SynthesisBulletin of the World Health Organization2014
Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries.
Synthesis in Bulletin of the World Health Organization, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses 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.
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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
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Integrating HIV services and other health services: A systematic review and meta-analysis.PLoS medicine · 2021Pooled it
- The per-patient costs of HIV services in South Africa: Systematic review and application in the South African HIV Investment Case.PloS one · 2019Pooled it
- Costs and cost-effectiveness of HIV/noncommunicable disease integration in Africa: from theory to practice.AIDS (London, England) · 2018Pooled it
- Cost-effectiveness of Xpert MTB/RIF for tuberculosis diagnosis in South Africa: a real-world cost analysis and economic evaluation.The Lancet. Global health · 2017Trial
- Trial
- Assessing the cost implications of integrating and scaling up HIV services for key populations in Kenya and Malawi.Health policy and planning · 2026Article
- From Clinical to Non-clinical Outcomes in the Treatment of HIV: An Economic and Organizational Impact Assessment.PharmacoEconomics - open · 2025Article
- Integrating SARS-CoV-2 rapid antigen testing in maternal, neonatal and child health, HIV, and TB clinics in Kenya and Cameroon: outcomes from the Catalysing COVID-19 Action Project.BMJ public health · 2024Article
- State of HIV costing in Latin America and the Caribbean: a systematic literature review.Revista panamericana de salud publica = Pan American journal of public health · 2024Review
- Article
- Approaches to improving the efficiency of HIV programme investments.BMJ global health · 2022Article
- Cost of integrating assisted partner services in HIV testing services in Kisumu and Homa Bay counties, Kenya: a microcosting study.BMC health services research · 2022Article
- The cost of community outreach HIV interventions: a case study in Thailand.BMC public health · 2022Article
- Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review.Implementation science communications · 2021Review
- Modelling costs of community-based HIV self-testing programmes in Southern Africa at scale: an econometric cost function analysis across five countries.BMJ global health · 2021Article
- Integrating Sexual and Reproductive Health Services Within HIV Services: WHO Guidance.Frontiers in global women's health · 2021Article
- Costs and economies of scale in the accelerated program for prevention of mother-to-child transmission of HIV in Zimbabwe.PloS one · 2020Article
- What is the cost of integration? Evidence from an integrated health and agriculture project to improve nutrition outcomes in Western Kenya.Health policy and planning · 2019Article
- Cost-per-diagnosis as a metric for monitoring cost-effectiveness of HIV testing programmes in low-income settings in southern Africa: health economic and modelling analysis.Journal of the International AIDS Society · 2019Article
- Supporting Adolescents to Adhere (SATA): Lessons learned from an intervention to achieve medication adherence targets among youth living with HIV in Uganda.Children and youth services review · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo synthesize the data available--on costs, efficiency and economies of scale and scope--for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale-up of human immunodeficiency virus (HIV) services in low- and middle-income countries.
methodsThe relevant peer-reviewed and "grey" literature from low- and middle-income countries was systematically reviewed. Search and analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
findingsOf the 82 empirical costing and efficiency studies identified, nine provided data on economies of scale. Scale explained much of the variation in the costs of several HIV services, particularly those of targeted HIV prevention for key populations and HIV testing and treatment. There is some evidence of economies of scope from integrating HIV counselling and testing services with several other services. Cost efficiency may also be improved by reducing input prices, task shifting and improving client adherence.
conclusionHIV programmes need to optimize the scale of service provision to achieve efficiency. Interventions that may enhance the potential for economies of scale include intensifying demand-creation activities, reducing the costs for service users, expanding existing programmes rather than creating new structures, and reducing attrition of existing service users. Models for integrated service delivery--which is, potentially, more efficient than the implementation of stand-alone services--should be investigated further. Further experimental evidence is required to understand how to best achieve efficiency gains in HIV programmes and assess the cost-effectiveness of each service-delivery model.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.