A Roadmap for Implementing Change in Costing Capacity and Practices: Improving cost analyses of HIV services and the use of cost information in strategic planning and program management

As bilateral and multilateral donors transition the role of funding HIV programs to the governments of low- and middle-income countries, pressure to manage scarce resources can mount. Yet many countries face challenges in quantifying the costs of future programs, ensuring that cost data are accurate and accessible, and optimizing planned activities for cost-effectiveness and technical efficiency. We designed this roadmap to help countries respond to such challenges. We have based the contents of this document on our experience supporting costing efforts in multiple countries, covering three main dimensions of costing capacity and practices: data & tools, knowledge & skills, and processes & governance. This roadmap adopts Kotter’s 8-Step Process for Leading Change for the purposes of costing improvement—from diagnosing weaknesses and creating a sense of urgency, to removing barriers to success and sustaining long-term changes. We developed a baseline assessment with corresponding suggestion sheets to assist with the initial steps of the change process. Countries aiming to improve their costing capabilities, particularly within organizations responding to HIV, can follow this 8-step process before, during, and after donor transition. In fact, we recommend that countries revisit the assessment and change process regularly to make continuous improvements. The roadmap concludes with examples of the change efforts underway in two countries to demonstrate that different aspects of costing may be at different points along the 8-step process. These country descriptions also show that improvements in costing can yield benefits in other aspects of a country’s HIV response.

EfD Authors

Mwai, Daniel

Sustainable Development Goals

Good Health and Well-Being