Meta-analysis of average costs of HIV testing and counselling and voluntary medical male circumcision across thirteen countries

  • Carlos Pineda-Antunez
  • Gisela Martinez-Silva
  • Diego Cerecero-Garcia
  • Lily Alexander
  • Drew B. Cameron
  • Chris Chiwevu
  • Lalit Dandona
  • Carol Dayo Obure
  • Steven Forsythe
  • Van Thu Nguyen
  • Stella Settumba
  • Michel Tchuenche
  • Hoang Van Minh
  • James G. Kahn
  • Gabriela Gomez
  • Sedona Sweeney
  • Anna Vassall
  • Lori Bollinger
  • Carol Levin
  • Sergio Bautista-Arredondo
Keywords: efficiency, unit cost, prevention, cost variation

Abstract

Objective: Explore facility-level average costs per client of HIV testing and counselling (HTC) and voluntary medical male circumcision (VMMC) services in 13 countries.

Methods: Through a literature search we identified studies that reported facility-level costs of HTC or VMMC programmes. We requested the primary data from authors and standardised the disparate data sources to make them comparable. We then conducted descriptive statistics and a meta-analysis to assess the cost variation among facilities. All costs were converted to 2017 US dollars ($).

Results: We gathered data from 14 studies across 13 countries and 772 facilities (552 HTC, 220 VMMC). The weighted average unit cost per client served was $15 (95% CI 12, 18) for HTC and $59 (95% CI 45, 74) for VMMC. On average, 38% of the mean unit cost for HTC corresponded to recurrent costs, 56% to personnel costs, and 6% to capital costs. For VMMC, 41% of the average unit cost corresponded to recurrent costs, 55% to personnel costs, and 4% to capital costs. We observed unit cost variation within and between countries, and lower costs in higher scale categories in all interventions.

Keywords: efficiency, unit cost, prevention, cost variation

Published
2019-12-09
Section
Articles

Journal Identifiers


eISSN: 1608-5906
print ISSN: 1727-9445