Cost and Cost Effectiveness of Public-Private Mix DOTS for Tuberculosis Control: A Case Study of District Chitral, KPK
Author: Farooq Ahmad

We assessed the cost and cost effectiveness of public private mix (PPM) directly observed treatment short course (DOTS) for tuberculosis control programs in mountainous district Chitral, Khyber Pakhtunkhwa. The study compared three strategies for the tuberculosis control under DOTS strategy in Chitral. The strategies for tuberculosis control which were included in the study were public sector, Aga Khan Health Service and Green Star Social Marketing. We collected cost and effectiveness data for all three strategies. Separate standardized questionnaire and interviews were used to collect providers’ costs and a questionnaire were generated to collect patient and their escorts’ costs. For that 165 patients and their treatment supporter were interviewed. Societal prospective were used to collect cost data. Successfully treated patients were used as a measure of effectiveness. The important sources of data are hospital expenditure records, finance unit and consultation with responsible staff members at district level and national tuberculosis control program Pakistan. To measure cost effectiveness both average and incremental cost effectiveness ratios were used. The total cost for public sector program was Rs.8134270, Rs.2543959 was estimated for Aga Khan Health Service (AKHS) and for Green Star Social Marketing (GSSM) it was Rs. 587357. The average cost per successfully treated patient were Rs.13119.8, Rs. 41031.6 and Rs. 13052.4 respectively. The average costs of public facility and GSSM nearly equal and we are unable to conclude which program is cost effective. After adding patients and their escorts costs to the total of public facility the GSSM becomes cost effective compared to public facility. In public facility the number of successfully treated patients were high and per patient cost is lower than the two programs. In term of incremental cost effectiveness ratio AKHS was cost effective strategy than GSSM. The average opportunity cost of patient was Rs.464.84. Supervisor:- Dr. Mahmood Khalid

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Keywords : Cost, KPK, Public-Private Mix DOTS, Tuberculosis
Supervisor: Mahmood Khalid

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