Deafness affects about 15-26% of the world’s population with an estimated prevalence of 3.7%
in South Africa. Although sign language Interpreters (SLIs) improve the communication
challenges in health care they are unaffordable for many Deaf people. On the other hand, there
are no legal provisions in place to ensure the provision of SLIs in the health sector in most
countries including South Africa. However, to advocate for funding of such initiatives, reliable
cost estimates are essential and such data is scarce. To bridge this gap, this study estimated the
costs of providing such a service at the District health services level based on estimates obtained
from a pilot-project that initiated the first South African Sign Language Interpreter (SASLI)
service in health-care. The ingredients method was used to calculate the unit cost per visit at the
SASLI Project level from a provider perspective. The average SASLI utilisation rate was
calculated from the projects records for 2008-2013. Sensitivity analyses were carried out to
determine the effect of changing the discount rate and personnel costs. The unit costs per
SASLI-assisted visit were used in estimating the costs of scaling up this service to the District
Health Services. Average utilisation rates increased from 1.66 to 3.58 per person per year from
2008-2013 with unmet need falling from 38.8% in 2008 to 10.8% by 2013.