Verbal Autopsy Costing & Budgeting Tool - PowerPoint Presentation

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2. Verbal AutopsyCosting & Budgeting ToolExperience in BrazilDaniel CobosResearch Fellow in Health Systems and Policies SwissTPH Innovation HubDaniel.cobos@swisstph.ch

3. CRVS Innovation Hub

4. CRVS Innovation Hub

5. RationaleRapid developments in VA associated cause of death computer algorithms such as Smart VA, InterVA, InSilico VA that can run mobile tablet-based devices makes the use of VA in routine CRVS a potentially practical undertaking There is little evidence of the cost of VA and no evidence to our knowledge of the cost of VA as part of CRVS routine operationsThere is a pressing need for a tool that can assist countries:Assisting those making budgets for VA by providing detailed frames to consider;Determining VA actual costs once countries start implementing; andModelling costs in alternative scenarios, including the changes in economic costs

6. The tool will help countries to answer the following questions:What are the cost of a verbal autopsy?Which activities have been implemented for VA?What are the personnel requirements for VA?

7. What are the main cost drivers of VA implementation?What are the cost implications for different scale up scenarios?What is the efficiency of the VA implementation?Are there cost saving opportunities?

8. DEVELOPMENT PROCESSReview of the literatureDevelopment of the first prototypePilot in 3 (4) countriesBrazilMyanmarRwandaFinal release of the tool

9. Costing vs BudgetingFuturePastImplementationAccounting systemActual expensesEstimation of potential cost

10. 10 chronic patients7 Antenatal care5 postnatal visits2 VAs$Incremental CostIncremental cost

11. The Tool

12. The Tool

13. The ToolTraining of trainersLaunch of VAServerMeetings of the mortality committeeRefresher trainings for interviewersActivities at the national or regional levelRegular supervisory visitsTime for VA interviewTabletsTraining of trainersLaunch of VAServerMeetings of the mortality committeeRefresher trainings for interviewersActivities at the national or regional levelRegular supervisory visitsTime for VA interviewTablets

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15. Pilot in BrazilData collection in Alagoas (July 2016) and Tocantins (November 2016)3 municipalities in Alagoas and 5 municipalities en TocantinsFirst test of the VA Costing and Budgeting toolExcluded cost of SVO investigation and national level

16. Some results970-980 BRLCost per VA146 VAs in 2015

17. Some resultsVariability in unit cost per VA

18. Some resultsCost drivers in Tocantins and Alagoas

19. Alagoas (Brazil)Some resultsCost drivers in Tocantins and Alagoas

20. BrazilMyanmar5404 VAs conducted146 VAs conductedCOST DRIVERS

21. Bangladesh1660 VAs conductedBrazil146 VAs conductedFUNDING SOURCE

22. Some resultsBrazil146 VAs conductedMyanmar5,404 VAs conducted

23. Some resultsInterviewers450 VA per FTEVA supervisors380 VA per FTEPhysicians710 VA per FTEInterviewers756 VA per FTEVA supervisors10,040 VA per FTEPhysiciansBrazil146 VAs conductedMyanmar5,404 VAs conducted

24. ModelingMyanmar

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26. Way forward for the toolDevelop a training package for D4H countries under developmentSupport from SwissTPH/UoM to use the tool in D4H countriesCountries USE the tool!! Starting with the CRVS Costing Tool

27. Way forward in BrazilUse the results of the costingEstimate the cost with a bigger sampleCompare cost with automated methods and necropsy

28. SummaryThe VA Costing & Budgeting tool is ready with support materialsCountries could use it: to make decisions about scale of VA implementation, to understand the cost implications of VA, orto assess the efficiency of the interventionTraining package and support can be provided from SwissTPH/UoM

29. Muito obrigado!