Shin Michelle B, Garcia Patricia J, Saldarriaga Enrique M, Fiestas José L, Ásbjörnsdóttir Kristjana H, Iribarren Sarah J, Barnabas Ruanne V, Gimbel Sarah
School of Nursing, University of Washington, Seattle, WA, United States.
School of Public Health, Cayetano Heredia University, Lima, Peru.
Lancet Reg Health Am. 2022 Apr;8. doi: 10.1016/j.lana.2021.100160. Epub 2021 Dec 29.
Cost data of human papillomavirus (HPV) self-sampling programs from low-and-middle-income countries is limited. We estimated the total and unit costs associated with the Hope Project, a community-based HPV self-sampling social entrepreneurship in Peru.
We conducted a micro-costing analysis from the program perspective to determine the unit costs of (1) recruitment/training of community women (Hope Ladies); (2) Hope Ladies distributing HPV self-sampling kits in their communities and the laboratory testing; and (3) Hope Ladies linking screened women with follow-up care. A procedural manual was used to identify the program's activities. A structured questionnaire and in-depth interviews were conducted with administrators to estimate the resource/time associated with activities. We obtained unit costs for each input previously identified from budgets and expenditure reports.
From November 2018 to March 2020, the program recruited and trained 62 Hope Ladies who distributed 4,882 HPV self-sampling kits in their communities. Of the screened women, 586 (12%) tested HPV positive. The annual cost per Hope Lady recruited/trained was $147·51 (2018 USD). The cost per HPV self-sampling kit distributed/tested was $45·39, the cost per woman followed up with results was $55·64, and the cost per HPV-positive woman identified was $378·14. Personnel and laboratory costs represented 56·1% and 24·7% of the total programmatic cost, respectively.
Our findings indicate that implementation of a community-based HPV self-sampling has competitive prices, which increases its likelihood to be feasible in Peru. Further economic evaluation is needed to quantify the incremental benefits of HPV self-sampling compared to more established options such as Pap tests.
Thomas Francis Jr. Fellowship provided funding for data collection. The Hope Project was funded by grants from Grand Challenges Canada (TTS-1812-21131), Uniting for Health Innovation, Global Initiative Against HPV and Cervical Cancer, University of Manitoba, and the John E. Fogarty International Center (5D43TW009375-05).
来自低收入和中等收入国家的人乳头瘤病毒（HPV）自我采样项目的成本数据有限。我们估算了秘鲁一项基于社区的HPV自我采样社会企业项目“希望工程”的总成本和单位成本。
我们从项目角度进行了微观成本分析，以确定以下方面的单位成本：（1）社区女性（希望女士）的招募/培训；（2）希望女士在其社区分发HPV自我采样试剂盒及实验室检测；（3）希望女士将接受筛查的女性与后续护理联系起来。使用一份程序手册来确定项目活动。与管理人员进行了结构化问卷调查和深入访谈，以估算与活动相关的资源/时间。我们从预算和支出报告中获取了先前确定的每个投入的单位成本。
2018年11月至2020年3月，该项目招募并培训了62名希望女士，她们在其社区分发了4882份HPV自我采样试剂盒。在接受筛查的女性中，586人（12%）HPV检测呈阳性。每名招募/培训的希望女士的年度成本为147.51美元（2018年美元）。每份分发/检测的HPV自我采样试剂盒的成本为45.39美元，每名有检测结果的随访女性的成本为
