COST ANALYSIS OF COMMUNITY WATER FLUORIDATION IN KERIAN, PERAK

Received 2024-02-19; Accepted 2024-03-26; Published 2024-03-27

Abstract

There is limited information available regarding the cost of community water fluoridation (CWF) in Malaysia. Issues related to the cessation of CWF since 2012 in one of the states in Malaysia, were due to the cost of fluoride chemical and the privatisation of water treatment facilities (WTF). Hence, this study aims to estimate the total and per capita cost of the CWF programme in Kerian, Perak, from 2015 to 2019. This was a retrospective record review, analysing CWF expenditure data in two WTF and two dental clinics in Kerian, Perak, from 2015 to 2019, using a healthcare provider perspective. The data on the population coverage of CWF in Kerian was obtained from the Perak Dental Division. Activity-based costing followed CWF guidelines for implementation, operation and maintenance, monitoring, and evaluation activities. All cost items (capital, manpower, safety, maintenance, chemical, and transportation) were presented in MYR 2015 with a 3.0% discount rate. Over the five-year period, the cost of the CWF programme was estimated as follows: MYR 242,644.33 (20.4%) for programme implementation, MYR 796,627.93 (66.9%) for programme operation and maintenance, MYR 147,542.05 (12.4%) for programme monitoring, and the remaining MYR 3,508.20 (0.3%) for programme evaluation. The highest contributor to the CWF programme cost was the fluoride chemical; sodium fluorosilicate, at MYR 450,364.53 (37.8%). The population that received fluoridated water was 189,015. From 2015 to 2019, the CWF programme in Kerian, Perak, incurred an estimated total cost of MYR 1,190,322.51, with a cost per capita of MYR 6.30. This cost analysis enables oral health policymakers and WTF authorities to make informed decisions about investing in the CWF programme.