Impact and Cost-Effectiveness of
Land
Evaluating The Socio-Economic
Love
A Collaboration Between Costello Medical and Taboobreaker Association 10th October 2022
Who are Costello Medical?
Costello Medical provides scientific, operational and design support in the analysis, interpretation and communication of clinical and health economic data
The Pro Bono division at Costello Medical provides these service free-of-charge to charities and non-profit organisations, to help improve health and healthcare globally
•
•
41 projects Undertaken on a pro bono basis in 2021 31 non-profits Partnered with globally in 2021 1,061 days Spent on pro bono work in 2021
Collaboration with Taboobreaker Association
Social return-on-investment model
Costello Medical held a Call for Projects in Global Health
We embarked on a collaboration with Taboobreaker Association to explore the impact of introducing Love Land
We received 18 applications; each project was individually assessed, through consideration of the benefits of the project for both the applicant and for Costello Medical
We selected the top 5 applicants and proposed potential projects that aligned with the applicants’ short- and long-term goals
Development of a social returnon-investment (SROI) model to explore the socio-economic impact of Love Land on its beneficiaries
Cost-effectiveness model
Development of a costeffectiveness model (CEM) to explore the feasibility of introducing Love Land from a payer perspective
SROI and Cost-Effectiveness Modelling
SROI
• SROI is an outcomes-based analysis, which enables organisations to understand, quantify and monetise their social and economic value
• An organisation’s SROI can be quantified by building an SROI model. This model’s final output is an SROI ratio, which indicates the amount of value (ZAR) delivered per R1 investment
• The SROI ratio can be calculated for specific groups or activities, meaning that SROI analysis is a powerful tool for communicating socio-economic value to different stakeholders
• A CEM is a health economics tool, used to understand how to allocate resources in healthcare most efficiently
• A CEM considers the resources (including costs, time and physical resources) and the health outcomes associated with a strategy, and compares these to alternative strategies
• The resources and health outcomes are combined into a single measure which quantifies the cost per unit of ‘health’ provided by the intervention
• The cost per unit of ‘health’ is used to determine which interventions are more efficient and preferable strategies to invest in, from the healthcare payer perspective
CEMSROI Modelling: Mapping Outcomes
During SROI modelling, a key step is the development of the impact map
This facilitates understanding of the relationships between different parameters, and provides an overview of how an organisation generates value for its stakeholders
Stakeholders Inputs Activities Outputs Outcomes
Who has an interest?
What are they putting in?
What does Taboobreaker Association do?
What are the direct and tangible endproducts?
What are the transformative changes for stakeholders?
App users
Volunteers
providers
Monetary input from funding bodies
Time input for software development
Development of the Ruby Island level on the Love Land app
users complete Ruby Island level of the app
Improved knowledge and understanding of menstrual hygiene
•
•
•
•
X
•
•
• Healthcare
SROI Modelling: Mapping Outcomes
• During SROI modelling, a key step is the development of the impact map
• This facilitates understanding of the relationships between different parameters and provides an overview of how an organisation generates value for its stakeholders
Activities Outputs Outcomes
What does Taboobreaker Association do?
What are the direct and tangible endproducts?
Development of the Ruby Island level on the Love Land app
Improved knowledge of menstruation and hygiene
Improved knowledge and understanding of menstrual hygiene
What are the transformative changes for stakeholders?
Implementation of menstrual hygiene processes into daily lives
Improved wellbeing for the app user
Short-term Medium-term Long-term
SROI Modelling: From Impact Maps to Monetised Outcomes
Love Land stakeholders
(e.g. app users, volunteers, healthcare providers)
Activities
How do we know that they benefited?
Indicators (ways of knowing that a change has taken place)
The indicator reveals the number of people benefitting from an outcome
How do we value that benefit?
Financial proxy (a financial value assigned to the change that took place)
Benefited stakeholders
Outcomes to stakeholders are assessed over a model time horizon
Multiplying the indicator by the financial proxy reveals the value of the outcome
The SROI ratio is calculated by dividing the summed value of all outcomes by the value of the initial investment
Cost-Effectiveness Modelling
Impact map development and literature searches
Data collection from Love Land app
Development of the CEM
• During the impact map development stage of the SROI analysis, relevant outcomes will be identified
• Additional targeted literature searches will be conducted to collect information on the current status quo for sexual health education. This is likely to constitute a combination of the programmes and schemes that are currently in place
• The data to be collected will be informed by the impact map and literature search results
• Typically, these data will include values for the intervention effectiveness, resource use and cost data
• Data are collected and extrapolated for an appropriate time period, likely to be a few years
• A CEM will be developed to compare the costs and impacts of using the app versus the current status quo for sexual health education
• The inputs to the model will cover different perspectives including, those of app users and healthcare providers
Anticipated Impact of Project Outputs on Taboobreaker Association
• SROI and cost-effectiveness analyses are useful for demonstrating the health and economic impact of Taboobreaker Association's Love Land app • They both demonstrate impact in an economically meaningful way, enabling them to be a useful resource for decision-making and resource allocation in health and social care SROI analysis 1 2 3 4 By quantifying the value of non-monetary outcomes of Love Land, Taboobreaker Association can reveal the breadth and depth of the app’s impact to funding bodies The model can be updated to forecast the impact of future activities, such as adding new levels or expanding beyond the South African setting; it can become a key internal decision-making tool Taboobreaker Association can compare the SROI ratios for different stakeholder groups to identify any where there may be a need for further support The impact maps can be used to visually demonstrate how Love Land app creates value for its stakeholders, and can be incorporated into promotional materials
Anticipated Impact of Project Outputs on Taboobreaker Association
SROI and
are
the
of
•
cost-effectiveness analyses
useful for demonstrating
health and economic impact
Taboobreaker Association's Love Land app • They both demonstrate impact in an economically meaningful way, enabling them to be a useful resource for decision-making and resource allocation in health and social care 1 2 3 Costeffectiveness analysis Taboobreaker Association can compare Love Land to other sexual health education interventions, supporting reimbursement applications or pricing negotiations to healthcare payers Taboobreaker Association can project the comparative efficiencies of resource use over a multiyear time horizon to show long-term cost-effectiveness to healthcare payers Taboobreaker Association can update the model regularly with new input data to ensure that it retains relevance for payer assessments in future years
