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UCL / TLOmodel

Epidemiology modelling framework for the Thanzi la Onse project
https://www.tlomodel.org/
MIT License
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Underestimation of consumables costs #1539

Open sakshimohan opened 6 hours ago

sakshimohan commented 6 hours ago

Currently we are underestimating the cost of consumables by $69 million or 38% of the 2018 expenditure reported in the Resource Mapping data.

This has occurred after merging in PR #1510 which updates the logging of consumables. This is likely because - i. we're not logging enough quantities of consumables Used for certain HSIs, ii. certain consumables are not included in the model at all. In order to expose this issue, I have compared -

  1. The estimated consumables cost to expenditure (2018) and projected budget data (2020-22) from Resource Mapping Round 7, and
  2. Logged Items_Used data to quantities dispensed reported in the OpenLMIS 2018 - The challenge with this is that we do not always know the units used in the OpenLMIS data so the focus here is to expose individual consumables which were dispensed as per OpenLMIS but not recorded as used in the TLO model.

The .csv file attached below summarises some of the key consumables for which we might be underestimating the quantity of consumables needed. pending_consumables_issues_4Dec2024.csv The columns to focus on are -

  1. Quantity dispensed as per OpenLMIS (unit unknown)
  2. Quantity dispensed as per TLO model (see chosen unit for TLO model)
  3. Module lead - to find which issues are addressed to you
  4. Notes - In this column, I describe the issue in detail and provide context for how comparison with resource mapping data reveals a discrepancy.

This figure summarises the issue. Detailed table comparison TLO cost estimates with resource mapping data below.

Image

sakshimohan commented 6 hours ago

Current status of calibration (Areas that need addressing in //bold//)

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Cost category | Calibration category | Actual Expenditure (RM) 2018 | Maximum (Annual Projected Budget 2020-2022) | TLO Cost Estimate ($) | Expenditure as per RM minus TLO Cost estimate -- | -- | -- | -- | -- | -- Facility operating costs | Facility utility bills | 12,142,707.98 | 31,595,108.55 | 25,731,776.58 |   Facility operating costs | Infrastructure - Rehabilitation | 4,117,616.05 | 11,684,723.49 | 5,570,953.60 |   Facility operating costs | Vehicles - Fuel and Maintenance | 24,393,757.96 | 32,411,573.39 | 18,710,184.48 |   Human resources for health | Health Worker Salaries | 114,418,952.79 | 133,228,884.25 | 107,230,088.91 |   Human resources for health | Health Worker Training - In-Service | 12,897,136.55 | 17,743,710.12 | 12,086,818.36 |   Human resources for health | Health Worker Training - Pre-Service | 1,277,697.67 | 2,665,199.15 | 2,852,164.56 |   Human resources for health | Mentorships & Supportive Supervision | 55,553,332.80 | 66,652,165.02 | 52,062,955.21 |   Medical consumables | //**Antimalarials**// | 681,848.59 | 8,094,056.65 | 25,609.00 | 656,239.59 Medical consumables | Antiretrovirals | 53,796,360.12 | 77,506,903.49 | 53,787,113.67 |   Medical consumables | //**Bednets**// | 3,552,600.00 | 28,061,308.64 | 463,707.63 | 3,088,892.37 Medical consumables | //**Cervical Cancer**// | 534,872.32 | 1,581,977.74 | 101,750.65 | 433,121.67 Medical consumables | Condoms and Lubricants | 210,313.84 | 11,211,211.72 | 423,034.86 |   Medical consumables | //**HIV Screening/Diagnostic Tests**// | 34,469,044.13 | 94,345,358.80 | 21,024,664.01 | 13,444,380.12 Medical consumables | //**Indoor Residual Spray**// | 7,272,001.18 | 13,194,497.82 |   |   Medical consumables | //**Malaria RDTs**// | 1,719,000.00 | 5,643,435.92 | 538,367.86 | 1,180,632.14 Medical consumables | //**Other Drugs, medical supplies, and commodities**// | 39,437,013.14 | 80,801,692.06 | 32,532,025.40 |   Medical consumables | //**Other family planning commodities**// | 12,323,143.36 | 21,052,691.19 | 1,981,220.53 | 10,341,922.83 Medical consumables | Supply Chain | 21,341,274.59 | 37,668,917.17 | 9,696,423.30 |   Medical consumables | //**TB Tests (including RDTs)** //| 599,011.62 | 6,695,563.77 | 53,719.77 | 545,291.85 Medical consumables | //**TB Treatment**// | 2,338,536.34 | 4,685,956.00 | 1,664,427.22 | 674,109.12 Medical consumables | //**Undernutrition commodities**// | 913,214.58 | 1,721,063.60 | 23,268.04 | 889,946.54 Medical consumables | Vaccines | 4,200,418.52 | 13,209,399.57 | 9,319,174.55 |   Medical consumables | //**Voluntary Male Medical Circumcision**// | 2,891,681.00 | 1,832,645.01 | 94,754.61 | 2,796,926.39 Medical equipment | //**Medical Equipment - Maintenance**// | 2,294,331.38 | 16,468,941.94 | 712,772.18 |   Medical equipment | //**Medical Equipment - Purchase**// | 3,754,149.89 | 19,024,579.29 | 525,327.86 |