Abstract:
Background: Reducing maternal and under-five mortality through the use of cost-effective strategies continues to be a challenge, particularly in Ethiopia. There is a paucity of knowledge on the cost of Maternal and Child Health (MCH) services in Ethiopia. This poses a challenge in the economic evaluation of these services and inhibits policy makers from making decisions about allocation of resources to improve health care. Providing up -to-date information about the costs of MCH services is therefore crucial. This study analyzed the overall cost of providing MCH services in public primary health care facilities around Butajira. Methods: A cross-sectional was carried out between February and June 2014. Six public primary health care facilities in Meskan district were selected randomly for the study. All maternal and child health-care related costs for the year 2012 Gregorian calendar were collected from the public service provider‘s perspective. The step-down allocation approach recommended by the World Health Organization (WHO) was used for the analysis. Results: The total annual cost of operating MCH services in the six primary health care facilities was US$110,182. The total costs attributable to antenatal care (ANC), delivery and postnatal care (PNC) services were US$14,582.7, US$22,324.2 and US$10,089.8 respectively. Medical supplies and personnel accounted for 40 % and 32 % of the total cost respectively. Overall, ANC accounted for 13.2 %, delivery 20.3 % and PNC 9 % of the total cost. Immunization and family planning (FP) comprised 27.0 % and 21.0 % of the total cost. The high costs of immunization and family planning can be attributed to high cost of vaccines and FP methods. The average unit cost was US$ 5.5 per MCH services, ranging from US$ 4.5 per under-five visit to US$ 15.7 per delivery service visit. Conclusion: This study has shown that the unit costs of MCH services provided in the primary health care facilities in a district level can be estimated. It is hoped that this study will provide a basis for further work of a similar nature. The results obtained in studies of this sort will provide useful information on the cost of various services in other primary health care unit setting. Total and unit costs at service delivery points can be used for cost effectiveness analyses of MCH services and projected into the future. Keywords: Total cost, unit cost, Antenatal care, postnatal care, Delivery, immunization and under five.