Influence of supply-side factors on voluntary medical male circumcision costs in Kenya, Rwanda, South Africa, and Zambia

PloS One
Sergio Bautista-ArredondoORPHEA study team

Abstract

In this study, we described facility-level voluntary medical male circumcision (VMMC) unit cost, examined unit cost variation across facilities, and investigated key facility characteristics associated with unit cost variation. We used data from 107 facilities in Kenya, Rwanda, South Africa, and Zambia covering 2011 or 2012. We used micro-costing to estimate economic costs from the service provider's perspective. Average annual costs per client were estimated in 2013 United States dollars (US$). Econometric analysis was used to explore the relationship between VMMC total and unit cost and facility characteristics. Average VMMC unit cost ranged from US$66 (SD US$79) in Kenya to US$160 (SD US$144) in South Africa. Total cost function estimates were consistent with economies of scale and scope. We found a negative association between the number of VMMC clients and VMMC unit cost with a 3% decrease in unit cost for every 10% increase in number of clients and we found a negative association between the provision of other HIV services and VMMC unit cost. Also, VMMC unit cost was lower in primary health care facilities than in hospitals, and lower in facilities implementing task shifting. Substantial efficiency gains could be made in ...Continue Reading

References

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Jul 22, 2014·JAMA : the Journal of the American Medical Association·Harsha ThirumurthyKawango Agot
Jan 1, 2014·BMC Health Services Research·Sergio Bautista-ArredondoUNKNOWN ORPHEA study team
Jan 15, 2016·Health Economics·Aurélia LépineAnna Vassall
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Mar 30, 2017·AIDS·Mwita WamburaUNKNOWN VMMC-Tanzania Study Group

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Citations

Nov 30, 2019·African Journal of AIDS Research : AJAR·Carlos Pineda-AntunezSergio Bautista-Arredondo
Nov 30, 2019·African Journal of AIDS Research : AJAR·Diego Cerecero-GarcíaSergio Bautista-Arredondo
Nov 26, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Joshua A Salomon
Sep 17, 2021·Insights Into Imaging·Kristen DeStigterSavvas Andronikou

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Methods Mentioned

BETA
circumcision
circumcisions

Software Mentioned

ORPHEA

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