Cost Analysis Issues Pertinent to Scale-up and Sustainability

Cost analysis informs implementation, scale-up and sustainability of health care systems innovations.  Absent from many costing models is an analysis of how costs are influenced by local circumstances and differentiating between essential versus options elements of effective service delivery models.  The diversity of districts participating in these programs of research provided the basis for examining these costing parameters from both societal and Ministry of Health perspectives.  Key issues that emerged included questions about the proportionality of costs that should be borne through volunteer versus paid work, and how to optimally cost elements associated with social capital.