scholarly journals Implementation Strategy and Cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
National Level ◽  
Demonstration Project ◽  
Immunization Program ◽  
Total Cost ◽  
School Based ◽  
Demand Creation ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Background Cost is as an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total cost of the program and the cost per fully immunized girl (FIG), and to project the total cost of implementing a similar immunization program at the national level. Methods We collected primary data through document review, participatory observation, and key informant interviews with project implementers at the central offices of the national immunization program, provincial and district health directorates, and in health facilities. We used a combination of micro-costing methods— the identification and measurement of resources quantities and valuation by application of unit costs, and gross costing—the consideration of resource bundles as they apply to the number of FIGs. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique under current guidelines to demonstrate the projected total annual cost for a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,601. The mean cost per FIG was $72 (95% CI: $62 - $83) in year one, $38 (95% CI: $37 - $40) in year two, and $54 (95% CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from implementation was $60 (95% CI: $50 - $72) in year one, $38 (95%CI: $31 - $46) in year two, and $48 (95%CI: $42 - $55) for years one and two. The projected annual cost of a two-dose vaccine program targeting all 10-year-old girls in the country was $18,156,549 ($15,865,384 - $20,748,196). The main cost drivers in the analysis were vaccine price, number of doses administered per recipient, program startup costs, and the costs of demand creation. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy would result in substantial costs. To achieve national-level HPV vaccine roll out and sustainability, stakeholders will need to negotiate vaccine prices and achieve better efficiency in startup activities and demand creation.

scholarly journals Implementation Strategy and Cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
National Level ◽  
Demonstration Project ◽  
Immunization Program ◽  
Total Cost ◽  
School Based ◽  
Demand Creation ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Background Cost is as an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total cost of the program and the cost per fully immunized girl (FIG), and to project the total cost of implementing a similar immunization program at the national level. Methods We collected primary data through document review, participatory observation, and key informant interviews with project implementers at the central offices of the national immunization program, provincial and district health directorates, and in health facilities. We used a combination of micro-costing methods— the identification and measurement of resources quantities and valuation by application of unit costs, and gross costing—the consideration of resource bundles as they apply to the number of FIGs. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique under current guidelines to demonstrate the projected total annual cost for a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,601. The mean cost per FIG was $72 (95% CI: $62 - $83) in year one, $38 (95% CI: $37 - $40) in year two, and $54 (95% CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from implementation was $60 (95% CI: $50 - $72) in year one, $38 (95%CI: $31 - $46) in year two, and $48 (95%CI: $42 - $55) for years one and two. The projected annual cost of a two-dose vaccine program targeting all 10-year-old girls in the country was $18,156,549 ($15,865,384 - $20,748,196). The main cost drivers in the analysis were vaccine price, number of doses administered per recipient, program startup costs, and the costs of demand creation. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy would result in substantial costs. To achieve national-level HPV vaccine roll out and sustainability, stakeholders will need to negotiate vaccine prices and achieve better efficiency in startup activities and demand creation.

scholarly journals Implementation Strategy and Cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
National Level ◽  
Demonstration Project ◽  
Immunization Program ◽  
Total Cost ◽  
School Based ◽  
Demand Creation ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Background Cost is as an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total cost of the program and the cost per fully immunized girl (FIG), and to project the total cost of implementing a similar immunization program at the national level. Methods We collected primary data through document review, participatory observation, and key informant interviews with project implementers at the central offices of the national immunization program, provincial and district health directorates, and in health facilities. We used a combination of micro-costing methods— the identification and measurement of resources quantities and valuation by application of unit costs, and gross costing—the consideration of resource bundles as they apply to the number of FIGs. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique under current guidelines to demonstrate the projected total annual cost for a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,601. The mean cost per FIG was $72 (95% CI: $62 - $83) in year one, $38 (95% CI: $37 - $40) in year two, and $54 (95% CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from implementation was $60 (95% CI: $50 - $72) in year one, $38 (95%CI: $31 - $46) in year two, and $48 (95%CI: $42 - $55) for years one and two. The projected annual cost of a two-dose vaccine program targeting all 10-year-old girls in the country was $18,156,549 ($15,865,384 - $20,748,196). The main cost drivers in the analysis were vaccine price, number of doses administered per recipient, program startup costs, and the costs of demand creation. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy would result in substantial costs. To achieve national-level HPV vaccine roll out and sustainability, stakeholders will need to negotiate vaccine prices and achieve better efficiency in startup activities and demand creation.

scholarly journals Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Annual Cost ◽  
Implementation Strategy ◽  
National Level ◽  
Vaccine Dose ◽  
Demonstration Project ◽  
Total Cost ◽  
School Based ◽  
The Mean ◽  
Mean Cost

Abstract Background Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program. Methods We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods—identification and measurement of resource quantities and valuation by application of unit costs, and gross costing—for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15–$23) in year two, and $24 (CI: $22–$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.

scholarly journals Potato Late Blight in the Columbia Basin: An Economic Analysis of the 1995 Epidemic

Plant Disease ◽  
1997 ◽  
Vol 81 (1) ◽  
pp. 103-106 ◽  
Author(s):  
D. A. Johnson ◽  
T. F. Cummings ◽  
P. B. Hamm ◽  
R. C. Rowe ◽  
J. S. Miller ◽  
...  
Keyword(s):  
Late Blight ◽  
Management Practice ◽  
Columbia Basin ◽  
Copper Hydroxide ◽  
Total Cost ◽  
Late Season ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
First Time

The cost of managing late blight in potatoes during a severe epidemic caused by new, aggressive strains of Phytophthora infestans in the Columbia Basin of Washington and Oregon in 1995 was documented. The mean number of fungicide applications per field varied from 5.1 to 6.3 for early- and midseason potatoes, and from 8.2 to 12.3 for late-season potatoes in the northern and southern Columbia Basin, respectively. In 1994, a year when late blight was not severe, the mean number of fungicide applications per field made to early- and midseason potatoes was 2.0; whereas late-season potatoes received a mean of 2.5 applications. The mean per acre cost of individual fungicides applied varied from $4.90 for copper hydroxide to $36.00 for propamocarb + chlorothalonil. Total per acre expenses (application costs plus fungicide material) for protecting the crop from late blight during 1995 ranged from $106.77 to $110.08 for early and midseason potatoes in different regions of the Columbia Basin and from $149.30 to $226.75 for lateseason potatoes in the northern and southern Columbia Basin, respectively. Approximately 28% of the crop was chemically desiccated before harvest as a disease management practice for the first time in 1995, resulting in an additional mean cost of $34.48/acre or $1.3 million for the region. Harvested yields were 4 to 6% less than in 1994. The total cost of managing late blight in the Columbia Basin in 1995 is estimated to have approached $30 million.

The cost of a general stochastic epidemic

1972 ◽  
Vol 9 (02) ◽  
pp. 257-269 ◽  
Author(s):  
J. Gani ◽  
D. Jerwood
Keyword(s):  
Recursive Equation ◽  
Stieltjes Transform ◽  
Stochastic Epidemic ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
General Stochastic

This paper is concerned with the cost Cis = aWis + bTis (a, b > 0) of a general stochastic epidemic starting with i infectives and s susceptibles; Tis denotes the duration of the epidemic, and Wis the area under the infective curve. The joint Laplace-Stieltjes transform of (Wis, Tis ) is studied, and a recursive equation derived for it. The duration Tis and its mean Nis are considered in some detail, as are also Wis and its mean Mis . Using the results obtained, bounds are found for the mean cost of the epidemic.

scholarly journals Comparison of the costs of HPV testing through community health campaigns versus home-based testing in rural Western Kenya: a microcosting study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033979
Author(s):  
Easter Elizabeth Olwanda ◽  
James G Kahn ◽  
Yujung Choi ◽  
Jessica Yasmine Islam ◽  
Megan Huchko
Keyword(s):  
Community Health ◽  
Outcome Measures ◽  
Health Campaigns ◽  
Capital Goods ◽  
Western Kenya ◽  
Home Based ◽  
Registration Number ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

ObjectivesTo estimate the cost of human papillomavirus (HPV)-based screening through community health campaigns (CHCs) and home-based testing.SettingCHCs and home-based testing in six communities in rural Western Kenya.ParticipantsCHCs and home-based screening reached 2297 and 1002 women aged 25–65 years, respectively.Outcome measuresOutcome measures were overall cost per woman screened achieved through the CHCs and home-based testing and the cost per woman for each activity comprising the screening intervention.ResultsThe mean cost per woman screened through CHCs and home-based testing were similar, at $37.7 (range $26.4–$52.0) and $37.1 (range $27.6–$54.0), respectively. For CHCs, personnel represented 49% of overall cost, supplies 25%, services 5% and capital goods 23%. For home-based testing, these were: personnel 73%, supplies 25%, services 1% and capital goods 2%. A greater number of participants was associated with a lower cost per participant.ConclusionsThe mean cost per woman screened is comparable for CHC and home-based testing, with differences in type of input. The CHCs generally reached more eligible women in the six communities, whereas home-based strategies more efficiently reached populations with low screening rates.Trial registration numberNCT02124252.

An Economic Evaluation of a Community-Based Organization Led HIV Self-Testing Program Among Men Who Have Sex With Men in China

2020 ◽  
Author(s):  
Shanzi Huang ◽  
Jason Ong ◽  
Wencan Dai ◽  
Xi He ◽  
Yi Zhou ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hiv Testing ◽  
Variable Cost ◽  
Community Based ◽  
Self Testing ◽  
Hiv Test ◽  
Community Based Organization ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Introduction: HIV self-testing (HIVST) is effective in improving the uptake of HIV testing among key populations. Complementary data on the cost-effectiveness of HIVST is critical for planning and scaling up HIVST. This study aimed to evaluate the cost-effectiveness of a community-based organization (CBO)-led HIVST model implemented in China. Method: A cost-effectiveness analysis (CEA) was conducted by comparing a CBO-led HIVST model with a CBO-led facility-based HIV rapid diagnostics testing (HIV-RDT) model. The full economic cost, including fixed and variable cost, from a health provider perspective using a micro costing approach was estimated. We determined the cost-effectiveness of these two HIV testing models over a two year time horizon (i.e. duration of the programs), and reported costs using US dollars (2020). Results: From January 2017 to December 2018, a total of 4,633 men tested in the HIVST model, and 1,780 men tested in the HIV-RDT model. The total number of new diagnosis was 155 for HIVST and 126 for the HIV-RDT model; the HIV test positivity was 3.3% (95% confidence interval (CI): 2.8-3.9) for the HIVST model and 7.1% (95% CI: 5.9-8.4) for the HIV-RDT model. The mean cost per person tested was $14.57 for HIVST and $24.74 for HIV-RDT. However, the mean cost per diagnosed was higher for HIVST ($435.52) compared with $349.44 for HIV-RDT.Conclusion: Our study confirms that compared to facility-based HIV-RDT, a community-based organization led HIVST program could have a cheaper mean cost per MSM tested for HIV in China. Better targeting of high-risk individuals would further improve the cost-effectiveness of HIVST.

scholarly journals Costs of care provided in a university hospital for children exposed to or infected with the HIV/AIDS

2007 ◽  
Vol 23 (suppl 3) ◽  
pp. S402-S413 ◽  
Author(s):  
Heloisa Helena de Sousa Marques ◽  
Bernard François Couttolenc ◽  
Maria do Rosário Dias de Oliveira Latorre ◽  
Maria Zilda de Aquino ◽  
Maria Ignez Garcia Aveiro ◽  
...  
Keyword(s):  
Medical Records ◽  
University Hospital ◽  
Accounting System ◽  
Cost Of Treatment ◽  
Costs Of Treatment ◽  
The Mean ◽  
Cost Accounting System ◽  
The Cost ◽  
Mean Cost ◽  
Hiv Aids

The objective of this study was to estimate and analyze the costs of treating children with HIV/AIDS at a university hospital in São Paulo, Brazil. The study collected and analyzed data from 291 medical records of children treated at the hospital as of March 2002. The costs of treatment were estimated for each category of patient (exposed and infected) and severity, based on the quantity of inputs and procedures used in treating each child, based on the cost accounting system used at the hospital. The total cost of treatment for children exposed to the HIV was R$ 956.41 and for those infected with HIV R$ 8,092.71 per year. The mean cost of ambulatory care was R$ 6,047.28 for children with severe conditions, R$ 3,714.45 for those with light/moderate conditions, and R$ 948.63 for the exposed. Hospitalized children had annual costs of R$ 19,353.34, R$ 18,823.16, and R$ 871.03, respectively. The medication was a major factor in the cost of treatment. Our estimates are comparable to the findings from other studies, but lower than corresponding findings from the international literature.

Botulism in Native Peoples - An Economic Study

1988 ◽  
Vol 51 (7) ◽  
pp. 581-587 ◽  
Author(s):  
EWENC. D.TODD
Keyword(s):  
Local Treatment ◽  
Future Health ◽  
Fermented Fish ◽  
Native Peoples ◽  
Health Care Practices ◽  
Northern Regions ◽  
Future Health Care ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Type E botulism occurs regularly in scattered locations in the Canadian Arctic and northern coastal British Columbia from the consumption of improperly fermented fish and marine mammal products by native peoples, with an average of eight cases and 1.5 deaths each year. Local treatment at nursing stations is often followed by the evacuation of the patients to the main northern hospitals, e.g. Iqaluit and Inuvik with subsequent intensive care, if necessary, in Montreal, Winnipeg, Edmonton or Vancouver. Estimates of costs of six incidents in these northern regions showed that the evacuation of patients was the most expensive component (mean, 31.2%), followed by hospitalization (23.8%) and investigation of the illnesses (19.4%). The mean cost per incident was over $70,000, or $7,200 per case. If these figures are extrapolated, the cost of botulism in these areas is about $2 million each year, with $1.5 million being considered the value of the lives lost. Current and future health care practices in northern regions should be evaluated in relation to these and other costs.

scholarly journals Expenditure survey on continued veno-venous hemodialysis procedure in the intensive care unit

2007 ◽  
Vol 15 (6) ◽  
pp. 1138-1143 ◽  
Author(s):  
Lígia Maria dal Secco ◽  
Valéria Castilho
Keyword(s):  
Total Expenditure ◽  
Procedure Time ◽  
Time Duration ◽  
Total Cost ◽  
Acute Renal Insufficiency ◽  
Male Patients ◽  
The Mean ◽  
Procedure Duration ◽  
Mean Cost ◽  
Dialytic Treatment

This study aimed to characterize patients submitted to dialytic treatment with CVVHD in ICUs; monitor procedure time duration; estimate nurses' labor wages and; estimate the direct procedures mean costs. The study was developed in a public teaching hospital located in São Paulo, Brazil. A total of 93 procedures performed in 50 patients composed the sample. The results showed the predominance of male patients (62%); mean age was 60.8 years old; ICU hospitalization time was 19.2 days; 86% of the patients died; 76% of the patients presented acute renal insufficiency and, mean procedure time per patient was 1.9. The mean procedure duration was 26.6 hours. The mean cost of nurses' wages were R$ 592.04 which represented 28.7% of the total cost. The mean total expenditure was R$ 2,065.36 ranging from R$ 733.65 to R$ 6,994.18.

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