ArticleJournal of the International AIDS Society2020
Layering and scaling up chronic non-communicable disease care on existing HIV care systems and acute care settings in Kenya: a cost and budget impact analysis.
Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 20 citations in OpenAlex.
- Economic outcomes among microfinance group members receiving community-based chronic disease care: Cluster randomized trial evidence from Kenya.Social science & medicine (1982) · 2024Trial
- Adaptations to an implementation study for integrating hypertension management into HIV care in Lagos, Nigeria: application of the FRAME.Implementation science communications · 2026Article
- Cardiovascular risk profiles in people living with HIV taking antiretroviral therapy in rural Lesotho: Findings from the PRECARIF study.Southern African journal of HIV medicine · 2026Article
- Cost and Budget Impact of Layering Depression Care Onto Existing HIV and Noncommunicable Disease Care Services in Western Kenya.Value in health regional issues · 2025Article
- Gaussian process emulation to improve efficiency of computationally intensive multidisease models: a practical tutorial with adaptable R code.BMC medical research methodology · 2024Article
- Lessons Learnt from HIV and Noncommunicable Disease Healthcare Integration in Sub-Saharan Africa.Global heart · 2024Review
- Pulmonary function tests and their associated factors in people living with HIV at Jimma medical center; Ethiopia: a comparative cross-sectional study.Frontiers in reproductive health · 2023Article
- Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya.Pilot and feasibility studies · 2022Article
- Trend Analysis of the Mortality Rates of the Top Three Causes of Death Among Chinese Residents from 2003 to 2019.International journal of public health · 2022Article
- HIV Viral Suppression among People Living with HIV on Antiretroviral Therapy in Haut-Katanga and Kinshasa Provinces of Democratic Republic of Congo.Healthcare (Basel, Switzerland) · 2021Article
- Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa.International journal of environmental research and public health · 2021Article
- Integrated screening and treatment services for HIV, hypertension and diabetes in Kenya: assessing the epidemiological impact and cost-effectiveness from a national and regional perspective.Journal of the International AIDS Society · 2020Article
- Towards evidence-based integration of services for HIV, non-communicable diseases and substance use: insights from modelling.Journal of the International AIDS Society · 2020Article
- Layering and scaling up chronic non-communicable disease care on existing HIV care systems and acute care settings in Kenya: a cost and budget impact analysis.Journal of the International AIDS Society · 2020Article
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Authors and funding
8 authors at 5 institutions in 5 countries.
Funding
Abstract
introductionLike many countries in sub-Saharan Africa, Kenya is experiencing a rapid rise in the burden of non-communicable diseases (NCDs): NCDs now contribute to over 50% of inpatient admissions and 40% of hospital deaths in the country. The Academic Model Providing Access to Healthcare (AMPATH) Chronic Disease Management (CDM) programme builds on lessons and capacity of HIV care to deliver chronic NCD care layered into both HIV and primary care platforms to over 24,000 patients across 69 health facilities in western Kenya. We conducted a cost and budget impact analysis of scaling up the AMPATH CDM programme in western Kenya using the International Society for Pharmacoeconomics and Outcomes Research guidelines.
methodsCosts of the CDM programme for the health system were measured retrospectively for 69 AMPATH clinics from 2014 to 2018 using programmatic records and clinic schedules to assign per clinic monthly costs. We quantified the additional costs to provide NCD care above those associated with existing HIV or acute care services, including clinician, staff, training, travel and equipment costs, but do not include drugs or consumables as they would be paid by the patient. We projected the budget impact of increasing CDM coverage to 50% of the eligible population from 2021 to 2025, and compared it with the county budgets from 2019.
resultsThe per visit cost of providing CDM care was $10.42 (SD $2.26), with costs at facilities added to HIV clinics $1.00 (95% CI: -$2:11 to $0.11) lower than at primary care facilities. The budget impact of adding 26,765 patients from 2021 to 2025 to the CDM programme was 3,088,928 under constant percent growth, and 3,451,732 under steady-state enrolment. Scaling up under the constant percent growth scenario resulted in 12% cost savings in the budget impact. The county programmatic CDM cost in 2025 was <1% of the county healthcare budgets from 2019.
conclusionsThe budget impact of scaling up AMPATH's CDM programme will be driven by annual growth scenarios, and facility/provider mix. By leveraging task shifting, referral systems and partnering with public and non-profit clinics without NCD services, AMPATH's CDM programme can provide critical NCD care to new, rural populations with minimal financial impact.
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