Phase 3

Financial Planning for DATs

Costs associated with the implementation of DATs include, but are not limited to, product procurement; technological support; staff costs; general running costs of DATs and its supporting infrastructure.

Generating a budget goes hand in hand with creating and submitting funding proposals for DAT implementation.

DAT Budgeting

Funding Proposals

Resources

Cost Considerations

When budgeting for DATs, cost considerations can be split into two overarching groups:

  • Capital expenditure (CAPEX) are once off costs associated with DAT adoption.
  • Operating expenditure (OPEX), are ongoing costs to use DATs within an existing TB treatment programme.

Capital expenditure (CAPEX)

Product Pricing

Shipping & Distribution

Installation & Training

Infrastructure Costs

Operating expenditure (OPEX)

Messaging Costs

Platform Costs

Labour & Technical Assistance

Replacement & Spare Parts

Implementation Costs

Broadly speaking, DATs require funding for the actual DAT product and the supporting infrastructure, as well for implementation of the DAT intervention. The following activities in implementation should be considered when budgeting for the DAT intervention.

The cost considerations for these activities vary per country and project setting and will need to be investigated further within the setting of implementation.

Consulting the following resources will also provide guidance on budgeting:

Technical Assistance

To ensure a successful DAT intervention it may be necessary to receive technical assistance (TA) during certain phases of planning & implementation, such as:

  • Budgeting & funding proposal writing
  • Implementation planning & design
  • Infrastructure assessment
  • Data analysis
  • Technical support
  • Capacity building

Get in touch with us should you require TA at any point in the planning and implementation journey.

Supply Chain & Commodity Management

Supply chain and commodity management contribute to cost fluctuations.

For example, costs may be reduced if:

  • DAT preparation and distribution are integrated into the existing supply chain.
  • Technology is sourced locally.
IT Support

A certain level of IT support is required for any successful digital health intervention. This includes:

  • First-line IT support (local, on the ground support and troubleshooting, such as health care facility computer updates).
  • Second-line IT support (on-distance support and troubleshooting, such as bug fixing by the adherence platform developer).
Telecommunications Aggregator

Telecommunication aggregators offer vital technical assistance in negotiating and setting up communications infrastructure within the country of implementation. This is particularly important for the Medication Sleeve or Label technology to function optimally. Telecom Aggregators are not necessary for the smart pill box or video supported treatment to function.

Training & Supervision

Training and supervision costs during implementation could include the following:

  • Training for healthcare workers upon intervention rollout, such as training patients on using the selected DAT, registering new patients onto the adherence platform, and accessing adherence data.
  • Follow up training on new technology functionalities.
  • Supervision and support to ensure quality control as part of patient support and capacity building.

Request Technical Assistance

Adjusted Cost at Scale

Generally, the cost per patient decreases as the DAT roll-out increases. One such example is the cost of setting up the adherence platform – the cost remains the same whether 1 patient or 1000 patients are enrolled. The project therefore becomes more cost effective when more patients are enrolled as cost can be spread out across all patients.

However, certain costs for infrastructure will increase as the patient number increases, for example, increased server space and bandwidth are required for reliable access to the adherence platform.

Getting a comprehensive quote for your context’s infrastructure requirements is vital to develop an accurate budget.

Total Cost of Ownership Tool

The Total Cost of Ownership (TCO) tool provides an estimated view of costs, quantifying capital, and operating expenses, so users can plan and budget for the adoption and scale-up of DATs according to the specified number of facilities/patients, average treatment duration, and the combination of DAT products used.

TCO Tool

Excel-based Total Cost of Ownership tool for DATs.

Funding Proposals

The Global Fund funding application guidance to formulate your country’s funding proposal.

WHO Guidelines

DAT inclusion in the WHO Consolidated Guidelines for Treatment (Care and Support)

Funding Proposals

Digital Adherence Technologies are taking a more prominent role globally in the treatment support of Tuberculosis.

The WHO’s consolidated guidelines on Tuberculosis for treatment (care and support) from July 2022 state that “treatment support alone is not likely to be sufficient to ensure good TB treatment outcomes, [and] additional interventions for treatment adherence need to be provided.”

The WHO also stated that “medication monitors had better rates of adherence and favourable outcomes, and combined interventions of SMS and medication monitors also showed better adherence compared to no intervention.”

Formulating your country’s funding proposal can be done in conjunction with the resources published by Global Fund.

Finalize DAT Implementation

Once the planning phases for implementation – assess; design; and budget – have been completed, your NTP will be well prepared to begin the finalizing phases of implementation, these include customizing, procuring and, training and integrating.

Technical Assistance

The Global DAT Task Force is fully funded to  offer technical assistance in all phases of planning for and implementing DATs.

Reach out to the DAT Task Force Secretariate should you require guidance for budgeting, punding proposal development & setting up your country’s DAT intervention.

Book a consultation

Implementing DATs

The phased, step-wise approach to implementing a DAT intervention.

Assess

Gain an understanding about influencing factors within your context for a DAT implementation.

Design

Considering multiple facets of a DAT intervention to ensure the design of a robust intervention that is relevant for your country context.

Budget

Cost factors associated with a DAT intervention in your context, including once-off costs and on-going programmatic costs.

Customization

Customize the DAT intervention to suit the needs of the local treatment setting.

Procurement

Steps in procurement to ensure the necessary technology is ordered and supportive infrastructure is in place before the intervention begins.

Train & Integrate

A training package to integrate DATs into the TB treatment programme to fully utilize the DAT for optimal efficiency and productivity.