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Hippo model for hidden costs

An introduction to 'hidden costs' to consider when budgeting the cost of a donation
Image of a hippo in water with only the top of its head above water with the table punching costs and the rest of the hippo has many other costs labels over the body representing hidden costs.
© THET 2015
When purchasing medical equipment this is only the first part of the total cost of ownership, particularly for complex medical equipment, where there are many other costs associated to the total cost of the donation.

When planning a donation, you need to consider all hidden costs. Otherwise, the donation may become a financial burden on the receiving health facility.

Identying the hidden costs

THET has developed the ‘Hippo model’. Hidden costs are those ‘hidden’ under water level, and may include:

  • Transport and installation costs
  • Operating costs (including purchase of consumable supplies, and power supply)
  • Maintenance costs (including spare parts)
  • Staff costs
  • Training costs
  • Costs of removal/disposal

A screenreadable PDF version of the ‘Hippo model’ is available to download.

It is good practice to budget for ongoing costs as 10% of the cost of purchase per year, although this will obviously vary depending on what you are donating.

Check whether the healthcare facility you are donating to has a budget for ongoing use and maintenance.

Talking point

How do you think you might go about checking if the healthcare facility has a budget for ongoing use and maintenance?

© St George’s, University of London
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Medical Equipment Donations to Low Resource Settings

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