Editing units of consumable required for each HSI

[sakshimohan]

There are a few challenges with the way in which units of consumables required are coded in modules -

1. Inconsistency in coding the quantity of consumables needed - Some modules express the units needed in terms of the proportion of the unit of issue (package sold) as per the name of the consumable in the original consumable name list from the 2016 One Health Tool. For instance, see line 1040 of alri.py where 0.01 of a package is required per HSI. Others specify these in terms of the number of individual units (smallest divisible unit). For instance, the contraception module assume 30 condoms issued per HSI.

2. Using the unit of issue as defined in the 2016 One Health Tool might lead to errors in costing especially if these units of issue change over time and costs are expressed in terms of a different unit of issue. For eg., costs expressed in terms of $/pack of 30 tablets whereas module coded to provide quantities assuming a pack of 60 tablets.

In order to address the inconsistency and ensure accuracy of costing, we wish to recode consumable quantities required by HSIs within modules to represent the quantity of the chosen unit of the consumable in terms of which price is expressed, such as a single vial, single ampoule, 1 gram of drug, 1ml of liquid etc. Some examples below -

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Consumable_name_tlo	Chosen_unit_for_price	Final_price_per_chosen_unit (USD, 2023)
Gentamycin, injection, 40 mg/ml in 2 ml vial	2 ml vial (40 mg/ml)	0.053693068
Ciprofloxacin 250mg_100_CMST	1 mg	0.000058701
Ferrous sulphate 200mg _1000_CMST	1 tablet (Ferrous sulphate 200mg/Folic acid 25mg)	0.001982148
Levonorgestrel 0.0375 mg, cycle	Tablet (Levonorgestrel 0.0375 mg/~30 micrograms)	0.043909897
Injectable artesunate	1 ampoule (60 mg artesunate)	0.109717557
Doxorubicin, 50 mg vial	1 vial (50 mg)	19.308152109
Bandage, crepe 7.5cm x 1.4m long , when stretched	1 cm long (7.5 cm wide)	0.002716640

For this PR, we request module leads to express the quantities of consumables needed in terms of theChosen_unit_for_price column of the consumables sheet in ~resources/costing/ResourceFile_cost_consumables.xlsx. If you think the unit in the resource file needs to be changed, feel free to suggest this.

Modules (Module leads to mark as done once updated):

• ALRI
• Bladder cancer
• Breast Cancer
• Cardiometabolic disorders
• Care of women during pregnancy
• Contraception
• COPD
• Depression
• Diarrhea
• EPI
• Epilepsy
• HIV
• Labour
• Malaria
• Measles
• Newborns
• Oesophagal cancer
• Other adult cancers
• Postnatal
• Prostate cancer
• Road traffic injuries
• Schisto
• Stunting
• TB
• Wasting

Useful references:

1. WHO Model list of essential medicines
2. Health Action International Price and Avilability List - useful international database but incomplete
3. Live Malawi CMST Catalogue

[sakshimohan]

Hi @tdm32 @joehcollins @EvaJanouskova @mnjowe @andrew-phillips-1 @timcolbourn @tbhallett
As discussed at the quarterly meeting, this is the PR to update the quantity of consumables requested within disease modules. I have now updated the consumables cost data to express costs in terms of smaller units, as described in the message above. Hope the request makes sense - feel free to reach out if not and I'm happy to clarify here or on a call.

[sakshimohan]

@tdm32 There are a few HIV consumables for which I wasn't able to extract costs from the sources that I was using (CMST Catalogue, EHP Tool, 2016 One Health Tool). I think we can use the Global Fund Pooled Purchasing Mechanism Reference Prices. Another possible source is this CHAI ARV Reference Price list but this is older (2016). Would you have any thoughts on what would be the appropriate regimen for the following three item codes -

2671 | First-line ART regimen: adult
2672 | First line ART regimen:  child
2673 | First line ART regimen: young child

199 | Nevirapine, tablet, 200 mg - only the cost of oral solution ("Nevirapine 10mg/mL oral suspension, 100mL bottle") is available

Similarly, for TB I'm using the Stop TB partnership Catalogue (info on patient kits here). Cat I and III Patient Kits (item codes 176 and 178) are listed here so those were straightforward to cost. But the following TB consumables aren't listed. Could you advise on these?
Note that for now I have included the cost as listed in the 2016 One Health Tool (but I had to use the unit 1 full treatment ("First line treatment for retreatment TB cases for adults") because the One Health Tool doesn't break down the cost.

184 | Solid culture and DST
177 | Cat. II Patient Kit A1
179 | Cat. II Patient Kit A2
181 | Treatment: second-line drugs
182 | MDR Fuel

[sakshimohan]

@joehcollins @EvaJanouskova Should the following consumables be treated as equipment? I've currently included the cost in the spreadsheet based on recent Central Medical Stores data but given how consumables are costed, we'll end up overestimating the cost of these by counting it each time the item code is needed. Another option is that we divide the unit costs by the number of times we expect these devices can be used before needing to be discarded.

2669 | Forceps, obstetric ($23)
2670 | Vacuum, obstetric ($129)

@joehcollins I also have a couple of notes on nutrition consumables if you'll be working on these. I extracted many of the costs from the UNICEF Supply Catalogue because UNICEF is the main supplier of nutrition consumables in Malawi and these were not in the Central Medical Stores list. Let me know if you think I should verify these with Ines -

213 | SAM theraputic foods | Cost based on 'Therapeutic CMV,tin 800g/CAR-6' from the UNICEF Supply Catalogue
208 | Corn Soya Blend (or Supercereal - CSB++) | Cost based on 'Emergency food ration,500g/CAR-24' from the UNICEF Supply Catalogue
214 | SAM medicines | Used 2016 One Health Tool cost but it's not clear what the consumable is
1015 | Dietary supplements (country-specific) | Cost based on 'Multiple micrn. pdr,custom sach./PAC-30' from the UNICEF Supply Catalogue

[tbhallett]

Thanks very much @sakshimohan -- this all looks very good and reasonable.

So, the definitive source is in the file resources/costing/ResourceFile_Costing.xlsx: sheet Consumables, column Z (shown below too).

I am wondering if we should also remove the columns named Costs and Expected Units per Case from the ResourceFile_Consumables_Items_and_Packages.csv, to avoid people (in the future) looking in the wrong place for this information/ and potentially merging in this column Z for each item_code there...?

Item_Code	Consumable_name_tlo	Chosen_unit_for_price
0	Levonorgestrel 0.0375 mg, cycle	Tablet (Levonorgestrel 0.0375 mg/~30 micrograms)
1	Levonorgestrel 0.15 mg + Ethinyl estradiol 30 mcg (Microgynon), cycle //97.2% users//; or Levonorgestrel 0.0375 mg, cycle //2.8% users//	Tablet (Levonorgestrel 0.15 mg + Ethinyl estradiol 30 mcg)
2	Condom, male	Single condom
3	Depot-Medroxyprogesterone Acetate 150 mg - 3 monthly	1 ml vial
5	Povidone iodine, solution, 10 %, 5 ml per injection	1 ml
6	Syringe, Autodisable SoloShot IX	1 syringe
7	IUD, Copper T-380A	1 IUD
8	Lidocaine HCl (in dextrose 7.5%), ampoule 2 ml	2 ml ampoule
9	Syringe, needle + swab	1 syringe
11	Needle suture intestinal round bodied A circle trocar_6_CMST	1 needle suture
12	Jadelle (implant), box of 2_CMST //84.8% users//; or Implanon (Etonogestrel 68 mg) //15.2% users//	1 implant (2 rods)
13	Implanon (Etonogestrel 68 mg)	1 implant
14	Atropine sulphate, injection, 1 mg in 1 ml ampoule	1 ml ampoule (1 mg/ml)
15	Diazepam, injection, 5 mg/ml, in 2 ml ampoule	2 ml ampoule (5 mg/ml)
16	Lidocaine, injection, 1 % in 20 ml vial	1 ml (1%)
17	Lidocaine, spray, 10%, 500 ml bottle	1 ml (10%)
21	Tape, adhesive, 2.5 cm wide, zinc oxide, 5 m roll	1 cm long (2.5 cm wide)
23	Paracetamol, tablet, 500 mg	1 mg
24	Cotton swab	1 g
25	Female Condom_1_CMST	1 condom
26	Misoprostol, tablet, 200 mcg	1 mcg
27	Ampicillin, powder for injection, 500 mg, vial	1 mg
28	Gentamycin, injection, 40 mg/ml in 2 ml vial	2 ml vial (40 mg/ml)
29	Metronidazole, injection, 500 mg in 100 ml vial	100 ml vial for IV (5 mg/ml)
30	Tetracycline, tablet, 500 mg	1 mg
33	Sodium chloride, injectable solution, 0,9 %, 500 ml	1 ml (0.9%)
39	Tetanus toxoid, injection	5 ml injection
40	Blood collecting tube, 5 ml	5 ml tube
41	Test, Rapid plasma reagin (RPR)	1 test
42	Benzathine benzylpenicillin, powder for injection, 2.4 million IU	1 injection (1.44g)
44	Ferrous sulphate 200mg _1000_CMST	1 tablet (Ferrous sulphate 200mg/Folic acid 25mg)
47	Urine analysis	1 bottle
49	Cotton wool, 500g_Each_FF007800_CMST	1 g
50	Haemoglobin test (HB)	1 test
52	Albendazole, tablet, 400 mg	1 mg
56	Oxytocin, injection, 10 IU in 1 ml ampoule	1 ml ampoule (10 IU/ml)
57	Bag, urine, collecting, 2000 ml	1 2000ml bag
58	Foley catheter	1 catheter
60	Hydralazine, powder for injection, 20 mg ampoule	1 ml (20 mg/ml)
61	Magnesium sulfate, injection, 500 mg/ml in 10-ml ampoule	10 ml ampoule (500 mg/ml)
64	Infant resuscitator, clear plastic + mask + bag_1_CMST	1 resuscitator
65	Ketamine, 10 ml vial, 50 mg/ml	10 ml vial (50 mg/ml)
66	Cefazolin, ampoule, 500 mg	1 mg
67	Blade, surgical, no. 22, sterile, disposable	1 blade
68	Tetracycline eye ointment, 1 %, tube 5 mg	1 g
70	Amoxicillin, powder/oral suspension, 125 mg/5 ml	1 ml (125mg/5ml)
71	Paracetamol syrup 120mg/5ml_0.0119047619047619_CMST	1 ml (120mg/5ml)
73	Iodine strong 10% solution_500ml_CMST	1 ml (10%)
74	Chlorhexidine 1.5% solution_5_CMST	1 ml (1.5%)
75	Gauze, swabs 8-ply 10cm x 10cm_100_FF010800_CMST	1 swab (10cm X 10cm)
76	Scalpel blade size 22 (individually wrapped)_100_CMST	1 blade
80	Giving set iv administration + needle 15 drops/ml_1_CMST	1 IV set
81	Ceftriaxone 1g, PFR_1_CMST	1 g
82	Catheter Foley's + urine bag (2000ml) 14g_1_CMST	1 catheter
84	Declofenac injection_1_CMST	3 ml ampoule (75 mg/ml)
86	Ampicillin injection 500mg, PFR_1_CMST	1 injection (500 mg)
88	surgical face mask, disp., with metal nose piece_50_IDA	1 mask
90	Halothane (fluothane)_250ml_CMST	1 ml
92	Metronidazole 200mg_1000_CMST	1 mg
93	Saline solution	1 ml (0.9%)
98	Water for injection, 10ml_1_CMST	10 ml ampoule
99	Benzylpenicillin 3g (5MU), PFR_1_CMST	1 g
101	Gauze, absorbent 90cm x 40m_1_CMST	1 cm long (84 cm wide)
102	Oxytocin 10 IU/ml, 1ml_1_CMST	1 ml (10 IU/ml)
103	Bandage, plaster of paris 15cm_12_CMST	1 bandage (15cm)
105	Metronidazole 5mg/ml, 100ml_1_CMST	1 ml (5 mg/ml)
106	Gentamicin Sulphate 40mg/ml, 2ml_1_CMST	2 ml vial (40 mg/ml)
112	Glove surgeons size 7 sterile_Pair_HH080400_CMST	1 pair of gloves
113	Paracetamol 500mg_1000_CMST	1 mg
117	Clean delivery kit	1 kit
120	Cannula iv (winged with injection pot) 16_1_CMST	1 cannula
123	Erythromycin, tablet, 250 mg	1 mg
125	Amoxycillin 250mg_1000_CMST	1 mg
126	Lancet, blood, disposable	1 lancet
127	Oxygen, 1000 liters, primarily with oxygen cylinders	1 litre
128	Complete blood count	1 bottle (5ml)
130	Gentamicin 40mg/ml, 2ml_1_CMST	2 ml vial (40 mg/ml)
134	Tube, feeding CH 8_1_CMST	1 tube
135	Disposables gloves, powder free, 100 pieces per box	1 pair of gloves
141	Blood, one unit	?
144	Hand washing with soap - cost per client	1ml
146	ORS, sachet	1 sachet
147	Zinc, tablet, 20 mg	1 mg
148	Ciprofloxacin 250mg_100_CMST	1 mg
149	ringer's lactate (Hartmann's solution), 1000 ml_12_IDA	1 ml
153	Syringe, autodisposable, BCG, 0.1 ml, with needle	1 dose
154	Safety box for used syringes/needles, 5 liter	1 disposed syringe (100 syringes per box)
155	Pneumococcal vaccine	1 dose
157	HPV vaccine	1 dose
162	Sulfamethoxazole + trimethropin, tablet 400 mg + 80 mg	1 ml (2.4 mg/ml)
163	Malaria test kit (RDT)	1 test
164	Lumefantrine 120mg/Artemether 20mg, 30x18_540_CMST	1 tablet (Lumefantrine 120mg/Artemether 20mg)
170	Injectable artesunate	1 ampoule (60 mg artesunate)
171	Cannula iv (winged with injection pot) 18_1_CMST	1 cannula
175	X-ray	1 film (35cm  X 43cm)
178	Cat. I & III Patient Kit B	1 kit (6 blisters (168) 4-FDCs (R150/H75/Z400/E275); 18 blisters (504) 2-FDC tablets (E400/H150))
184	Solid culture and DST	1 culture tube
187	Xpert	1 cartridge
190	VL Test	1 test
191	CD4 test	1 test
192	Isoniazid/Pyridoxine, tablet 300 mg	1 tablet (Isoniazid 300mg/Pyridoxine 25mg)
196	Test, HIV EIA Elisa	1 test
197	male circumcision kit, consumables (10 procedures)_1_IDA	1 kit
198	Nevirapine, oral solution, 10 mg/ml	1 ml (10 mg/ml)
199	Nevirapine, tablet, 200 mg	1 mg
202	Sulfamethoxazole + trimethropin, oral suspension, 240 mg, 100 ml	1 ml
203	Cotrimoxazole 120mg_1000_CMST	1 mg
204	Cotrimoxizole, 960mg pppy	1 mg
206	Culture test	1 test kit
209	Vitamin A, caplet, 100,000 IU	1 capsule (100,000 IU)
212	Vitamin A, caplet, 200,000 IU	1 capsule (200,000 IU)
213	SAM theraputic foods	1 g (Therapeutic complex of vitamins and minerals (CMV))
216	Blood glucose level test	1 test strip
221	Hydrochlorothiazide 25mg_1000_CMST	1 mg
222	Methyldopa 250mg_1000_CMST	1 mg
225	Frusemide 40mg_1000_CMST	1 mg
226	Aspirin 300mg_1000_CMST	1 mg
227	Insulin soluble 100 IU/ml, 10ml_1_CMST	10 ml vial (100 IU/ml)
232	Glibenclamide 5mg_1000_CMST	1 mg
233	Metformin hydrochloride 500mg_100_CMST	1 mg
234	Simvastatin, 15 mg	1 mg
238	Doxorubicin, 50 mg vial	1 vial (50 mg)
239	Cisplatin 50mg Injection	1 vial (50 mg)
240	5-Fluorouracil 500mg injection	1 shot (500mg)
242	diclofenac sodium 25 mg, enteric coated_1000_IDA	1 mg
243	morphine sulphate 10 mg/ml, 1 ml, injection (nt)_10_IDA	1 ml (10 mg/ml)
244	Bandage, crepe 7.5cm x 1.4m long , when stretched	1 cm long (7.5 cm wide)
247	Suture pack	1 suture pack
248	Flucloxacillin 250mg_100_CMST	1 mg
249	Plaster of Paris (POP) 10cm x 7.5cm slab_12_CMST	1 slab (10cm x 7.5cm)
259	Vincristin 1mg Injection	1 ml (1 mg/ml)
260	Paclitaxel 100mg Injection	1 ml (6 mg/ml)
261	Cyclophosphamide, 1 g	1 mg
262	Methylprednisolone acetate sub-conj. 40mg/ml,2ml_1_CMST	2 ml vial (40 mg/ml)
263	bleomycin powder 15 mg (15,000 IU) (**)_1_IDA	1 mg (1000 IU/mg)
264	Vinblastin 10mg injection	10 ml vial (1 mg/ml)
265	Dacarbazine 500mg injection	1 vial (500 mg)
267	Amitriptyline 25mg_100_CMST	1 mg
268	Fluoxetine 20mg_1000_CMST	1 mg
275	Sodium valproate 200mg_100_CMST	1 mg
276	Carbamazepine 200mg_1000_CMST	1 mg
278	Phenobarbital, 100 mg	1 mg
279	Phenytoin sodium 100mg_1000_CMST	1 mg
280	Diazepam 5mg_1000_CMST	1 mg
284	Clonidine, .1 mg	1 mcg
286	Praziquantel 600mg_1000_CMST	1 mg
288	Diclofenac sodium 100mg _100_CMST	1 mg
289	Catheter Foley's + urine bag (2000ml) 10g_1_CMST	1 urine bag (2L)
291	Prednisolone 5mg_100_CMST	1 mg
292	Aminophylline 100mg, tablets	1 mg
293	Salbutamol Inhaler 100mcg/dose - 200 doses	1 dose (100 mcg)
295	Paracetamol, tablet, 100 mg	1 mg
296	Salbutamol, tablet, 4 mg	1 mg
297	Salbutamol, syrup, 2 mg/5 ml	1 ml (2 mg/5 ml)
298	Salbutamol sulphate 1mg/ml, 5ml_1_CMST	5 ml vial (1 mg/ml)
299	Amoxycillin 125mg/5ml suspension, PFR_0.025_CMST	1 ml (125 mg/5 ml)
300	Tube, nasogastric CH 8_1_CMST	1 tube
307	Atropine sulphate 600 micrograms/ml, 1ml_Each_BB006600_CMST //1 unit 50% patients ‚Üí 0.5 units per case//	1 ml (600 mcg/ml)
1007	Calcium, tablet, 600 mg	1 mg
1191	Tenofovir (TDF)/Emtricitabine (FTC), tablet, 300/200 mg	1 tablet (TDF 300mg/ FTC 200 mg)
1220	F-75 therapeutic milk, 102.5 g	1g
1223	F-100 therapeutic diet, sach., 114g/CAR-90	1g
1227	Therapeutic spread, sachet 92g/CAR-150	1 sachet
1827	Dexamethasone 5mg/ml, 5ml_1_CMST	1 ml (4 mg/ml)
1831	Flucloxacillin 250mg, vial, PFR_1_CMST	1 mg
1871	Cetrimide 15% + chlorhexidine 1.5% solution.for dilution _5_CMST	1 ml (Cetrimide 15% + chlorhexidine 1.5%)
1933	Glove disposable powdered latex medium_100_CMST	1 pair of gloves
1960	Syringe, autodestruct, 5ml, disposable, hypoluer with 21g needle_Each_HH150000_CMST + Alcohol swabs/wipes 70% isopropyl alcohol 100 pieces_100_FF000300_CMST	1 syringe (5 ml) + alcohol swab
2008	Hepatitis B test kit-Dertemine_100 tests_CMST	1 test
2019	Pregnancy slide test kit_100_CMST	1 test
2064	Dianeal + Dextrose 1.5% intraperitoneal dialysis soln. with minicap_2L_CMST	1 dialysis
2338	ceftriaxon 500 mg, powder for injection_10_IDA	1 g
2564	tramadol HCl 100 mg/2 ml, for injection_100_IDA	1 vial (100mg)
2578	vitamin B12 (cyanocobalamine) 1 mg/ml, 1 ml, inj._100_IDA	?
2606	Benzylpenicillin 1g (1MU), PFR_1_CMST	1 vial (1.44g/2.4 MU)
2669	Forceps, obstetric	1 pair of forceps
2670	Vacuum, obstetric	1 vacuum extractor
2676	Polyamide monofilament suture sterile 1, on 40mm 3/8 circle reverse cutting needle_12_GG005100_CMST	1 suture pack
2677	Catgut chromic suture sterile 0, 75cm, round bodied ¬Ω circle 40mm needle_12_GG000600_CMST	1 suture pack
10	Trocar	1 trocar
31	Methylergometrine, Injection 0.2 mg/ml, 1 ml amp	1 ml ampoule
32	Pethidine, 50 mg/ml, 2 ml ampoule	1 ampoule of 2ml (50 mg/ml)
36	Epinephrine, ampoule, 1 mg/ml	1 ampoule of 4ml (1 mg/ml)
45	Albendazole 200mg_1000_CMST	1 mg
131	Cephalotin, 100 ml vial	1 vial of 1g
132	Ampicillin injection 250mg, PFR_1_CMST	1 vial of 500mg
133	Dextrose (glucose) 5%, 1000ml_1_CMST	1 ml (5%)
140	Ferrous Salt + Folic Acid, tablet, 200 + 0.25 mg	1 tablet (Ferrous sulphate 200mg/Folic acid 25mg)
145	Hygienic disposal of children's stools - cost per client	Consumables needed for one client
150	Rotavirus vaccine	1 dose
151	Polio vaccine	1 dose
158	Measles vaccine	1 dose
160	Insecticide-treated net	1 net
161	Indoor residual spraying drugs/supplies to service a client	IRS for one client
176	Cat. I & III Patient Kit A	1 kit (6 blisters (168) 4-FDC tablets (R150/H75/Z400/E275); 12 blisters (336) 2-FDC tablets (R150/H75))
177	Cat. II Patient Kit A1	1 full treatment ("First line treatment for retreatment TB cases for adults")
179	Cat. II Patient Kit A2	1 full treatment ("First line treatment for retreatment TB cases for children")
181	Treatment: second-line drugs	1 full treatment ("Case management of MDR cases")
182	MDR Fuel	1 assay kit
200	DNA PCR for infant after birth	1 test
205	Nutrition supplements in first six months drugs/supplies to service a client	1 sachet (multiple micronutrient)
207	Smear test	1 test
208	Corn Soya Blend (or Supercereal - CSB++)	1 g
214	SAM medicines	1 full treatment ("Management of severe malnutrition (children)")
266	Leucovorin 50mg injection	1 vial (5 mg)
281	Thiamine (vitamin B1), 100 mg
283	Methadone, 5 mg	1 ml
285	Mectizan	1 full treatment ("Onchocerciasis mass drug administration")
287	I/V R/lactate 3Lts	1 full treatment ("LF hydrocele surgery")
290	Underpants	1 underpant
1015	Dietary supplements (country-specific)	1 sachet
1197	Pentavalent vaccine (DPT, Hep B, Hib)	1 dose
1221	Supplementary spread, sachet 92g/CAR-150	1 sachet (92g)
2580	vitamin K1 (phytomenadione) 1 mg/ml, 1 ml, inj._100_IDA	1 ml (2 mg/ml)
2671	First-line ART regimen: adult	1 tablet (Abacavir/Dolutegravir/Lamivudine 600/50/300mg)
2672	First line ART regimen:  older child	1 tablet (Abacavir/Dolutegravir/Lamivudine 60/5/30mg)
2673	First line ART regimen: young child	1 tablet (Abacavir/Dolutegravir/Lamivudine 60/5/30mg)
2678	Isoniazid/Rifepentine	1 tablet (3HP - Isoniazid 300mg/Rifapentine 300mg)
1237	Specimen container	1 container
1239	Biopsy needle	1 needle

[tbhallett]

Also, here is the updated Module Leaders designations.

[sakshimohan]

I am wondering if we should also remove the columns named Costs and Expected Units per Case from the ResourceFile_Consumables_Items_and_Packages.csv, to avoid people (in the future) looking in the wrong place for this information/ and potentially merging in this column Z for each item_code there...?

Makes sense, @tbhallett. I'll update generate_consumables_item_codes_and_packages.py remove those columns.

[EvaJanouskova]

I am wondering if we should also remove the columns named Costs and Expected Units per Case from the ResourceFile_Consumables_Items_and_Packages.csv, to avoid people (in the future) looking in the wrong place for this information/ and potentially merging in this column Z for each item_code there...?

I do not agree with this. I always felt it would be much better if consumables in all modules are rather called by the Intervention_Pkg name than being defined inside the code. That way, it would be much easier to set up the model for other countries later. With all set within the model instead in the RF, it will be pain then. Costs could be in the separate RF per chosen unit, that is okay. But the names of Intervention_Pkg with the setup of consumables and expected units for that intervention would be better if they are in the ResourceFile_Consumables_Items_and_Packages.csv.

In future, I would also like to see there a column saying which consumable is essential/optional for that Intervention_Pkg, so nothing has to be in the code and can potentially differ for different countries without touching the code.

Hence, I think it I would be better if the column Expected Units per Case stays and in future all the consumables calls are changed to use the RF.

[tdm32]

@sakshimohan branch consumables/editing_units_required_TM is now ready for review. It contains the updated item codes/item units for malaria.

Note:
IPTP for malaria should be Fansidar Sulfadoxine-pyrimethamine (SP)
In the consumables resourcefile (items and packages), malaria iptp for pregnant women is listed as Sulfamethoxazole + trimethropin, tablet 400 mg + 80 mg which is cotrimoxazole. This is indicated for pregnant women with HIV, but not HIV- pregnant women. The correct item (Fansidar is the brand name) is imported from OneHealth and has no dosage associated with it. I have used the commonly used dosage (each tablet containing 500 mg/25 mg SP) for assumptions on quantities required.

Also the individual unit for Sulfamethoxazole + trimethropin, tablet 400 mg + 80 mg should be 1 tablet.

Please let me know if you spot anything I've missed - thanks so much!

[joehcollins]

Thanks for this @sakshimohan. Are you happy for us to just push any changes to this branch?

[joehcollins]

@joehcollins @EvaJanouskova Should the following consumables be treated as equipment? I've currently included the cost in the spreadsheet based on recent Central Medical Stores data but given how consumables are costed, we'll end up overestimating the cost of these by counting it each time the item code is needed. Another option is that we divide the unit costs by the number of times we expect these devices can be used before needing to be discarded.

2669 | Forceps, obstetric ($23) 2670 | Vacuum, obstetric ($129)

@joehcollins I also have a couple of notes on nutrition consumables if you'll be working on these. I extracted many of the costs from the UNICEF Supply Catalogue because UNICEF is the main supplier of nutrition consumables in Malawi and these were not in the Central Medical Stores list. Let me know if you think I should verify these with Ines -

213 | SAM theraputic foods | Cost based on 'Therapeutic CMV,tin 800g/CAR-6' from the UNICEF Supply Catalogue 208 | Corn Soya Blend (or Supercereal - CSB++) | Cost based on 'Emergency food ration,500g/CAR-24' from the UNICEF Supply Catalogue 214 | SAM medicines | Used 2016 One Health Tool cost but it's not clear what the consumable is 1015 | Dietary supplements (country-specific) | Cost based on 'Multiple micrn. pdr,custom sach./PAC-30' from the UNICEF Supply Catalogue

r.e. forceps/vacuum we currently have kept these items as consumables in the model so we can use their presumed availability to determine if the relevant intervention does or doesnt happen. This could maybe be replaced when we have the essential consumable equipment logic. Wonder what @tbhallett thinks about doing the cost per use approach? Otherwise we just ignore until we cost it properly with the equipment approach...

r.e. nutrition bits - i think they're stunting/wasting interventions so that would be @EvaJanouskova

[joehcollins]

Another quick question for @sakshimohan - is there an error for item code 52 (Albendazole, tablet, 400mg) as the chosen unit for price is 1g when for item code 45 (Albendazole 200mg) its 1mg? Also maybe i've misunderstood but then in the code when i want an individual to have a single dose of item code 52, i'm requesting 400 of that item code? This varies from other items which have a smallest unit of one tablet?

[sakshimohan]

Thanks for this @sakshimohan. Are you happy for us to just push any changes to this branch?

Hi @joehcollins. Yes, absolutely. Feel free to push changes to this branch.

r.e. forceps/vacuum we currently have kept these items as consumables in the model so we can use their presumed availability to determine if the relevant intervention does or doesnt happen. This could maybe be replaced when we have the essential consumable equipment logic. Wonder what @tbhallett thinks about doing the cost per use approach? Otherwise we just ignore until we cost it properly with the equipment approach...

Makes sense if you think it is important to account for their availability. I'll have a quick chat about this during my meeting with Tim this morning.

Another quick question for @sakshimohan - is there an error for item code 52 (Albendazole, tablet, 400mg) as the chosen unit for price is 1g when for item code 45 (Albendazole 200mg) its 1mg? Also maybe i've misunderstood but then in the code when i want an individual to have a single dose of item code 52, i'm requesting 400 of that item code? This varies from other items which have a smallest unit of one tablet?

Sorry that was indeed a typo - the price is expressed at $/mg. I've corrected this now. It's correct that for Albendazole you would need to request 400 units of item code 52 if you need one 400mg tablet. I realise that this can be confusing but we decided to go with this after discussing at the quarterly meeting that some of these tablets might be sold in different concentrations. For eg., albendazole itself is sold as either 200 mg or 400 mg tablets, even though you're using these item codes 45 and 52 for different interventions.
I've tried to use tablets only in the cases where there were two compounds involved (eg. Ferrous sulphate/Folic Acid) because there wasn't an easy way to express these in terms of smaller quantities. Hope this makes sense. If, based on your medical knowledge, you think that some of these should be reverted to tablets because it makes logical sense, feel free to suggest this and I can make the update.

[EvaJanouskova]

I am wondering if we should also remove the columns named Costs and Expected Units per Case from the ResourceFile_Consumables_Items_and_Packages.csv, to avoid people (in the future) looking in the wrong place for this information/ and potentially merging in this column Z for each item_code there...?

I do not agree with this. I always felt it would be much better if consumables in all modules are rather called by the Intervention_Pkg name than being defined inside the code. That way, it would be much easier to set up the model for other countries later. With all set within the model instead in the RF, it will be pain then. Costs could be in the separate RF per chosen unit, that is okay. But the names of Intervention_Pkg with the setup of consumables and expected units for that intervention would be better if they are in the ResourceFile_Consumables_Items_and_Packages.csv.

In future, I would also like to see there a column saying which consumable is essential/optional for that Intervention_Pkg, so nothing has to be in the code and can potentially differ for different countries without touching the code.

Hence, I think it I would be better if the column Expected Units per Case stays and in future all the consumables calls are changed to use the RF.

If you decide to remove the Intervention_Pkg at the end, you will need to check where the fnc get_item_codes_from_package_name is used and changed that.

[sakshimohan]

If you decide to remove the Intervention_Pkg at the end, you will need to check where the fnc get_item_codes_from_package_name is used and changed that.

Hi @EvaJanouskova. We decided that for now we'll just keep the current structure for how we deal with consumables, i.e. specifying quantity needed within modules, and consider a more serious overhaul where everything is moved with RFs in the future. @tbhallett will raise a separate issue for me to update the ResourceFile_Consumables_Items_and_Packages.csv to remove Expected_units_per_case and Unit_Cost columns. Just to clarify, the plan is to retain the Intervention_Pkg column. (Issue #1303)
We've said that it's lower in terms of priority for now so I'll reach out to you in due course so see if you want to retain any information in the columns you had manually added to ResourceFile_Consumables_Items_and_Packages.csv for your contraception work.

[joehcollins]

@sakshimohan - can we please have the minimum unit for disposable gloves as 2 as opposed to 1 glove - so we dont need to specify we need two every time in the code?

Thanks!

[tbhallett]

debug test_contraception_coverage_with_use_healthsystem

[EvaJanouskova]

all good

[tbhallett]

@sakshimohan -- we think we're done with this.

@tbhallett will double-check calibrations (long_run_all_diseases run is: long_run_all_diseases-2024-05-31T160939Z)

@sakshimohan please check that these changes are the ones you want to come in on this PR.

Hooray!!!!

[tbhallett]

Master at current tip (#1273 just merged)	This branch

[tbhallett]

Master at current tip (#1273 just merged)	This branch

[tbhallett]

No evidence of wild changes in the calibrations being introduced in this branch ✅

[tbhallett]

@sakshimohan -- this is OK with me to merge, if you're also happy?

(I presume you're happy with the change in the scripts/resource file that you manage).

[sakshimohan]

@sakshimohan -- this is OK with me to merge, if you're also happy?

(I presume you're happy with the change in the scripts/resource file that you manage).

Hi @tbhallett. Thanks for running the comparison with master. It looks ready to merge to me.