The Community Health Planning and Costing Tool is a dynamic analytic tool that was successfully applied in 6 countries in sub-Saharan Africa, providing evidence on costs and resource requirements for achieving universal access to integrated packages of primary health care provided by community health workers.

Some of the programs covered in this study were designed before calculating the costs and faced challenges to achieve their goals. Therefore, it is crucial that costs be modeled and funding sources identified during the planning process so that the final program can be adequately resourced.

The scope and resource requirements of community health programs are different in every country, and therefore, each program must be costed individually when it is designed to facilitate resource mobilization and implementation.

The Community Health Planning and Costing Tool can be used to cost community health programs and to model changes in services and unit costs on a regular basis.

Ensuring access to a package of integrated primary health care services is essential for achieving universal health coverage. In many countries, community health programs are necessary for primary health care service provision, but they are generally underfunded, and countries often lack the necessary evidence on costs and resource requirements. We conducted prospective cost analyses of community health programs in 6 countries in sub-Saharan Africa using the Community Health Planning and Costing Tool.

The Community Health Planning and Costing Tool is a spreadsheet-based tool designed to cost key programmatic elements of community health services packages, including training, equipment, incentives, supervision, and management. In each country, stakeholders defined a package of community health services and corresponding standard treatment guidelines to estimate normative costs, which were applied to program scale-up targets. The data were entered into the tool, and cost models were prepared for different geographical and service utilization scenarios. The results were reviewed and validated with the governments, implementing partners, and expert panels. Additional scale-up scenarios were modeled, taking into account probable constraints to increasing community health service provision and potential funding limitations.

The services and scope of community health service packages varied by country, depending on contextual factors and determined health priorities. The package costs also varied significantly depending on the size and contents of the service package, the service delivery approach, the remuneration of the community health workers, and the cost of medicines and supplies.

Community health programs and service packages are different in every country and change over time as they evolve. They should be routinely costed as an integral part of the planning and budgeting process and to ensure that sufficient resources are allocated for their effective and efficient implementation.

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