What STEPS does
STEPS helps policy makers and partners explore options for scaling Field Epidemiology Training Programmes in India. It links three core inputs:
- Preferences and willingness to pay (WTP) estimates from a preference study using a discrete choice experiment with stakeholders.
- Cost components and templates that combine submissions from WHO, NIE and NCDC for Frontline, Intermediate and Advanced programmes into a single structure for each tier.
- Simple epidemiological multipliers that translate training scale up and faster outbreak response into indicative health benefits.
WTP is the approximate rupee value stakeholders in the preference study place on a configuration. Mixed logit is a regression model that allows these preference weights to vary across stakeholders.
Disclaimer: The cost savings from averted outbreaks were not provided by field epidemiologists. Instead, we use estimates drawn from the current literature that are based on endemic conditions. The tool can be adapted and tailored to reflect the needs and resources identified by key stakeholders, partner organisations and decision makers.
How to use the tool
- Go to the Configuration tab and choose programme tier, career incentive, mentorship intensity, response time, delivery mode, number of cohorts, cohort size and cost per trainee per month.
- Keep the cost slider within the range used in the preference study (75,000 to 400,000 rupees per trainee per month).
- Click Apply configuration. The model from the preference study then calculates endorsement and WTP values for the chosen design.
- Use View results summary to open a concise scenario summary.
- Save promising scenarios in the Saved scenarios tab and download them as Excel or a policy brief PDF for reporting and documentation.
- For sensitivity checks, use the National simulation and WTP-based benefits / Sensitivity tabs to see how results change with cohorts, endorsement and benefit definitions, and use the Settings tab to adjust multipliers.
Attributes and levels in the FETP preference study
The preference study (discrete choice experiment) asked stakeholders to choose between alternative FETP programme designs and an opt out option. Each programme was described by the attributes below.
Programme design attributes
Intermediate (12 months)
Advanced (24 months)
University qualification
Government career pathway
Medium (3 to 4 fellows per mentor)
High (maximum 2 fellows per mentor)
Fully in person
Fully online
Detect and respond within 15 days
Detect and respond within 7 days
Opt out and cost components
The opt out constant captures the tendency to choose no FETP option. STEPS uses this when predicting overall endorsement of any FETP configuration versus opting out.
Settings and key assumptions
Use this panel to adjust core multipliers for this browser session. Changes feed into the Results, National simulation and WTP-based benefits / Sensitivity tabs.
Use these settings when aligning STEPS with updated national estimates or partner discussions. You can change the indicative value per outbreak, the planning horizon used in benefit calculations and the INR per USD rate for display.
Settings log for this session
This log records changes made to settings during the current browser session. It can be used to document assumptions for workshops, annexes and discussions with ministries and partners.
Background
The University of Newcastle is developing a business case for strengthening and scaling FETP programmes in India. STEPS is one of the tools in this work. It provides a structured way to test scale up options and explain cost, benefit and WTP implications in policy discussions.
For full details, including model specification, estimation outputs, formulae and worked examples, refer to the technical appendix. Open the technical appendix in a new tab.
Prepared by Mesfin Genie, PhD, Newcastle Business School, The University of Newcastle, Australia. For questions or clarifications please contact mesfin.genie@newcastle.edu.au.
Configure an FETP scale up option
Use this to test different cohort sizes.
Increase this to explore national scale up.
Keep this aligned with the planning horizon in the Settings tab.
All endorsement and WTP results in STEPS are based on a mixed logit preference model estimated from the preference study. The model is applied automatically to the configuration you select.
All calculations are in INR. USD values use a simple exchange rate for display only and can be adjusted in the Settings tab.
Where the cost configuration has opportunity cost, this adds it to economic costs.
Current configuration at a glance
Headline recommendation
Apply a configuration to see a concise recommendation that combines endorsement, WTP, costs and indicative benefits.
Briefing text (copy into emails or reports)
Once a configuration is applied, this box will provide a short narrative summary that you can copy into briefing notes or meeting minutes.
Endorsement and opt out
The percentage of stakeholders likely to support funding this training option.
The percentage of stakeholders predicted to choose the opt-out option rather than support the configured FETP option.
Willingness to pay and economic outcomes
The estimated monthly amount stakeholders are willing to pay per trainee. Higher values mean higher perceived value.
The estimated total value stakeholders place on the programme for one cohort, not an actual budget.
The direct cost of delivering the programme to one cohort, not including the cost of trainee time.
Programme cost plus opportunity cost where applicable. This is the main cost figure used in benefit cost ratios.
This shows whether the health benefits from better outbreak response are greater than the costs for one cohort of trainees.
A comparison of outbreak benefits to costs for one cohort. Values above 1 mean benefits outweigh costs.
Epidemiological implications
Estimated number of graduates produced across all planned cohorts, adjusting for endorsement and completion rates.
Approximate number of outbreak responses that could be supported per year once all graduates are in post under this configuration.
An estimate of the value of better outbreak response from one group of trainees, based on assumptions in the model.
Cost structure and sources
Cost components in STEPS are based on harmonised submissions from WHO, NIE and NCDC and are combined into a single cost template for each tier. The template covers direct cost categories such as salary and benefits, training, equipment, travel and trainee support, plus indirect cost categories and explicit opportunity cost.
When the opportunity cost switch in the Configuration tab is on, components marked as opportunity cost are included to form total economic cost. When the switch is off, results focus on financial costs only. The costing table summarises how much each component contributes to programme cost and to total economic cost for the current configuration.
Cost components for this configuration
| Component | Share of programme cost | Amount per cohort | Amount per trainee per month | Notes |
|---|
National simulation and sensitivity
This tab scales the current configuration to the national level using the number of cohorts you have selected. To see how results change, adjust cost, cohort size, number of cohorts or the epidemiological multipliers in the Settings tab and explore the WTP-based benefits and outbreak benefit definitions in the WTP-based benefits / Sensitivity tab.
National economic picture
This shows the combined value that stakeholders place on the training programme across all trainees and cohorts. It reflects how much the selected training configuration is valued, alongside the expected benefits from improved outbreak response.
These totals are calculated by scaling up the per-cohort costs and benefits to include all cohorts. While the overall costs, benefits, and total willingness to pay increase as the programme scales up, the benefit-cost ratio remains the same.
National epidemiological impact
The numbers shown already reflect national totals, taking into account programme size, number of cohorts, and expected outbreak impacts. To see how results change, you can adjust the number of cohorts, try different programme tiers, or change assumptions in the Settings tab.
Text summary for business cases
Once a configuration is applied, this section will summarise national graduates, total economic cost, total indicative epidemiological benefit, net benefit, total WTP and annual outbreak responses in plain language that can be dropped directly into concept notes or project documents.
WTP-based benefits and sensitivity summary
This tab brings together preference based benefits from the preference study, outbreak related epidemiological benefits and cost measures. All benefit values are indicative approximations.
Benefit definition and stakeholder view
Switch between pure preference based benefits, combined preference and epidemiological benefits, or a view that scales WTP by endorsement.
These options adjust the indicative outbreak cost saving used in benefit calculations for this tab.
After changing the dropdown, click Apply value to refresh the sensitivity calculations and charts for the selected outbreak value.
When this switch is off, the epidemiological outbreak benefit column shows that outbreak benefits are not included and cost benefit indicators reflect WTP only.
Leave this empty to rely on the endorsement rate from the preference model. Enter a value to test alternative endorsement assumptions for ministries of health, finance or partners.
The export buttons download the sensitivity table exactly as displayed on screen so that results can be pasted directly into concept notes, annexes or briefing materials.
Headline WTP-based benefits and cost benefit metrics
| Scenario | Cost (INR, chosen horizon) | Total economic cost, all cohorts (million ₹) | Net benefit, all cohorts (million ₹) | Total WTP benefit (INR) | WTP from outbreak response capacity (INR) | Epidemiological outbreak benefit (INR) | Endorsement rate used (%) | Effective WTP benefit (INR) | Benefit cost ratio (WTP only) | Net present value (WTP only, INR) | Benefit cost ratio (WTP plus epidemiological benefit) | Net present value (WTP plus epidemiological benefit, INR) |
|---|
Detailed sensitivity matrix
The detailed matrix below retains the full set of core columns for the sensitivity view. It can be used alongside the headline table above to cross check results and document alternative model specifications or stakeholder group assumptions.
| Scenario | Model | Endorsement rate | Cost per cohort (INR) | Total WTP benefit per cohort (INR) | WTP benefit from response capacity (INR) | Epidemiological outbreak benefit per cohort (INR) | Benefit cost ratio (WTP only) | Net present value (WTP only, INR) | Benefit cost ratio (WTP plus epidemiological benefit) | Net present value (WTP plus epidemiological benefit, INR) | Effective WTP benefit per cohort (INR) | Effective combined benefit per cohort (INR) |
|---|
Endorsement adjusted effective benefits multiply the benefit measure by the endorsement rate for that scenario.
Interpret scenarios with Microsoft Copilot
This tab prepares a combined interpretation prompt so that Microsoft Copilot can produce a structured policy briefing. The STEPS tool never sends data automatically. You review the full text, copy it when you are ready and paste it into Copilot in a separate browser tab.
How to use Copilot with STEPS
Define and apply a scenario in STEPS, then move to this tab to generate an interpretation prompt with the latest scenario for Microsoft Copilot.
Prepare and copy the interpretation prompt
When you click the button, STEPS refreshes the Copilot prompt using the latest configuration, attempts to copy the full text to your clipboard and opens Microsoft Copilot in a new tab. If automatic copying is blocked, you can copy directly from the panel below and paste it into the new Copilot window.
Saved scenarios for comparison
Use this table to compare FETP options and support the business case. Saved scenarios are also used for downloads.
| Shortlist | Name | Tags | Programme tier | Career incentive | Mentorship | Delivery mode | Response time | Cohorts | Trainees per cohort | Cost per trainee per month | Preference model | Endorsement | WTP per trainee per month | Total WTP (all cohorts) | Benefit cost ratio | Total economic cost (all cohorts) | Total indicative epidemiological benefit (all cohorts) | Net epidemiological benefit (all cohorts) | Outbreak responses per year | Notes |
|---|