Estimating the cost of HIV services for key populations provided by the LINKAGES program in Kenya and Malawi
Rattachement africain : Malawi, us, Kenya, mx. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Data remain scarce on the costs of HIV services for key populations (KPs). The objective of this study was to bridge this gap in the literature by estimating the unit costs of HIV services delivered to KPs in the LINKAGES program in Kenya and Malawi. We estimated the mean total unit costs of seven clinical services: post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), HIV testing services (HTS), antiretroviral therapy (ART), sexually transmitted infection (STI) services, sexual and reproductive health (SRH) services, and management of sexual violence (MSV). These costs take into account the costs of non-clinical services delivered alongside clinical services and the pre-service and above-service program management integral to the LINKAGES program. METHODS: Data were collected at all implementation levels of the LINKAGES program including 30 drop-in-centers (DICs) in Kenya and 15 in Malawi. This study was conducted from the provider's perspective. We estimated economic costs for FY 2019 and cost estimates include start-up costs. Start-up and capital costs were annualized using a discount rate of 3%. We used a combination of top-down and bottom-up costing approaches. Top-down methods were used to estimate the costs of headquarters, country offices, and implementing partners. Bottom-up micro-costing methods were used to measure the quantities and prices of inputs used to produce services in DICs. Volume-weighted mean unit costs were calculated for each clinical service. Costs are presented in 2019 United States dollars (US$). RESULTS: The mean total unit costs per service ranged from US$18 (95% CI: 16, 21) for STI services to US$635 (95% CI: 484, 785) for PrEP in Kenya and from US$41 (95% CI: 37, 44) for STI services to US$1,240 (95% CI 1156, 1324) for MSV in Malawi. Clinical costs accounted for between 21 and 59% of total mean unit costs in Kenya, and between 25 and 38% in Malawi. Indirect costs-including start-up activities, the costs of KP interventions implemented alongside clinical services, and program management and data monitoring-made up the remaining costs incurred. CONCLUSIONS: A better understanding of the cost of HIV services is highly relevant for budgeting and planning purposes and for optimizing HIV services. When considering all service delivery costs of a comprehensive HIV service package for KPs, costs of services can be significantly higher than when considering direct clinical service costs alone. These estimates can inform investment cases, strategic plans and other budgeting exercises.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Estimating the cost of HIV services for key populations provided by the LINKAGES program in Kenya and Malawi
- Date Crossref
- 04/04/2023
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Public Health Institute of Malawi Malawi (code pays fourni par la source)Structure de recherche
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Christian Health Association of Malawi Malawi (code pays fourni par la source)Institution
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Family Health International 360 pays non établi dans la noticeOrganisation à but non lucratif
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University of Malawi Zomba, Malawi (code pays fourni par la source)Université ou école supérieure
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Kenyatta University Nairobi, Kenya (code pays fourni par la source)Université ou école supérieure
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Instituto Nacional de Salud Pública pays non établi dans la noticeOrganisme public
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Independent Researcher pays non établi dans la noticeInstitution
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National Institute of Public Health (INSP) Division of Health Economics and Health Systems Innovations pays non établi dans la noticeStructure de recherche
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Lilongwe FHI 360 Lilongwe, Malawi (pays nommé en fin d’affiliation)Organisation à but non lucratif
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FHI 360 Nairobi, Kenya (pays nommé en fin d’affiliation)Institution
Public Health Institute of Malawi (Malawi), Christian Health Association of Malawi (Malawi) et Family Health International 360, avec 7 autres affiliations. Pays d’affiliation : Malawi, Kenya.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.