVC Programs?
• Budgeting for current and future needs• Resource allocation• Understand what are the cost drivers• Cost-effectiveness analysis
Background:Comparison of Two Countries
Ethiopia Botswana
Population 82,950,000 2,070,000
GDP per Capita $358 $7,403
Adult (15-49) HIV Prevalence 1.5% 25%
Population per km 72 3
Cost of 1 liter of milk $0.85 $1.63
Children orphaned by all causes 5,450,000 130,000
Orphans per capita 6.6% 6.3%
Total Adult Literacy 30 84
2
Approach
Sites Costed
• 19 Sites Costed in Ethiopia• 19 Sites Costed in Botswana
Location of Costed OVC Sites
Costing Approach
• Economic Costing – All resources were assigned a value, including
donated items• Initial study not designed to assess
effectiveness of services
Costing Approach
• All Costs Disaggregated to one of seven OVC Services– Economic Strengthening/Income Generation– Food & Nutrition– Shelter and Care/Clothing and Bedding– Education– Health Care– Psychosocial Support (PSS)– Child Protection/Legal Support
Results
Cost per OVC Reached
Ethiopia Botswana$0
$100$200$300$400$500$600$700$800$900
$1,000
$80
$946
Ethiopia
Median Number of OVC Reached
Ethiopia Botswana0
500
1,000
1,500
2,000
2,500
3,000
2,400
138
Variation in Unit Cost by Scale
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000$10
$100
$1,000
$10,000
$100,000
Botswana Ethiopia
Number of OVC Reached/Year
Cost
per
OVC
Rea
ched
(US$
)
Percentage of Children Receiving Each Service
Economic S
trength
ening/I
GA
Food/N
utrition
Shelt
er & Care
Educati
on
Health
Care PSS
Child Protec
tion/Lega
l Support
0%
20%
40%
60%
80%
100%
7%
55%
15%
75%86% 86%
45%
9%
38%
5%
40%
11%
76%
1%
Ethiopia Botswana
Unit Cost by Service
Economic S
trength
ening/IGA
Food/N
utrition
Shelte
r & Care
Education
Health Care PSS
Child Protecti
on/Lega
l Support
$1
$10
$100
$1,000
$10,000
$181$64
$33 $21
$6 $4
$1
$220$433
$2,388
$512 $331 $220 $189
Ethiopia Botswana
Distribution of Costs
Ethiopia
Botswana
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
LaborMaterialsEquipmentTransportationOverhead
Conclusions
Conclusions
• The cost of the OVC program is substantially higher in Botswana (US$946) than in Ethiopia (US$80).
• Despite the lower cost in Ethiopia, the number of services provided per child is greater in Ethiopia.
Conclusions (2)• The higher cost in Botswana is in part due to
scale (Ethiopia’s OVC programs are, on average, 17 times larger than those in Botswana).
• The cost components in Botswana and Ethiopia are comparable, although Botswana’s program is more labor-intensive and Ethiopia’s programs have lower overhead costs.
• Some of the cost differences are due to cost of living, geographic and demographic differences.
Conclusions (3)
• The analysis cannot determine which program is more cost-effective, but this cost analysis is the first step in evaluating cost-effectiveness.