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CRVS tools

Verbal autopsy costing and budgeting tool

Integrating VA into existing CRVS systems should improve collection of data and information on causes of death which can be used to support health planning, priority setting, monitoring and evaluation in countries with incomplete vital registration systems. Indeed it is expected to substantially increase the completeness of death registration since it strengthens the critical first step of CRVS, notification.  Such integration will be a complex undertaking and poses a large number of design issues for stewards of CRVS. 

Despite the increasing interest in integrating VA methods into routine CRVS data collection systems at country level, the full extension of VA is yet to be incorporated in CRVS anywhere except in Brazil. This is attributed in part to the dearth of information on the costs of adopting VA based surveillance systems. To date few studies have attempted to estimate the costs of the different components of verbal autopsy based surveillance in LMICs. 

The cost of VA in CRVS systems is unknown. This is a critical issue for policy makers and managers. There is a pressing need for a tool that can assist the forecasting such costs for budget and planning purposes, and also for monitoring and analysing such costs as implementation of VA scales up. 

A verbal autopsy costing and budgeting tool has been developed to help planners and managers determine the costs and cost drivers of implementing verbal autopsy systems. This tool can be customized to country context and covers all aspects of a verbal autopsy system including start-up costs, training costs, community-level service delivery costs, as well as support, supervision, and management costs at all administrative levels. 

Additionally, the tool has a budgeting element that can be used to estimate budgets for VA systems, and will allow modelling of different scenarios of scale and implementation to find the most cost-efficient approach.

The VA costing and budgeting tool consists of a single Excel file (.xlsx) where users define their assumptions for the costing exercise, collect general information about the country and cost information, and are provided with the results of the analysis. It is organized in three main sections: costing section, budgeting section and modelling section.

The tool automatically produces the following outputs:

  • total program costs for baseline year by activity and input type
  • unit costs per VA
  • key costs drivers during the implementation

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Developing a verbal autopsy costing and budgeting tool

This paper describes the Verbal Autopsy Costing and Budgeting Tool that has been developed by the Swiss Tropical and Public Health Institute and the University of Melbourne. The tool estimates the resources needed to implement verbal autopsy (VA) as part of a routine civil registration and vital statistics (CRVS) system. The tool has been piloted in four different countries, representing different stages of implementation of VA activities, and the tool was able to demonstrate the relatively low ongoing cost of conducting routine VA when integrated within a CRVS system.

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Authors: Cobos Muñoz D, Monzon Llamas L, Dayo C, Renggli S, deSavigny D

Publication date: January 2019

Resource type: CRVS technical outcome series

Related resources: Challenges associated with automated VA training and rollout


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Summary: Understanding the VA costing and budgeting tool

A VA costing and budgeting tool has been developed to help determine the financial and economic costs of implementing routine VA, based on six activity groups: start-up activities, governance activities, program management, supervision, refresher training, VA delivery and analysis.

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VA Costing Tool

The purpose of the VA Costing Tool is to help planners and managers to determine the costs of implementing verbal autopsy systems. The Tool can be customised to the country’s context and covers all aspects of a VA system, including start-up costs, training costs, community-level service delivery costs, as well as governance, supervision, and management costs at all administrative levels. Additionally, the Tool has a budgeting and a modelling component. The former can be used to estimate budgets for VA systems, whereas the latter can be used to model different VA implementation scenarios. NOTE: clicking on the 'download resource' button will automatically save the Excel file to your PC.

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VA Costing Tool: Report template

This template can be used to summarise key outputs from the VA Costing Tool, to assist planners and managers to determine the costs of implementing verbal autopsy systems. The template is based on three key areas of the Tool: total program costs for baseline year by activity and input type; average costs per VA; and key drivers of costs. NOTE: clicking on the 'download resource' button will automatically save the Word document to your PC.

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VA Costing Tool: User guide

This user guide provides program planners and managers with instructions for using the accompanying VA Costing Tool. The purpose of the VA Costing Tool is to help you to determine the costs of implementing VA within CRVS systems, including identifying key cost drivers and estimating total budget requirements.

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