Pineda-Antunez Carlos, Martinez-Silva Gisela, Cerecero-Garcia Diego, Alexander Lily, Cameron Drew B, Chiwevu Chris, Dandona Lalit, Obure Carol Dayo, Forsythe Steven, Nguyen Van Thu, Settumba Stella, Tchuenche Michel, Van Minh Hoang, Kahn James G, Gomez Gabriela, Sweeney Sedona, Vassall Anna, Bollinger Lori, Levin Carol, Bautista-Arredondo Sergio
Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico.
Department of Global Health, University of Washington, Seattle, USA.
Afr J AIDS Res. 2019 Dec;18(4):341-349. doi: 10.2989/16085906.2019.1679850.
Explore facility-level average costs per client of HIV testing and counselling (HTC) and voluntary medical male circumcision (VMMC) services in 13 countries. 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 ($). 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 $59 (95% CI 45, 74) for VMMC. On average, 38% of the mean unit cost for HTC corresponded to recurrent costs, 56% to personnel costs, and 6% to capital costs. For VMMC, 41% of the average unit cost corresponded to recurrent costs, 55% to personnel costs, and 4% to capital costs. We observed unit cost variation within and between countries, and lower costs in higher scale categories in all interventions.
探究13个国家中每位客户接受艾滋病毒检测与咨询（HTC）以及男性自愿医学包皮环切术（VMMC）服务的机构层面平均成本。通过文献检索，我们确定了报告HTC或VMMC项目机构层面成本的研究。我们向作者索要原始数据，并对不同的数据来源进行标准化处理，使其具有可比性。然后，我们进行了描述性统计和荟萃分析，以评估各机构之间的成本差异。所有成本均换算为2017年美元（$）。我们收集了来自13个国家772家机构（552家提供HTC服务，220家提供VMMC服务）的14项研究的数据。HTC服务每位客户的加权平均单位成本为15美元（95%置信区间12美元，18美元），VMMC服务为59美元（95%置信区间45美元，74美元）。平均而言，HTC平均单位成本的38%对应经常性成本，56%对应人员成本，6%对应资本成本。对于VMMC服务，平均单位成本的41%对应经常性成本，55%对应人员成本，4%对应资本成本。我们观察到各国国内和国家之间的单位成本存在差异，并且在所有干预措施中，规模较大类别中的成本较低。
