Potential uses of cost analyses in child survival programmes: evidence from Africa

How can analyses of costs and cost-effectiveness help international health care specialists to monitor service delivery, evaluate activities, plan for improvements in programmes, and arrange for adequate financing? Answers illustrated in this paper include comparison of the average costs of specific services among local health care facilities for monitoring and supervision purposes; interpretation of total and average costs to increase programme efficiency; consideration of the relative cost-effectiveness of various immunization strategies; projection of recurrent costs to indicate the magnitude of future financing needs; and, derivation of information incidental to cost analyses, but essential to programme operations and personnel management. Supportive examples include results from child survival programmes in Africa, with particular emphasis on evaluations of some national programme components from the Combatting Childhood Communicable Diseases (CCCD) Project.