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Background: Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The aim of this study was to determine the unit cost of maternal and child health (MCH) programme provided at Primary Health Centers (PHCs) and to examine the variation in unit cost in different PHCs. Methodology: The present study was carried out in three PHCs of Ahmedabad district namely Sanathal, Nandej, and Uperdal, between 1 April, 2006 and 31 March, 2007. For estimating the cost of a health program, information on all the physical and human resources that were basic inputs to the PHC services were collected and grouped into two categories, non-recurrent (capital resources vehicles, buildings, etc.) and recurrent resources (salaries, drugs, vaccines, contraceptives, maintenance, etc.). To generate the required data, two types of schedules were developed, daily time schedule and PHC/SC (Subcenter) information schedule. Results: Unit cost for each contact of MCH beneficiaries was Rs. 54.87 at Sanathal PHC, Rs. 87.63 at Nandej PHC and Rs. 70.01 at Uperdal PHC. Conclusion: Even though maternal and child health services are free, utilization of these services at the health centres were low, particularly for delivery, leading to high unit costs. [ABSTRACT FROM AUTHOR]