Budget and Cost Estimates: Example from Mozambique
This post summarizes a webinar that took place in July 2025 for representatives of countries planning to launch sample registration systems.
Budgeting for sample registration systems (SRS) is complicated, but analyzing existing systems can simplify the process. In a July 2025 webinar, Malick Kante from the Johns Hopkins Bloomberg School of Public Health and others discussed budget and costing analysis from the sample mortality registration system in Mozambique and other global systems.
Cost Analysis from Mozambique
A 2023 analysis of the Mozambican system, published in the American Journal of Tropical Medicine and Hygiene, examined the start-up (fixed) costs and average annual operating costs during years 2017-2020 based on implementation in 700 clusters. Authors found that approximately two million dollars were spent on setting up the system, with infrastructure, technological investments, and training activities making up over 80% of these start-up costs. Annually, the system costs $984,771 per year, of which 66% was spent on wages and data collection incentives. This led to an estimate of $37–$42 per vital event captured by the system (including deaths, pregnancies, and pregnancy outcomes) and $303–$340 per verbal and social autopsy conducted on a reported death.
Read the paper titled Implementing the Countrywide Mortality Surveillance in Action in Mozambique: How Much Did It Cost?
Other Budgeting Considerations
Daniel Cobos from the Swiss Tropical and Public Health Institute noted that budgeting is not just about calculating money or funding but also about identifying which resources are available and which are needed. For example, existing staff may be assigned to work on the system rather than hiring new staff.
In-kind contributions were also discussed during the July webinar. Although it can be challenging to calculate a cost for these, it is useful to make note of any in-kind contributions being utilized. One example is of vehicles that have already been purchased for another data collection activity which may be available to use for sample registration systems.
Another possible expense includes using physician coding. For example, in Sierra Leone’s SRS, this costs about $2 per record. At least two physicians are needed per record, and in Sierra Leone they have teams of up to 12 physicians.
Changing exchange rates may also present a challenge in countries where these fluctuate frequently.
Another consideration is that these country-level budgeting tools do not include costs for external technical assistance. This is not included in the template because often the country does not know the cost, and further discussions are needed between country teams and technical assistance teams to determine costs and budgets for such activities.
