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Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe

BACKGROUND: Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three...

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Autores principales: Mwenge, Lawrence, Sande, Linda, Mangenah, Collin, Ahmed, Nurilign, Kanema, Sarah, d’Elbée, Marc, Sibanda, Euphemia, Kalua, Thokozani, Ncube, Gertrude, Johnson, Cheryl C., Hatzold, Karin, Cowan, Frances M., Corbett, Elizabeth L., Ayles, Helen, Maheswaran, Hendramoorthy, Terris-Prestholt, Fern
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642898/
https://www.ncbi.nlm.nih.gov/pubmed/29036171
http://dx.doi.org/10.1371/journal.pone.0185740
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author Mwenge, Lawrence
Sande, Linda
Mangenah, Collin
Ahmed, Nurilign
Kanema, Sarah
d’Elbée, Marc
Sibanda, Euphemia
Kalua, Thokozani
Ncube, Gertrude
Johnson, Cheryl C.
Hatzold, Karin
Cowan, Frances M.
Corbett, Elizabeth L.
Ayles, Helen
Maheswaran, Hendramoorthy
Terris-Prestholt, Fern
author_facet Mwenge, Lawrence
Sande, Linda
Mangenah, Collin
Ahmed, Nurilign
Kanema, Sarah
d’Elbée, Marc
Sibanda, Euphemia
Kalua, Thokozani
Ncube, Gertrude
Johnson, Cheryl C.
Hatzold, Karin
Cowan, Frances M.
Corbett, Elizabeth L.
Ayles, Helen
Maheswaran, Hendramoorthy
Terris-Prestholt, Fern
author_sort Mwenge, Lawrence
collection PubMed
description BACKGROUND: Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three southern African countries with high HIV burden. METHODS: Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs. RESULTS: Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03.9 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. CONCLUSIONS: Health facility based HIV testing remains an essential service to meet HIV universal access goals. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggests that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services.
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spelling pubmed-56428982017-10-30 Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe Mwenge, Lawrence Sande, Linda Mangenah, Collin Ahmed, Nurilign Kanema, Sarah d’Elbée, Marc Sibanda, Euphemia Kalua, Thokozani Ncube, Gertrude Johnson, Cheryl C. Hatzold, Karin Cowan, Frances M. Corbett, Elizabeth L. Ayles, Helen Maheswaran, Hendramoorthy Terris-Prestholt, Fern PLoS One Research Article BACKGROUND: Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three southern African countries with high HIV burden. METHODS: Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs. RESULTS: Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03.9 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. CONCLUSIONS: Health facility based HIV testing remains an essential service to meet HIV universal access goals. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggests that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services. Public Library of Science 2017-10-16 /pmc/articles/PMC5642898/ /pubmed/29036171 http://dx.doi.org/10.1371/journal.pone.0185740 Text en © 2017 Mwenge et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Mwenge, Lawrence
Sande, Linda
Mangenah, Collin
Ahmed, Nurilign
Kanema, Sarah
d’Elbée, Marc
Sibanda, Euphemia
Kalua, Thokozani
Ncube, Gertrude
Johnson, Cheryl C.
Hatzold, Karin
Cowan, Frances M.
Corbett, Elizabeth L.
Ayles, Helen
Maheswaran, Hendramoorthy
Terris-Prestholt, Fern
Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
title Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
title_full Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
title_fullStr Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
title_full_unstemmed Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
title_short Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
title_sort costs of facility-based hiv testing in malawi, zambia and zimbabwe
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642898/
https://www.ncbi.nlm.nih.gov/pubmed/29036171
http://dx.doi.org/10.1371/journal.pone.0185740
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