OneHealth Tool Integrated Strategic Planning and Costing
How much does it cost to scale up nutrition
specific and sensitive interventions
implemented through the health sector?
How many lives will be saved?
2
In most countries, the majority of
interventions are nutrition specific that are
implemented through the health sector
Many nutrition sensitive interventions are
going to be implemented thought the health
sector, e.g. health, wat-san
Why cost nutrition interventions as part of
national health plans?
Source: SUN Financial Tracking & Resource Mobilization
http://scalingupnutrition.org/about/financial-tracking-resource-mobilization
3
Nutrition interventions in the OneHealth Tool
• All nutrition specific interventions
recommended in WHO Essential
Nutrition Actions (2013)
• Nutrition sensitive interventions
implemented by the health
sector
• Intervention inputs calculated
based on guidance and
evidence as published on the
WHO e-Library of Evidence for
Nutrition Actions
National
Hospital
Health Centre
Outreach
Community
Strengthening Health Systems
Lives saved;
healthier
populations
Supply
chain Infrastructure
Human
Resources
Community mobilization, demand generation, programme management
Increasing coverage
of effective
interventions
OneHealth Tool Models cost and impact with a health systems approach
Health Financing Health Information Governance
Financial affordability
Malaria
TB
HIV
Repro
ductive
Health
Wate
r & S
anitatio
n
Imm
unizatio
n
Child
Health
Nutritio
n
Oth
ers
Non co
mm
unicab
le
What does the OneHealth Tool do?
Ensures comparability
A standardized costing approach
across programmes
One health programme
Avoid vertical approaches
How many lives could be
saved? How much could
stunting be reduced?
Improving population health
How many doctors, nurses,
CHWs are needed to health
and nutrition interventions?
Links programme plans to a health
systems platform
How much will the health plan
cost? How much will it cost to
scale-up nutrition interventions?
Costing as part of the planning process
• Drugs and supplies (units/treatment case, price/unit)
• Number of people (target population, incidence, coverage)
• Estimated staff time (to compare with HR plans) • Programme costs (training, advocacy, M&E, supervision, etc.)
Costing of nutrition intervention progammes
Nutrition activities within a health sector plan: Estimating health worker needs
Comparing anticipated supply of health workers with the expected demand
Estimated time needed
for service delivery
Available FTE
nurses
Nutrition activities within a health sector plan:
What will be the demands on the supply chain?
Volume of commodities transported in Logistics system,
% share by programme
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Non Communicable disease
Nutrition
Vaccination
HIV/AIDS
Malaria
TB
Child health
Maternal/newborn and
reproductive health
Nutrition activities within a health sector plan:
What will be the demands on outpatient care?
Predicted number of outpatient visits, by programme area
-
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
70,000,000
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Nutrition
HIV/AIDS
Malaria
Vaccination
Child health
Maternal/newborn and
reproductive health
Summary at 2020
Scenario Cost of Plan
(all years)
Intervention demand
on nurses time
(end year)
Under five
mortality rate
(end year)
Burkina 50 % coverage 712 million 56% 90
Burkina 70 % coverage 777 million 110% 79
Burkina 90 % coverage 848 million 131% 71
Comparing scenarios
0
2,000
4,000
6,000
8,000
10,000
12,000
20112012
20132014
20152016
20172018
20192020
Nur
ses,
FTE
's
Nurses available
FTE's neededBurkina 50
FTE's neededBurkina 70
FTE's neededBurkina 90
11
Estimating impact
LiST (Lives Saved Tool)
estimates impact on
•Mortality
•Nutritional status
•Breastfeeding
practices
Added value of OneHealth Tool for nutrition planning
• Evidence-based nutrition actions
• Estimate impact and costs of
- Different scaling-up scenarios
- Changes in treatment guidelines
• System-wide approach rather than vertical programmes
• Accessing domestic resources: assessment of
affordability of nutrition interventions within a sector-
wide financial space analysis
• Allow identification of health system bottlenecks for
nutrition
Angola
Benin
Botswana
Burkina Faso
Cape Verde
Democratic Republic of the Congo
Ethiopia
Indonesia
Kenya
Mauritania
Morocco
Mozambique
Papua New Guinea
Paraguay
Senegal
Sierra Leone
Sri Lanka
South Africa
Sudan
Tajikistan
Turkmenistan
Zambia
Viet Nam
Countries that have used/currently using the OneHealth Tool
Country application example (1)
Ethiopia MNH Roadmap 2012-2015
Nutrition interventions: •IFA to pregnant women •Feeding counselling of LBW infants •Breastfeeding counselling and promotion
•Drug and supply costs are attributed to each programme
Disclaimer: the estimates presented in this slide represent work in progress.
They are included for illustration purposes only and should not be cited.
Country application example (2)
Ethiopia MNH Roadmap 2012-2015
Nutrition interventions: •IFA to pregnant women •Feeding counselling of LBW infants •Breastfeeding counselling and promotion •Impact of breastfeeding counselling on breastfeeding in infants <1 month is estimated in LiST
Disclaimer: the estimates presented in this slide represent work in progress.
They are included for illustration purposes only and should not be cited.
0
10
20
30
40
50
60
70
80
90
100
2011 2012 2013 2014 2015
Not breastfeeding
Partial breastfeeding
Predominant breastfeeding
Exclusive breastfeeding
Country application example (3)
Sudan National Health Plan 2011-2016
Nutrition interventions: •Food fortification •IFA to pregnant women •Breastfeeding counselling and promotion •Management of SAM •Management of MAM •A share of health systems costs can be attributed to
each programme
Disclaimer: the estimates presented in this slide represent work in progress.
They are included for illustration purposes only and should not be cited.
Country application example (4)
Sudan National Health Plan 2011-2016
Nutrition interventions: •Food fortification •IFA to pregnant women •Breastfeeding counselling and promotion •Management of SAM •Management of MAM •Human resources time spent to implement planned activities translated into estimated number of HWs for the nutrition programme
Disclaimer: the estimates presented in this slide represent work in progress.
They are included for illustration purposes only and should not be cited.
OneHealth Tool
Life saver function –
response within 2
working days
http://www.internationalhealthpartnership.net/en/tools/one-health-tool/
Help screen
Documents OneHealth Tool available in • English
• French
• Arabic and Spanish versions in
pipeline
For further information email [email protected] or contact
Kaia Engesveen, WHO Department of Nutrition for Health and Development, [email protected]
Karin Stenberg, WHO Department of Health Systems Financing, [email protected]
