Costs of visits for holistic care in reproductive health in Guatemala

The costs and cost-effectiveness of providing multiple reproductive health care services in each visit to Guatemalan Ministry of Public Health and Social Assistance facilities were compared to those of the traditional vertical system. The Ministry and the Population Council had previously tested an algorithm to help service providers identify and meet multiple reproductive health needs in each visit. The new system resulted in increases in the number of family planning consultations and in other services such as pre- and postnatal care and vaccinations. The present study compared costs of integrated and vertical services in health centers and posts in Quetzaltenango and San Marcos to test the hypothesis that the integrated system of service delivery would have lower average costs be more cost-effective and reduce costs to the client. The results demonstrated that average costs were lower in the integrated model especially in family planning consultations prenatal and well-child care. Integrated services were cost-effective in the sense that more services were provided per consultation at the same cost. Estimated costs per visit to clients were found to be similar for integrated or vertical services. Integrated services make more effective use of time avoid duplication of administrative procedures and limit unnecessary client visits.