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Table 1 Provider and patient costs (in 2016 US Dollars) for antenatal care in Gaibandha district

From: Antenatal care in rural Bangladesh: current state of costs, content and recommendations for effective service delivery

Level of care (n = number of pregnant women)

Community Level (n = 34)

Facility Level (n = 36)

Care setting

Gov’t

(n=14)

BRAC

(n=12)

Smiling Sun (n=8)

Community Clinic (n=10)

Upazila Health Complex (n=10)

Maternal and Child Welfare Center (n=10)

Smiling Sun (n=6)

Provider costs

Service costs

Staff level

Family Welfare Visitor

Shyastho Kormi

Paramedic

Family Welfare Visitor

Nurse

Family Welfare Visitor

Paramedic & Counselor

Staff monthly salary ($)

182-390

78

286

182-390

208-455

182-390

286

Service time per patient (min)

6 (5-10)

25 (21-25)

10 (9-10)

5 (5-6)

17 (10-20)

10 (5-14)

28 (18-30)

Total service costs

0.17 (6%)

0.18 (21%)

0.27 (28%)

0.13 (4%)

0.55 (16%)

0.27 (9%)

0.75 (51%)

Drug costsa

Iron & Folic acid ($)

0.32-0.39

0.13

0.13

0.32-0.39

0.32-0.39

0.32-0.39

0.13

Calcium ($)

0.45-0.65

0.13-0.19

0.13

0.45-0.65

0.45-0.65

0.45-0.65

0.13

Vitamin B Complex ($)

n/a

0.26-0.47

0.45

n/a

n/a

n/a

0.45

Misoprostol ($)

1.95

n/a

n/a

1.95

1.95

1.95

n/a

Total drug costs

2.86 (94%)

0.66 (79%)

0.71 (72%)

2.86 (96%)

2.86 (84%)

2.86 (91%)

0.71 (49%)

Total provider costs

3.03

0.84

0.98

2.99

3.41

3.13

1.46

Average provider costs (USD, 2016)

$1.62

$2.75

Patient costsb

Indirect costs

Hourly wagec ($)

0.58 (0.36-0.71)

0.52 (0.43-0.69)

0.88 (0.42-0.10)

0.48 (0.36-0.92)

0.52 (0.44-0.84)

0.62 (0.44-0.84)

0.66 (0.36-0.66)

Travel time (a round trip, min)

20 (10-55)

13(6-33)

10 (10-17)

10 (10-20)

48 (41-60)

120 (70-120)

40 (25-70)

Waiting time (min)

13 (5-56)

15 (2-30)

6 (4-17)

20 (8-30)

40 (15-105)

120 (90-210)

8 (1-10)

Consultation time (min)

10 (8-10)

30 (24-35)

18 (9-20)

4 (2-9)

13 (10-28)

10 (10-20)

30 (23-41)

Pharmacy time (min)

0 (0-0)

0 (0-1)

0 (0-0)

0 (0-0)

1 (0-4)

0 (0-0)

0 (0-0)

Total time (min)

73 (46-114)

78 (43-97)

34 (27-44)

43 (27-52)

153 (78-182)

260 (195~292)

90 (70-106)

Total wage loss (total time x hourly wage)

0.70 (0.48-0.96) (100%)

0.49 (0.31-1.03) (43%)

0.49 (0.31-0.91) (100%)

0.44 (0.25-0.61) (77%)

1.19 (0.69-2.29) (80%)

2.25 (1.40-5.96) (42%)

0.81 (0.40-0.94) (53%)

Direct costs

Admission fee ($)

0

0

0

0

0.04 (0.04-0.04)

0

0

Medical service fee ($)

0

0.65 (0.65-0.65)

0

0

0

1.89 (1.20-2.93)

1.56 (1.02-1.62)

Transportation ($)

0

0

0

0.13 (0-0.2)

0.45 (0.32-0.56)

0.52 (0.23-0.91)

0.65 (0.52-0.78)

Others ($)

0

0

0

0

0

0.71 (0.13-1.30)

0

Total direct costs

0 (0%)

0.65 (0.65-0.65) (57%)

0 (0%)

0.13 (0-0.2) (23%)

0.49 (0.04-0.56) (20%)

3.12 (1.27-4.48) (58%)

2.21 (0.59-1.36) (47%)

Total patient costs

0.70

1.14

0.49

0.57

1.68

5.37

3.02

Average patient costs (USD, 2016)

$0.78

$2.66

Average provider and patient costs (USD, 2016)

$2.40

$5.41

  1. aProviders’ monthly salary estimates and drug costs are based on interviews with organization managers and drug inventory documents in the facilities. Provision of medicines and supplements may vary depending on government supply in stock. Unit drug cost are slightly different by product brands
  2. bPatient costs are based on direct service observation (n=70) and exit interviews with pregnant women (n = 70) Wage, time, and patient costs data represent median estimates and interquartile ranges (25% and 75%)
  3. cHour wages are estimated based on women/husbands’ reported monthly salaries. Total wage loss was calculated based on multiplying the estimated hourly wage and total time spend to seek care