ArticleJournal of the International AIDS Society2016
Annual cost of antiretroviral therapy among three service delivery models in Uganda.
Article in Journal of the International AIDS Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cost of Differentiated HIV Antiretroviral Therapy Delivery Strategies in Sub-Saharan Africa: A Systematic Review.Journal of acquired immune deficiency syndromes (1999) · 2019Pooled it
- Viral load care of HIV-1 infected children and adolescents: A longitudinal study in rural Zimbabwe.PloS one · 2021Trial
- Factors associated with loss-to-follow-up of HIV-positive mothers and their infants enrolled in HIV care clinic: A qualitative study.BMC public health · 2020Trial
- Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys.AIDS (London, England) · 2018Trial
- Uptake of community-based differentiated antiretroviral therapy service delivery and associated factors among people living with HIV in Ethiopia: a multicenter cross-sectional study.Frontiers in public health · 2024Article
- Development of novel composite data quality scores to evaluate facility-level data quality in electronic data in Kenya: a nationwide retrospective cohort study.BMC health services research · 2023Article
- Uptake of community antiretroviral group delivery models for persons living with HIV in Arua district, Uganda: A parallel convergent mixed methods study.PLOS global public health · 2023Article
- Article
- Patient-incurred costs in a differentiated service delivery club intervention compared to standard clinical care in Northwest Tanzania.Journal of the International AIDS Society · 2021Article
- Cost-effectiveness of one month of daily isoniazid and rifapentine versus three months of weekly isoniazid and rifapentine for prevention of tuberculosis among people receiving antiretroviral therapy in Uganda.Journal of the International AIDS Society · 2020Article
- Quality matters: Redefining child TB care with an emphasis on quality.Journal of clinical tuberculosis and other mycobacterial diseases · 2019Article
- A Review of Differentiated Service Delivery for HIV Treatment: Effectiveness, Mechanisms, Targeting, and Scale.Current HIV/AIDS reports · 2019Review
- Can differentiated care models solve the crisis in HIV treatment financing? Analysis of prospects for 38 countries in sub-Saharan Africa.Journal of the International AIDS Society · 2017Article
- Evidence for scale up: the differentiated care research agenda.Journal of the International AIDS Society · 2017Article
- Lessons learned and study results from HIVCore: an HIV implementation science initiative.Journal of the International AIDS Society · 2016Article
- Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.Journal of the International AIDS Society · 2016Article
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9 authors.
Funding
Abstract
introductionIn response to the increasing burden of HIV, the Ugandan government has employed different service delivery models since 2004 that aim to reduce costs and remove barriers to accessing HIV care. These models include community-based approaches to delivering antiretroviral therapy (ART) and delegating tasks to lower-level health workers. This study aimed to provide data on annual ART cost per client among three different service delivery models in Uganda.
methodsCosting data for the entire year 2012 were retrospectively collected as part of a larger task-shifting study conducted in three organizations in Uganda: Kitovu Mobile (KM), the AIDS Support Organisation (TASO) and Uganda Cares (UC). A standard cost data capture tool was developed and used to retrospectively collect cost information regarding antiretroviral (ARV) drugs and non-ARV drugs, ART-related lab tests, personnel and administrative costs. A random sample of four TASO centres (out of 11), four UC clinics (out of 29) and all KM outreach units were selected for the study.
resultsCost varied across sites within each organization as well as across the three organizations. In addition, the number of annual ART visits was more frequent in rural areas and through KM (the community distribution model), which played a major part in the overall annual ART cost. The annual cost per client (in USD) was $404 for KM, $332 for TASO and $257 for UC. These estimates were lower than previous analyses in Uganda or the region compared to data from 2001 to 2009, but comparable with recent estimates using data from 2010 to 2013. ARVs accounted for the majority of the total cost, followed by personnel and operational costs.
conclusionsThe study provides updated data on annual cost per ART visit for three service delivery models in Uganda. These data will be vital for in-country budgetary efforts to ensure that universal access to ART, as called for in the 2015 World Health Organization (WHO) guidelines, is achievable. The lower annual ART cost found in this study indicates that we may be able to treat all people with HIV as laid out in the 2015 WHO guidelines. The variation of costs across sites and the three models indicates the potential for efficiency gains.
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