Cost comparison of a rapid results initiative against standard clinic-based model to scale-up voluntary medical male circumcision in Kenya

• DOI: 10.1371/journal.pgph.0000817
• Publication Date: 2023-03-29T17:40:44Z
• Authors: Katrin Jaradeh; Tyler Van Fleet K...; Jackline Cheruiyot; Francesca Odhiambo; Elizabeth A. Bukusi; Craig R. Cohen; Starley B. Shade
• Keywords: Ledger; Liberian dollar

Voluntary male medical circumcision (VMMC) reduces HIV acquisition by up to 60%. Kenya has successfully scaled VMMC an estimated 91% of eligible men and boys in certain regions combination due cultural circumcisions. as a program is implemented regionally traditionally non-circumcising counties where the prevalence still below 91%, ranging from 56.4% 66.7%. Given that funding toward expected decline coming years, it important identify what models service delivery are most appropriate efficient sustainably meet needs new cohorts' men. To this end, we compared costs facility-based one within rapid results initiative (RRI), public health scheduled during school holidays perform many procedures over short period. We employed activity-based micro-costing estimate costs, implementer perspective, RRI-based conducted between October 2017 September 2018 at 41 sites Kisumu County, supported Family AIDS care & Education Services (FACES). site visits reviewed financial ledger programmatic data quantify resources consumed number performed routine RRIs. Ledger were used fixed recurring cost per (CPC) United States dollar (USD). A sensitivity analysis was done CPC allocated 6 months RRI. Overall, FACES spent $3,092,891 services 42,139 year. This included $2,644,910 stable $139,786 procedure $308,195 for RRI-specific activities. Over year, 49% (n = 20,625) part 51% 21,514) Procedures $99.35 circumcision, those RRIs $48.51 according our analysis, ranges $287.24 RRI ranged $29.81 $48.51. The substantially lower than unit reported previous costing studies. conclude campaigns, such RRI, offer sustainable approach VMMC.