Background: Cost data are useful in health planning, budgeting and for assessing the efficiency of services. However, such data are not easily available from developing countries. We therefore estimated the cost incurred for the year 1991-92 on a primary health centre in northern India, which is affiliated to an academic institution.
Methods: The total costs incurred included the capital costs for land, building, furniture, vehicles and equipment as well as the recurrent costs for salaries, drugs and vaccines, diesel and maintenance. Except for land, where the 'opportunity cost' was calculated, the current market rates were considered for all other factors. A discount rate of 10% was used in the study.
Results: A total of Rs 777,015 (US $24,282) was incurred on the primary health centre in the study year, 80% being recurrent costs. Salaries constituted 62% of the total costs. A sum of Rs 30 (US $0.94) per head per year on primary health care was being incurred.
Conclusion: Salaries constitute the bulk of the cost incurred on health. Approximately Rs 28 (40%) of the Rs 69 spent per head per year on health services by the Government of India is incurred on providing primary health care services.
PIP: Primary health care in India is provided by a chain of primary health centers (PHC) which are staffed by a medical officer and para-professional health workers. The multipurpose workers (MPW) deliver health services such as immunization and antenatal care. Each male and female worker team serves a population of approximately 5000, while the PHC serves a population of approximately 30,000. The MPWs are supervised by two health assistants, one male and one female, while the medical officer supervises the workers and provides curative services. The authors report findings from their study of the cost of providing health care through the Chhainsa PHC of the Comprehensive Rural Health Services Project in Ballabgarh, Haryana, during 1991-92. Such data are useful in health planning, budgeting, and assessing the efficiency of services. The authors note that Chhainsa PHC caters to a population of 25,762 and that it is not a prototype of others in the country as it is run by a medical college, the All India Institute of Medical Sciences. Capital costs were assessed for land, building, furniture, vehicles, and equipment, as well as the recurrent costs for salaries, drugs, and vaccine, diesel, and maintenance. Current market costs were considered for all factors except land for which the opportunity cost was calculated. A 10% discount rate was used in the study. The analysis found that Rs 777,015 was incurred on the primary health center in the study year, 80% being recurrent costs. Salaries constituted 62% of total costs, drugs and equipment 10% of recurrent costs, and vaccines and other family welfare items 4% of the total annual costs. Salaries therefore consume the bulk of expenditures for health. It costs Rs 30 per head per year to run the PHC. This per head estimate is probably high compared to other PHCs in India. So, out of Rs 69 per capita currently spent on health in India, approximately 44% appears to be spent on primary health care.