Cost of Community Integrated Prevention Campaign for Malaria, HIV, and Diarrhea in Rural Kenya

• Type of Material: Article
• Authors: James G. Kahn, University of California; Brian Harris, University of California; Jonathan H. Mermin, Emory University; Thomas Clasen, Emory University; Eric Lugada, CHF International; Mark Grabowksy, United Nations Foundation; Mikkel Verstergaard Frandsen, Vestergaard Frandsen; Navneet Garg, Vestergaard Asia Private Ltd.
• Language: English
• Date: 2011-12-21
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2011 Kahn et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://www.biomedcentral.com/1472-6963/11/346
• Title of Journal or Parent Work: BMC Health Services Research
• ISSN: 1472-6963
• Volume: 11
• Issue: 346
• Start Page: 1
• End Page: 8
• Grant/Funding Information: EL and TC were paid by VF for other work related to this campaign.; JGK and BH were contracted to conduct this analysis by Vestergaard Frandsen
• Research Categories: Health Sciences, Public Health

Abstract

Background Delivery of community-based prevention services for HIV, malaria, and diarrhea is a major priority and challenge in rural Africa. Integrated delivery campaigns may offer a mechanism to achieve high coverage and efficiency. Methods We quantified the resources and costs to implement a large-scale integrated prevention campaign in Lurambi Division, Western Province, Kenya that reached 47,133 individuals (and 83% of eligible adults) in 7 days. The campaign provided HIV testing, condoms, and prevention education materials; a long-lasting insecticide-treated bed net; and a water filter. Data were obtained primarily from logistical and expenditure data maintained by implementing partners. We estimated the projected cost of a Scaled-Up Replication (SUR), assuming reliance on local managers, potential efficiencies of scale, and other adjustments. Results The cost per person served was $41.66 for the initial campaign and was projected at $31.98 for the SUR. The SUR cost included 67% for commodities (mainly water filters and bed nets) and 20% for personnel. The SUR projected unit cost per person served, by disease, was $6.27 for malaria (nets and training), $15.80 for diarrhea (filters and training), and $9.91 for HIV (test kits, counseling, condoms, and CD4 testing at each site). Conclusions A large-scale, rapidly implemented, integrated health campaign provided services to 80% of a rural Kenyan population with relatively low cost. Scaling up this design may provide similar services to larger populations at lower cost per person.