Mobile Outreach Services for Family Planning in Tanzania: A Cost Analysis
Report No. 14, October 2013
Mobile outreach is a vital service delivery approach to expand access to long-acting and permanent methods of contraception (LA/PMs) to women in underserved areas. However, only limited information is available on the cost efficiency of different outreach service models used to provide LA/PMs. To better inform program planning and decision making on mobile outreach for family planning in Tanzania, the EngenderHealth-led RESPOND Project, through its partner FHI 360, conducted an analysis of the financial costs for the country’s three principal models of mobile family planning services: two public programs run by the national Ministry of Health and Social Welfare (MOHSW) and a public-private partnership run by the not-for-profit organization Marie Stopes International/Tanzania (MST). Retrospective cost analyses of the ongoing service delivery phase of each model were conducted. Limitations in the availability and consistency of data precluded the calculation of representative cost estimates for the MOHSW models. Therefore, this report presents the results of the analysis for the MST model only.
Selected Key Findings
- Over a five-month period, in 29 outreach expeditions, the six MST teams provided LA/PMs to more than 14,000 women, producing an estimated 76,000 couple-years of protection (CYPs). The average cost per LA/PM acceptor was US $22.37, ranging by expedition from $14.40 to $36.75. The average cost per CYP was US $4.28, varying by expedition from $2.39 to $6.80.
- Labor was the single largest cost component (39%) of the MST outreach model, closely followed by the costs of contraceptives and expendable supplies, which accounted for 36% of the total average cost per acceptor. Transportation and overhead costs accounted for 10% and 13%, respectively.
- Individual expeditions served anywhere from 171 to 829 clients. The method mix provided also varied by team and expedition. One expedition exclusively performed minilaparotomy, while around half of the expeditions provided fewer than 50 hormonal implants. Overall, the method mix provided in all outreach expeditions was 44% minilaparotomy procedures, 37% intrauterine device insertions, and 20% implant insertions.