ABSTRACT
Background & objectives: Visceral leishmaniasis, locally known as kala-azar (KA) has been considered as a major public health problem in Bangladesh, India and Nepal that affects 100,000 people per year with 147 million people at risk. Elimination of infectious disease is an ultimate goal of the public health system, therefore, the efforts have recently gained momentum from various organizations and governments to expand KA interventions in the endemic countries. The paper aims to estimate discounted net benefits and internal rate of return (IRR) to evaluate the economic feasibility for elimination of KA by utilizing available secondary information. Methods: Cross-sectional data were collected from different sources to estimate societal costs of and benefits from KA interventions with a 13-year project period. Total costs are estimated based on the unit cost of inputs used for interventions. The benefits are derived from productivity change and resources saved due to reduction of KA incidence. Net benefits and IRRs are estimated based on standard procedures used in the field of economics, subsequently the sensitivity analysis is conducted. Results: A total discounted net benefit of KA intervention is Nepalese Rupees (NRs) 65,287 million with 35% IRR. The result suggests that for every rupee invested in KA intervention at present will yield NRs 71 in future. The regional benefits from the interventions will be greater than the sum of benefits gained by the individual country due to its nature of public goods. Conclusion: Elimination of KA is a good investment opportunity for the Government and international partners involved in the health sector.
ABSTRACT
Environmental pressures from such sources an economic condition, the government and inter-institutional competition create managerial challenges. Economic pressures may be forcing dietetic dept, in hospital to utilize cost, benefit analysis to assist them in their problem solving. Cost, benefit analysis have been widely used in business, industry and many other fields with only limited application to foodservice. Due to the lack or this information the purposes of this study were to identify use of cost, benefit analysis in hospital foodservice system to evaluate the economic efficiency of alternatives, and to make recommendation for operation system change. Using the cost?benefit method, cash flows are separated into cost and benefits. For an alternative to be selected, indicators, such as NPV, benefit-cost ratio (B/C ratio) with 5% discount rate per annum. The sensitivity analysis was also conducted with difference rate 3%, 7% respectively and reduced employee payroll change. The result of this study can be summarized as follows : 1. The total cost of investment for operation system change was 390,570 thousand won and the total benefit through operation system change was 865,808 thousand won. 2. Net present value(NPV) for 5 years was 475,239 thousand won and benefit-cost ratio was 2.22. 3. In sensitivity analysis with different discount rate 3%, 7%, benefit-cost ratio was 2.25, 2.18 respectively, with total reduced employee payroll change, benefit-cost ratio was 2.86. In conclusion, total benefits were exceeded total costs. Therefore, the project of operation system change in hospital foodservice was found to be economically efficient.