Cost analysis as a management tool for improving the efficiency of primary care: some examples from Java.

Health programs in developing countries increasingly face limited or even reduced budgets. More and better services might be produced from these resources by improving efficiency through better management and program design. Cost analysis at individual health units can help identify sources of inefficiency, and provide guidance to managers as to where they can achieve important gains in productivity. This paper presents several examples from health centers and sub-centers in rural Java. Indonesia, showing how inefficiencies in staffing patterns, personnel management, and drug management can affect cost-efficiency. Routine analysis of cost data could provide the basis for management incentives to local health units to increase both outputs and quality of care.