Cost of introducing group prenatal care (GPC) in Bangladesh: a supply-side perspective

Background: Progress towards Millennium Development Goals (MDG) 5 is uneven across different countries. Maternal and neonatal deaths occur mainly in developing countries especially in rural areas and among the poor communities due to underutilization of maternal services. It is evident that group prenatal care (GPC) model could improve health-care utilization among pregnant women that suit in developing countries. The GPC model has introduced in a public facility in the context of Bangladesh, and this study intended to estimate the incremental cost of introducing GPC model over the existing government health-care facility. Methods: Activity-based costing method was employed for analysis of cost during 2015–2016 in a selected Maternal and Child Welfare Centre (MCWC) in Bangladesh. Cost information was collected by applying ingredients approach considering supply-side perspective. Results: The total cost of integrating GPC model over the government service delivery system was estimated to be BDT 1,186,868 (US$15,216.3). The proportion of cost for the start-up period and implementation cost covered approximately 24% and 76% of the total intervention costs, respectively. Considering the total number of per session beneficiary (N = 844), the average cost of the per-beneficiary per-GPC session was BDT 1406 (US$18.0) while cost per beneficiary (N = 300) was estimated to be BDT 3956 (US$50.7) and cost per session (N = 125) was BDT 9495 (US$121.7). Conclusions: It appears from the findings that the built-in interventions of GPC model are doable in the existing government settings at the grass-root level and perhaps at a lower cost if adjusted with the existing government and NGO functionaries.