The comprehensiveness and composition of a clinical care package of high cost-effectiveness will vary from country to country, taking into account epidemiological conditions, local preferences and health needs, and the level of income. The provision of hospital-based emergency care other than the interventions mentioned above would depend on day-to-day capacity and availability of resources, but might include treatment of most fractures and well as appendectomies. At modest increases in spending, relatively cost-effective measures for the treatment of some common noncommunicable conditions could be included. Examples include: low-cost protocols for treatment of heart disease using aspirin and anti-hypertensive drugs; treatment for cervical cancer; drug treatment of some psychoses; and removal of cataracts.
The most sophisticated facility required to deliver the minimum elements of the essential clinical package is a district hospital. Providing services in lower-level facilities allows costs to be contained at modest levels for minimal versions of the essential clinical package. The cost is about US$8 per person each year in low-income countries and $15 in middle-income countries. Widespread adoption of an essential clinical package would have a tremendous positive impact on the health of people in developing countries. If 80% of the population were reached, it is estimated that 24% of the current burden of disease in low-income countries and 11% of that in middle-income countries could be averted.