Summary
- SCI has provided a fuller picture of its overall spending than we had seen in the past.
- The majority of SCI's expenditure of unrestricted funds in the past year has been on starting a national treatment program in Ethiopia. The United Kingdom's Department for International Development (DFID) is now considering providing several years of funding for the program.
- Other expenditures of unrestricted funds have included assisting new programs in three other countries, supplementing funding in countries funded by DFID, and general organization costs.
- We have seen only limited recent monitoring and evaluation results. SCI has provided detailed monitoring plans for one country, giving us greater confidence that future monitoring will be similar to past monitoring for which we've seen detailed results.
- We do not have detailed plans for how SCI will use additional unrestricted funding. However, we believe that SCI has used unrestricted funds in productive ways in the past and the overall need for funding in the countries in which it is working remains substantially greater than available funding.
- A study of a past SCI program indicates that governments may contribute about 30% of the cost of the program (primarily through in-kind contributions, such as staff time). We have increased our estimates of SCI's cost-per-treatment by 30%.
Published: October 2013
Table of Contents
For our SCI review, previous updates, and other SCI-related content, see our content summary page.
Process used for this update
For this update, we decided to focus on two main questions that we determined were most core to our understanding of SCI and its impact. We asked SCI these two questions in mid-2013:
- Can SCI share a more detailed and conceptual budget, including details of unrestricted spending? How much, in both monetary and non-monetary contributions, do other actors contribute to the deworming programs that SCI supports?
- Can SCI share recent monitoring and evaluation results, including technical details?
SCI provided responses to these questions in SCI report to GiveWell (September 2013) and other supporting documents listed below. The rest of this update summarizes and comments on what we have learned.
Full spending breakdown
We have previously reported that we have been unable to get a comprehensive picture of SCI's total spending. SCI has recently shared with us the most comprehensive spending breakdown we have seen to date. This breakdown increases our confidence in our understanding of how SCI works.
The spending breakdown covers SCI's work under a large, 5-year grant from the UK's Department for International Development (DFID), which comprises the majority of SCI's current funding, between the start of the project in 2010 and March 2013.1 SCI also provided a list of other current grants, which are restricted to (a) national deworming programs in Burundi and Rwanda, and (b) research projects.2 The remainder is unrestricted funding (discussed in the next section).
Under the DFID grant, SCI has spent about 48% on salaries and travel expenses for management and technical staff and 52% on program expenses (this excludes the cost of drugs, which are funded under a separate DFID grant).3 To further break down program expenses, SCI provided a budget for Malawi; program expenses in Malawi account for about 14% of all program expenses.4 The types of expenditures listed were in line with our understanding of SCI's role from past conversations (public and private) and our 2011 site visit, though at a higher level of detail.
In-country spending extrapolated from Malawi example5
Budget item | % of spending | Description |
---|---|---|
Technical personnel and travel | 36% | UK-based Technical Director, country programme managers, health economist, biostatistician, data manager; Ugandan-based capacity building advisor. Technical Assistance: Consultancy fees for expertise. |
Management personnel and travel | 12% | UK-based SCI and Liverpool School of Tropical Medicine personnel undertaking project operational and financial management; project administration. |
Program: Monitoring | 14% | Includes sentinel site monitoring for cohort studies, coverage validation surveys, and knowledge, attitudes and practices surveys. |
Program: Mass drug administration costs | 12% | SCI provided a further breakdown of this category for two example countries. The components of this category overlap with other categories listed here (e.g. training and social mobilization). It isn't clear to us what distinguishes expenses in this category. |
Program: Training | 7% | Includes training of trainers, training of teachers and health workers, and training materials. |
Program: Supervision | 5% | No further information available. |
Program: Office support and materials | 5% | Includes program office support, treatment registers and dose poles. |
Program: Meetings | 3% | Includes pre- and post-program meetings for planning and evaluation. |
Program: Social mobilization | 3% | No further information available. |
Program: Drug transportation | 3% | No further information available. |
Activities funded with unrestricted funds
In our last update in November 2012, we reported on how SCI had spent unrestricted funds between November 2011 (when GiveWell first recommended SCI) and October 2012. We reported (after checking this number with SCI) that as of October 2012, SCI held $2.65 million in unrestricted funds.6 As part of this update, we sought to understand SCI's use of unrestricted funds between October 2012 and August 2013. SCI told us that it had held $1.96 million in unrestricted funds as of October 1, 2012,7 about $660,000 less than we previously thought. We have assumed that we miscommunicated with SCI last year; one possibility is that the numbers we received included some restricted funds and we may not have fully excluded all restricted funds in our adjustment. We have used the more recent figure for this update.
Between October 2012 and August 2013, SCI received an additional $2.34 million, spent about $1.65 million, and committed to spend an additional $1.83 million (primarily between September 2013 and June 2014).8
As of August 31, 2013, SCI had about $2.65 million in unrestricted funds on hand, of which about $813,000 were uncommitted. In September 2013, GiveWell granted about $191,000 to SCI,9 bringing the uncommitted total to just over $1 million.10
Since November 2011, SCI has received $4.41 million in unrestricted funds,11 of which we can confidently attribute about $2.1 million to GiveWell's recommendation.12
Spending since October 2012
Since October 2012, SCI has spent unrestricted funds in the following ways:13
- Supporting country programs not funded by DFID or other restricted funds ($1,374,000, 83% of funding):
- Ethiopia ($929,000, 56% of spending): In addition, a donor has committed £100,000 per year for the next five years to Ethiopia. The first £100,000 has been spent and is included in the figures below. SCI's spending includes funds that have been transferred to Ethiopia and not yet spent by the country. In-country spending to date:
- $324,000 to distribute 1.4 million combination deworming treatments and 6.8 million STH-only treatments to school-aged children in September 2013. The drugs for this distribution have been donated.14
- $402,000 to conduct disease mapping of schistosomiasis and STHs. A further $351,000 will be spent by the end of 2013 to complete this mapping (these funds have already been transferred to Ethiopia).15
- $50,000 to launch Ethopia's NTD Master Plan.16
- Zimbabwe ($172,000, 10% of spending): SCI provided $158,000 in October 2012 for prevalence mapping and baseline data collection in Zimbabwe;17 we do not know how the remaining $14,000 was spent.
- Senegal ($141,000, 9% of spending): SCI has conducted schistosomiasis prevalence mapping in Senegal.18
- Mauritania ($62,000, 4% of spending): SCI has funded delivery costs for schistosomiasis treatment and training for nurses.19
- Yemen ($58,000, 4% of spending): SCI provided assistance (likely technical assistance) to the second round of treatment in Yemen.20
- Democratic Republic of the Congo and Madagascar ($13,000, 1% of spending): The programs in DRC and Madagascar are currently in exploratory phases. We do not have details on how this funding was spent.
- Ethiopia ($929,000, 56% of spending): In addition, a donor has committed £100,000 per year for the next five years to Ethiopia. The first £100,000 has been spent and is included in the figures below. SCI's spending includes funds that have been transferred to Ethiopia and not yet spent by the country. In-country spending to date:
- Supplementing DFID funding in four countries ($90,000, 5% of spending): Most of this amount was spent in Cote D'Ivoire and Mozambique.21 The remainder was spent on programs in Liberia and Uganda. It is not clear to us why additional funding was required in these countries, but we have not inquired on this point because spending in DFID countries made up a small portion of overall unrestricted spending.
- General organization costs ($163,000, 10% of spending): This includes salaries and travel expenses for general staff not supported by large grants. These staff work on investigating possible new country programs, supporting established programs, and fundraising.22
- Other ($36,000, 2% of spending): SCI spent small sums on programs in Rwanda (primarily funded by the End Fund) and on "enhanced monitoring and evaluation."23
In total, of the funds SCI has spent since October 2012 (including funds transferred to Ethiopia that Ethiopia expects to spend in the coming months), about 64% was spent on prevalence mapping surveys, 20% on treatment, 10% on general organization costs, and 7% on other uses or unspecified uses.24
SCI has also continued work in Rwanda and Burundi with funds restricted to those countries.25 A large portion of the treatments in these two countries have been STH-only treatments, instead of the combination STH and schistosomiasis treatments that SCI has traditionally focused on, and some treatments have been provided to pre-school children and adults, instead of the school-aged children that SCI has traditionally focused on.26
Funding commitments
SCI has committed about $1.8 million in unrestricted funds to future activities. About 70% of this is committed to mapping and treatment in four countries in the next year: Mozambique, Ethiopia, Zimbabwe, and DRC. The remainder is primarily for research, including operational research in Burundi,27 monitoring and evaluation in Senegal for a USAID-funded program,28 and four projects in the category "Enhanced Monitoring and Evaluation," which includes funds to match a grant from the Gates Foundation to study cysticercosis in Malawi (details in footnote).29
Spending category | Amount | Expected date of expenditure |
---|---|---|
General organization costs | $46,776 | Oct 2013 |
Enhanced monitoring and evaluation | $186,130 | Sep - Dec 2013 |
Burundi – capacity building research | $70,164 | Sep 2013 |
DRC – mapping | $93,552 | Aug 2014 |
Ethiopia – mapping and treatment | $346,922 | Dec 2013 |
Mozambique – treatment | $623,680 | Mar 2014 |
Senegal – M&E support for USAID program | $249,472 | Over the next 4 years |
Zimbabwe – mapping and treatment | $218,288 | Jun 2014 |
Has SCI used and committed unrestricted funds well?
Broadly, SCI has used or committed unrestricted funds in ways that seem likely to assist the goal of starting and expanding national deworming treatment programs. We do not, however, have a clear understanding of the specific impact of these funds on the number of children receiving treatment or on the quality of programs. A few observations that contribute to our thinking on the impact of unrestricted funds:
- DFID funding is restricted to eight specific countries. To date, SCI has largely used unrestricted funds in countries that are not funded by DFID, suggesting that it would not have been able to do this work without unrestricted funding.
- As discussed more below, DFID is now considering funding deworming programs in Ethiopia and DRC, where SCI previously used unrestricted funds to do program planning, prevalence mapping and regional treatment (Ethiopia) and some limited exploratory work (DRC). There is a possibility that unrestricted funds played an key role in allowing SCI to secure a large grant (if the grant is awarded) for these new programs (i.e. "leveraging" funds from other funders). We are interested in investigating this possibility further through conversations with DFID, but have not yet been able to do so.
- On the other hand, there is a possibility that other funders are leveraging SCI's unrestricted funds. For example, SCI plans to use unrestricted funds to provide monitoring and evaluation in Senegal for a USAID-funded program and to provide additional treatments in Mozambique, which is funded by DFID. USAID and DFID may have provided funding for these activities if SCI had not been able to use unrestricted funds to provide them.
Does SCI have room for more funding?
Unmet global need for schistosomiasis treatment
SCI reports that there is a substantial unmet need for schistosomiasis treatment in the countries in which it is working. According to one source that SCI sent us, only 26% of the need in these countries will be filled in 2013; 30 the treatment numbers in this source conflict with numbers from another source SCI sent us,31 though both sets of numbers suggest that total treatments are well below the World Health Organization's estimate of population at risk.
Need for unrestricted funds
While we generally have a good sense for where unrestricted funds are being spent, it remains somewhat unclear to us how unrestricted funds fit in with funds from other sources. In particular, SCI's largest source of funding is from DFID. In 2010, DFID awarded £10 million to SCI, plus £15 million to purchase drugs, to deliver 75 million combination deworming treatments. DFID is currently considering a second grant of £25 million to increase the total number of treatments to 200 million. SCI has proposed that the second grant be divided two-thirds to SCI and one-third for drugs. The proposal also includes an expansion of the program to include Ethiopia and DRC,32 countries where SCI previously used only unrestricted funds or grants from private donors.
This proposal seems to suggest that the expected cost of the program has declined by about 25%, allowing the program to cover more people and expand to an additional two countries. All of the savings is in the average cost of drugs, perhaps due in part to increased drug donations from Merck.33
2010 DFID award | With proposed 2013 award | |
---|---|---|
SCI budget | £10 million | £26.6 million |
Drug budget | £15 million | £23.4 million |
# of treatments | 75 million | 200 million |
SCI cost per treatment | £0.13 | £0.13 |
Drug cost per treatment | £0.20 | £0.12 |
Total cost per treatment | £0.33 | £0.25 |
If SCI receives the additional grant from DFID, it would mean a significant increase in SCI's budget. Scaling up quickly can be challenging for many organizations due to limited staff capacity, ability to hire well and quickly, and other bottlenecks, but we believe this is somewhat less of a concern in SCI's case because (a) SCI has a track record of expanding programs relatively quickly after receiving large grants; (b) the grant would be largely used to expand existing country programs to more children (the only country out of the ten where SCI is not already funding a treatment program is DRC), which we would guess presents a clearer and less uncertain path to scale-up than starting in a new country.
At the same time, SCI has committed $624,000 in unrestricted funds to fund treatments in Mozambique, a DFID-funded country, in 2014 (see above). This raises the question of whether unrestricted funds are replacing funding that DFID would have provided otherwise, and what the true impact is of unrestricted funds on the margin.
Bottom line
We continue to recommend unrestricted funding to SCI because we believe that SCI has used unrestricted funds in productive ways in the past and because the overall need for funding in the countries in which it is working remains substantially greater than available funding.
Evaluation of previously funded activities
As in previous updates, at this point, we do not have a concrete sense of the impact of the programs that SCI has funded with the unrestricted funds it has received since November 2011. Partly this is because the full process from committing funding to executing programs to collecting data on them can take years; partly this is because SCI has shared only limited data with us.
SCI reports that it has collected baseline and at least one follow up round (following one or more rounds of treatment) of data from 8 of the 15 countries it is working in and baseline data only from an additional 5 countries.34 Prevalence mapping data only has been collected in the remaining two countries: Cote d'Ivoire and Ethiopia.35
We have not seen an update on what portion of SCI-funded treatments have been given to school-aged children versus other groups.
Liberia baseline and detailed methodology: We have seen baseline data and detailed methodology from Liberia only.36 We have not seen follow up data from any country. Judging from the Liberia example, SCI has and will collect data using the same methods that it used in earlier programs, which we have detailed in our full review of SCI.37
Ethiopia monitoring plans: We plan to pay particular attention to results in Ethiopia, where a large portion of SCI's unrestricted funds have been spent or will be spent in the next year. We have seen only a short description of SCI's monitoring plans for Ethiopia. These plans sound similar to SCI's plans for Liberia.38
Burundi coverage survey: In our November 2012 update on SCI, we reported that a treatment coverage survey had been conducted in Burundi in September 2012 and that we had not yet seen the results. Since then, SCI has shared some results; we have not seen detailed methodology or full results. SCI reports that 98% of children "swallowed ALB/PZQ";39 we are unsure whether this means that 98% of targeted children took drugs or whether 98% of those who received drugs took them. Because Burundi is not funded by unrestricted funds, we have not made it a priority to follow up on this question.
We also reported in our last update that SCI had conducted a “KAP” (knowledge, attitude, practice) survey in Yemen. We have not seen results from this survey.
Update to cost-per-treatment
Our cost-per-unit-delivered estimate for the Against Malaria Foundation (AMF), includes both costs incurred by AMF and costs incurred by other parties, such as local governments. Our estimate of cost-per-unit-delivered for SCI has not included this information, because of difficulties obtaining information on the costs incurred by other parties and because it was our understanding from SCI that the vast majority of costs of the program were contributed by SCI, while governments provided some in-kind assistance, such as office space.
We revisited the issue of costs incurred by other parties for this update. SCI pointed us to a paper, published in 2011, on the costs of a SCI-funded deworming program in four districts of Niger in 2004-2006.40 The study aimed to account for all costs of the program including costs funded by the government and non-financial costs such as the value of volunteers' time.41 The study is of a single country, looked at a program that was carried out 7-9 years ago, and the program may differ in some ways from current programs,42 but overall it is of high quality and provides us with a sense for the portion of resources contributed by SCI versus non-SCI parties.
Non-SCI costs were 18% of the total cost of the program and 33% of the cost of school-based deworming (the program also included community-based deworming).43 It is our understanding that in recent programs SCI has continued to do some community-based deworming but that most of its treatments are delivered through schools. Therefore, we conservatively use a figure of 30% to adjust our cost-per-treatment estimates.
To account for these costs, we do a simple adjustment by adding a government portion to our estimate of SCI’s costs that accounts for 30% of the total cost-per-treatment. Details are in this spreadsheet. In our analysis of SCI’s cost-per-treatment, we have not yet incorporated recent spending and treatments; we have instead used data from completed Gates Foundation and USAID grants and other grants that SCI received concurrently. To incorporate recent data, we would need recent estimates of donated drugs and drugs purchased with DFID funds. We have not yet sought out this data.
In short, we estimate:
- The upper-bound on the cost-per-treatment during the period studied was $1.13. This analysis includes all grants received by January 2011 in "SCI's costs," with the exception of the DFID grant, which was awarded in late 2010.
- Our best guess excludes a few more grants that, based on conversations with SCI, we believe can reasonably be excluded from the cost of treatment. This best guess is intended to be fairly conservative. Under these assumptions, we estimate the cost-per-treatment at $0.99.
- A less conservative estimate, that attempts to subtract out research costs that SCI told us were above and beyond normal monitoring and evaluation costs, yields $0.72 per treatment.
- An estimate based on the funding received from DFID and the number of treatments committed under that grant, yields an expected cost of additional treatments of $0.73, though (a) this does not include costs such as organizational overhead and (b) SCI notes that it is possible that this funding will be supplemented with other funding to achieve the treatment goals.
Note that SCI's USAID grants involved some treatments for diseases other than schistosomiasis and STHs; we do not include these treatments in the denominator of "cost per treatment" or the value of donated drugs in the numerator of "cost per treatment."
Sources
- 1
- 2
- 3
SCI report to GiveWell (September 2013), Pgs 2-3.
- 4
- 5
Data from SCI report to GiveWell (September 2013), Pgs 2-4.
- 6
SCI financial details and summary (November 2011 to October 2012), Sheet Summary.
- 7
- 8
SCI financial update (September 2013), Sheet Summary.
- 9
Donors make restricted donations to GiveWell to support SCI and to support our top charities generally. GiveWell then makes grants to SCI with these donations.
- 10
SCI financial update (September 2013), Sheet Summary.
- 11
SCI financial update (September 2013), Sheet Combined with previous updates.
- 12
SCI financial update (September 2013), Sheet Due to GiveWell.
- 13
- 14
Spending figures from SCI report to Ethiopia donor (August 2013), Pg 4. Conversion to USD in SCI financial update (September 2013), Sheet Ethiopia.
"Merck Serono (via the WHO) have donated 3.5 million tablets of praziquantel (sufficient to treat approximately 1.4 million school-aged children at 2.5 tablets per dose) and Johnson and Johnson (via Children Without Worms) have donated 6.8 million tablets of mebendazole (sufficient to treat 6.8 million school-aged children)." SCI support of the distribution of donated drugs in Ethiopia (August 2013), Pg 1. - 15
Spending figures from SCI report to Ethiopia donor (August 2013), Pg 4. Conversion to USD in SCI financial update (September 2013), Sheet Ethiopia.
“The SCI is providing financial support for mapping. Approximately 78,000 school-aged children from 2,600 schools will be sampled to provide a representative picture of the distribution of infection of both forms of SCH and STHs, as well as of water, sanitation and hygiene facilities. 41 mapping teams will conduct the surveys, commencing in October, with all teams working simultaneously in order to complete the mapping in an estimated two months." SCI report to Ethiopia donor (August 2013), Pgs 1-2. - 16
Spending figures from SCI report to Ethiopia donor (August 2013), Pg 4. Conversion to USD in SCI financial update (September 2013), Sheet Ethiopia.
- 17
As we reported in our November 2012 update on SCI, SCI transferred $158,000 to Zimbabwe in October 2012.
- 18
SCI presentation on Burundi, Rwanda, Senegal, and Mauritania (June 2013), Pgs 16-17 and SCI director's presentation (June 2013), Pg 9.
- 19
SCI presentation on Burundi, Rwanda, Senegal, and Mauritania (June 2013), Pg 20.
- 20
- 21
- 22
"Salary support and travel for part time Donor relationship manager. Development and production of promotional material… Support for SCI staff working on investigating the possibilities of new country programmes and supporting established programmes as needed. Longer term support for staff is usually allocated to larger awards however having a flexible funding mechanism is essential to maintain experienced staff." SCI report to GiveWell (September 2013), Pg 6.
- 23
"Enhanced Monitoring and Evaluation: Supports work that conducts additional monitoring and evaluation of programmes to answer specific operational questions that assist in the validation and development of international guidelines." SCI report to GiveWell (September 2013), Pg 6.
- 24
SCI financial update (September 2013), Sheet Summary.
- 25
SCI presentation on Burundi, Rwanda, Senegal, and Mauritania (June 2013).
- 26
Burundi (June 2012 to January 2013):
- School-age children schistosomiasis treatments: 652,889
- Adult schistosomiasis treatments: 279,405
- School-age children STH treatments: 3,940,280 in one round and 3,977,190 in the next round
- Adult women STH treatments: 123,115 in one round and 128,455 in the next round
Rwanda (December 2007 to May 2012):
- Pre-school-age children STH treatments: 10.1 million
- Lactating women STH treatments: 439,000
- School-age children STH treatments: 19.3 million
- School-age children schistosomiasis treatments: 577,000
- Adult combination treatments: 251,000
SCI presentation on Burundi, Rwanda, Senegal, and Mauritania (June 2013), Pgs 5 and 11.
- 27
"University of Antwerp – Analysis of the best approaches to capacity building in Burundi." SCI report to GiveWell (September 2013), Pg 7.
- 28
"Senegal Ministry of Health – Support of M&E of USAID funded SCH treatment at request of MOH." SCI report to GiveWell (September 2013), Pg 7.
- 29
- "University of Queensland – £9,375 – PhD student support for development of decision making tools for NTD programme managers."
- "University of Cambridge – £70,000 – Collaboration with University of Cambridge assessing strategies to increase coverage."
- "Ugandan Ministry of Health – £20,000 – Enhanced M&E in Uganda to explore elimination strategies."
- "Technical University Munich – £20,000 – Matched funding with BMGF to support cysticercosis project in Malawi."
- 30
- Total population at risk, estimated by the World Health Organization: 104 million. We have not vetted this estimate.
- Total 2013 treatments, including treatments provided by SCI: 27 million.
- Total 2013 treatments provided by SCI: 12.6 million.
SCI financial update (September 2013), Sheet Global need.
- 31
Total planned schistosomiasis treatments 2013/14 for 14 countries: 25.5 million. SCI director's presentation (June 2013), Pg 11.
Summary of discrepancies:
SCI financial update (September 2013), Sheet Global need. - 32
- 33
- 34
- 35
- 36
"In order to demonstrate in more detail an on-going monitoring and evaluation process within a designated country supported by SCI we have taken the example of Liberia (see below)." SCI report to GiveWell (September 2013), Pg 11. Data on Pgs 12-14.
- 37
- 38
"As part of the national control programme, a longitudinal cohort of individuals will be recruited in order to help monitor the health impact of the programme. These individuals (mostly school-aged children) will be taken from a representative sample of areas across the country, with the size of the cohort estimated using a statistical sample-size calculator. These individuals will be followed up prior to mass treatment at baseline and every year in order to provide an estimate of the impact of the control programme on those people who receive treatment." SCI report to Ethiopia donor (August 2013), Pg 3.
- 39
SCI presentation on Burundi, Rwanda, Senegal, and Mauritania (June 2013), Pg 7. Note that this source says that survey was completed in June 2012, rather than September 2012 as we previously reported.
- 40
- 41
“This was a retrospective study which covered a two year period from April 2004 to May 2006, including the first and second years of MDA and related programme activities in four health districts. All data on first year costs at national, regional, district, and sub district levels were taken from the PNLBG accounts and receipts and records of staff missions or activities. Second year cost data for national and regional level activities were taken from receipts. District and sub district, school and community MDA resource use data for 2005 were collected in June 2006 through a retrospective survey…
The main cost elements include: the programme specific expenditure; the opportunity cost or value of government contributions related to in-kind costs of using local government staff and vehicles and the value of CDD’s time (taken as the daily agricultural labour rate); and the international costs of programme co-ordination, reporting and technical support." Leslie et al. 2011, Pg 3.
- 42
Two examples of how the area of study may not be representative of all areas in which SCI works:
- Due to low school enrollment rates, a substantial portion of the program was through community distribution. Current SCI programs focus on school-based distribution. "The primary school net enrolment rate (NER) in 2004 in Niger was 41%... To achieve high treatment coverage in targeted school age children and at risk adults two treatment strategies, school-based and community-based distribution, were established." Leslie et al. 2011, Pg 2.
- "The cost per treatment and prevalence figures relate to the study sample of four districts located in the Niger River Valley. This was and is an area of high disease prevalence and high population density relative to other parts of the country. The costs per person treated may be higher in lower density and more remote areas." Leslie et al. 2011, Pg 8.
- 43
- Programme expenditure: 75%
- Government cost: 18%
- International tech. support: 7%
Leslie et al. 2011, Pg 5.
It is our understanding from the paper and our past conversations with SCI that "programme expenditure" was fully funded by SCI. It is also our understanding that "international tech. support" refers to SCI staff time and travel costs; we're somewhat less confident in this than in the former understanding. Government costs are "related to in-kind costs of using local government staff and vehicles and the value of CDD’s time (taken as the daily agricultural labour rate)." Leslie et al. 2011, Pg 3.
Calculating non-SCI costs of school-based delivery:- The average cost/treatment in the study was $0.58. At 7% of the total cost, international tech. support accounts for $0.04/treatment.
- “The full economic delivery cost of school based treatment in 2005/06 was $0.76, and community treatment was $0.46. If only programme costs are included these figures are $0.47 and $0.41 respectively.” Leslie et al. 2011, Pgs 7-8.
- Therefore, non-program costs (government and international tech. support) are $0.29 ($0.76 - $0.47) of the $0.76 cost of each school based treatment. Since $0.04 is international tech. support, that leaves $0.25 of government costs, or 33% of the total cost.