ArticlePloS one2014
Cost drivers for voluntary medical male circumcision using primary source data from sub-Saharan Africa.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of Economic Analysis of Surgical Mission Trips Using the World Health Organization Criteria.World journal of surgery · 2016Pooled it
- Cost and Cost-Effectiveness of a Demand Creation Intervention to Increase Uptake of Voluntary Medical Male Circumcision in Tanzania: Spending More to Spend Less.Journal of acquired immune deficiency syndromes (1999) · 2018Trial
- Unit cost repositories for health program planning and evaluation: a report on research in practice with lessons learned.BMC public health · 2023Article
- Article
- The voluntary medical male circumcision Site Capacity and Productivity Assessment Tool (SCPT): An innovative visual management tool to optimize site service delivery.PLOS global public health · 2022Article
- An economic evaluation of an intervention to increase demand for medical male circumcision among men aged 25-49 years in South Africa.BMC health services research · 2021Article
- Appraising the value of evidence generation activities: an HIV modelling study.BMJ global health · 2018Article
- Article
- Influence of supply-side factors on voluntary medical male circumcision costs in Kenya, Rwanda, South Africa, and Zambia.PloS one · 2018Article
- HIV prevention where it is needed most: comparison of strategies for the geographical allocation of interventions.Journal of the International AIDS Society · 2017Article
- Lives Saved Tool (LiST) costing: a module to examine costs and prioritize interventions.BMC public health · 2017Article
- Article
- Trends in the Marginal Cost of Male Circumcision in Rural Rakai Uganda.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- VMMC Devices-Introducing a New Innovation to a Public Health Intervention.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis.PLoS medicine · 2016Article
- Article
- Toward a Systematic Approach to Generating Demand for Voluntary Medical Male Circumcision: Insights and Results From Field Studies.Global health, science and practice · 2015Review
- Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.PLoS medicine · 2014Article
- Scaling-up voluntary medical male circumcision - what have we learned?HIV/AIDS (Auckland, N.Z.) · 2014Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAs voluntary medical male circumcision (VMMC) programs scale up, there is a pressing need for information about the important cost drivers, and potential efficiency gains. We examine those cost drivers here, and estimate the potential efficiency gains through an econometric model. METHODS AND
findingsWe examined the main cost drivers (i.e., personnel and consumables) associated with providing VMMC in sub-Saharan Africa along a number of dimensions, including facility type and service provider. Primary source facility level data from Kenya, Namibia, South Africa, Tanzania, Uganda, and Zambia were utilized throughout. We estimated the efficiency gains by econometrically estimating a cost function in order to calculate the impact of scale and other relevant factors. Personnel and consumables were estimated at 36% and 28%, respectively, of total costs across countries. Economies of scale (EOS) is estimated to be eight at the median volume of VMMCs performed, and EOS falls from 23 at the 25th percentile volume of VMMCs performed to 5.1 at the 75th percentile.
conclusionsThe analysis suggests that there is significant room for efficiency improvement as indicated by declining EOS as VMMC volume increases. The scale of the fall in EOS as VMMC volume increases suggests that we are still at the ascension phase of the scale-up of VMMC, where continuing to add new sites results in additional start-up costs as well. A key aspect of improving efficiency is task sharing VMMC procedures, due to the large percentage of overall costs associated with personnel costs. In addition, efficiency improvements in consumables are likely to occur over time as prices and distribution costs decrease.
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Registered trials
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