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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 settingGov’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 costsService costsStaff levelFamily Welfare VisitorShyastho KormiParamedicFamily Welfare VisitorNurseFamily Welfare VisitorParamedic & Counselor
Staff monthly salary ($)182-39078286182-390208-455182-390286
Service time per patient (min)6 (5-10)25 (21-25)10 (9-10)5 (5-6)17 (10-20)10 (5-14)28 (18-30)
Total service costs0.17 (6%)0.18 (21%)0.27 (28%)0.13 (4%)0.55 (16%)0.27 (9%)0.75 (51%)
Drug costsaIron & Folic acid ($)0.32-0.390.130.130.32-0.390.32-0.390.32-0.390.13
Calcium ($)0.45-0.650.13-0.190.130.45-0.650.45-0.650.45-0.650.13
Vitamin B Complex ($)n/a0.26-0.470.45n/an/an/a0.45
Misoprostol ($)1.95n/an/a1.951.951.95n/a
Total drug costs2.86 (94%)0.66 (79%)0.71 (72%)2.86 (96%)2.86 (84%)2.86 (91%)0.71 (49%)
Total provider costs3.030.840.982.993.413.131.46
Average provider costs (USD, 2016)$1.62$2.75
Patient costsbIndirect costsHourly wagec ($)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 costsAdmission fee ($)00000.04 (0.04-0.04)00
Medical service fee ($)00.65 (0.65-0.65)0001.89 (1.20-2.93)1.56 (1.02-1.62)
Transportation ($)0000.13 (0-0.2)0.45 (0.32-0.56)0.52 (0.23-0.91)0.65 (0.52-0.78)
Others ($)000000.71 (0.13-1.30)0
Total direct costs0 (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 costs0.701.140.490.571.685.373.02
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