The cost of implementing the Systems Analysis and Improvement Approach for a cluster randomized trial integrating HIV testing into family planning services in Mombasa County, Kenya.
The cost of implementing the Systems Analysis and Improvement Approach for a cluster randomized trial integrating HIV testing into family planning services in Mombasa County, Kenya.
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DOI：
10.1186/s12913-022-08828-z
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发表时间：
2022-12-05
影响因子：
2.8
通讯作者：
中科院分区：
文献类型：
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作者：
尽管在计划生育 (FP) 诊所进行艾滋病毒检测是让妇女参与艾滋病毒治疗和预防服务的一种很有前景的方法，但肯尼亚计划生育诊所的艾滋病毒检测率较低。 2018 年，肯尼亚蒙巴萨实施了一项整群随机试验，应用系统分析和改进方法 (SAIA) 将 HIV 检测纳入 FP 服务 (1K24HD088229-01)。我们估算了肯尼亚蒙巴萨 FP HIV SAIA 实施的增量成本并探讨了成本驱动因素。我们从付款人的角度对 FP HIV SAIA 随机对照试验进行了成本评估。我们确定了干预的相关活动，包括启动、培训、研究和 FP HIV SAIA。我们使用时间和运动研究来估计活动时间负担。我们通过员工访谈和计划预算得出单位成本。我们提出了两种不同情景的成本估算：实施情况包括卫生部支持的干预措施的研究和预计成本。所有费用均以 2018 年美元报告。对于每年向新 FP 客户进行 36,086 次 HIV 检测的计划产出，我们估计年度计划总成本为 91,994 美元，每个新 FP 客户的平均服务成本为 2.55 美元。人员和艾滋病毒快速检测试剂盒分别占计划成本的 55% 和 21%。假设计划产出没有变化并且在 MOH 情景下提高效率，则服务每个新 FP 客户的估计成本将降至 1.30 美元，计划成本降低 49%。 FP HIV SAIA 是一种低成本、灵活的实施策略，旨在促进 HIV 检测与 FP 服务的综合提供。虽然 FP HIV SAIA 干预措施的成本影响必须随着时间的推移继续进行评估，但这些发现提供了针对具体情况的成本数据，可用于有关干预措施实施和扩展的预算规划和决策。该试验于 2016 年 12 月 15 日在 ClinicalTrials.gov 上注册 (NCT02994355)。
Although HIV testing in family planning (FP) clinics is a promising approach for engaging women in HIV treatment and prevention services, HIV testing rates are low in FP clinics in Kenya. In 2018, a cluster randomized trial was implemented in Mombasa, Kenya applying the Systems Analysis and Improvement Approach (SAIA) to integrate HIV testing into FP services (1K24HD088229-01). We estimated the incremental costs and explored cost drivers of the FP HIV SAIA implementation in Mombasa, Kenya. We conducted a costing evaluation from the payer perspective for the FP HIV SAIA randomized control trial. We identified relevant activities for the intervention including start-up, training, research and FP HIV SAIA. We estimated activity time burden using a time-and motion study. We derived unit costs through staff interviews and programmatic budgets. We present cost estimates for two different scenarios: as-implemented including research and projected costs for a Ministry of Health-supported intervention. All costs are reported in 2018 USD. For an annual program output of 36,086 HIV tests administered to new FP clients, we estimated the total annual program cost to be $91,994 with an average cost per new FP client served of $2.55. Personnel and HIV rapid testing kits comprised 55% and 21% of programmatic costs, respectively. Assuming no changes to program outputs and with efficiency gains under the MOH scenario, the estimated cost per new FP client served decreased to $1.30 with a programmatic cost reduction of 49%. FP HIV SAIA is a low-cost and flexible implementation strategy for facilitating integrated delivery of HIV testing alongside FP services. Although cost implications of the FP HIV SAIA intervention must continue to be evaluated over time, these findings provide context-specific cost data useful for budget planning and decision-making regarding intervention delivery and expansion. The trial was registered on December 15, 2016, with clinicaltrials.gov (NCT02994355).
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影响因子：
15.8
作者：
Baeten JM;Heffron R;Kidoguchi L;Mugo NR;Katabira E;Bukusi EA;Asiimwe S;Haberer JE;Morton J;Ngure K;Bulya N;Odoyo J;Tindimwebwa E;Hendrix C;Marzinke MA;Ware NC;Wyatt MA;Morrison S;Haugen H;Mujugira A;Donnell D;Celum C;Partners Demonstration Project Team
通讯作者：
Partners Demonstration Project Team
DOI：
10.3390/ijerph18105289
发表时间：
2021-05-16
影响因子：
--
作者：
Astawesegn FH;Stulz V;Agho KE;Mannan H;Conroy E;Ogbo FA
通讯作者：
Ogbo FA
影响因子：
3.7
作者：
Mwenge L;Sande L;Mangenah C;Ahmed N;Kanema S;d'Elbée M;Sibanda E;Kalua T;Ncube G;Johnson CC;Hatzold K;Cowan FM;Corbett EL;Ayles H;Maheswaran H;Terris-Prestholt F
通讯作者：
Terris-Prestholt F
影响因子：
1.7
作者：
Irungu, Elizabeth M.;Sharma, Monisha;Heffron, Renee
通讯作者：
Heffron, Renee
影响因子：
8.4
作者：
Assefa, Yibeltal;Gilks, Charles F.;Hill, Peter S.
通讯作者：
Hill, Peter S.