Costing of HIV services, Uganda and United Republic of Tanzania.

Autor: McBain RK; Center for Integration Science, Brigham and Women's Hospital, 75 Francis Street, Boston, MA02115, United States of America (USA)., Jordan M; Institute for Global Health and Development, Brandeis University, Waltham, USA., Kapologwe NA; President's Office - Regional Administration, Dar es Salaam, United Republic of Tanzania., Kagaayi J; Department of Health Economics, Makerere University School of Public Health, Kampala, Uganda., Kiracho EE; Department of Health Economics, Makerere University School of Public Health, Kampala, Uganda., Nandakumar AK; Institute for Global Health and Development, Brandeis University, Waltham, USA.
Jazyk: angličtina
Zdroj: Bulletin of the World Health Organization [Bull World Health Organ] 2023 Oct 01; Vol. 101 (10), pp. 626-636. Date of Electronic Publication: 2023 Aug 22.
DOI: 10.2471/BLT.22.289580
Abstrakt: Objective: To evaluate resource allocation and costs associated with delivery of human immunodeficiency virus (HIV) services in Uganda and the United Republic of Tanzania.
Methods: We used time-driven activity-based costing to determine the resources consumed and costs of providing five HIV services in Uganda and the United Republic of Tanzania: antiretroviral therapy (ART); HIV testing and counselling; prevention of mother-to-child transmission; voluntary male medical circumcision; and pre-exposure prophylaxis.
Findings: Country-based teams undertook time-driven activity-based costing with 1119 adults in Uganda and 886 adults in the United Republic of Tanzania. In Uganda, service delivery costs ranged from 8.18 United States dollars (US$) per visit for HIV testing and counselling to US$ 43.43 for ART (for clients in whom HIV was suppressed). In the United Republic of Tanzania, these costs ranged from US$ 3.67 per visit for HIV testing and counselling to US$ 28.00 for voluntary male medical circumcision. In both countries, consumables were the main cost driver, accounting for more than 60% of expenditure. Process maps showed that in both countries, registration, measurement of vital signs, consultation and medication dispensing were the steps that occurred most frequently for ART clients.
Conclusion: Establishing a rigorous, longitudinal system for tracking investments in HIV services that includes thousands of clients and numerous facilities is achievable in different settings with a high HIV burden. Consistent engagement of implementation partners and standardized training and data collection instruments proved essential for the success of these exercises.
((c) 2023 The authors; licensee World Health Organization.)
Databáze: MEDLINE
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