Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review
Abstract Background Community-based interventions (CBIs) are interventions aimed at improving the well-being of people in a community. CBIs for HIV testing seek to increase the availability of testing services to populations that have been identified as at high risk by reaching them in homes, school...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-07-01
|
Series: | Implementation Science Communications |
Subjects: | |
Online Access: | https://doi.org/10.1186/s43058-021-00177-y |
id |
doaj-16e58dcef5a94c24b119746f067b24b9 |
---|---|
record_format |
Article |
spelling |
doaj-16e58dcef5a94c24b119746f067b24b92021-07-11T11:04:37ZengBMCImplementation Science Communications2662-22112021-07-012112110.1186/s43058-021-00177-yCosts of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic reviewFlorida Uzoaru0Ucheoma Nwaozuru1Jason J. Ong2Felix Obi3Chisom Obiezu-Umeh4Joseph D. Tucker5Thembekile Shato6Stacey L. Mason7Victoria Carter8Sunita Manu9Rhonda BeLue10Oliver Ezechi11Juliet Iwelunmor12College of Public Health and Social Justice, Saint Louis UniversityCollege of Public Health and Social Justice, Saint Louis UniversityDepartment of Clinical Research and Development, London School of Hygiene and Tropical Medicine, United Kingdom Central Clinical School, Monash UniversityHealth Policy Research Group, University of NigeriaCollege of Public Health and Social Justice, Saint Louis UniversityDivision of Infectious Diseases, School of Medicine, University of North Carolina at Chapel HillCollege of Public Health and Social Justice, Saint Louis UniversityCollege of Public Health and Social Justice, Saint Louis UniversityCollege of Public Health and Social Justice, Saint Louis UniversityCollege of Public Health and Social Justice, Saint Louis UniversityCollege of Public Health and Social Justice, Saint Louis UniversityClinical Sciences Department, Nigerian Institute of Medical ResearchCollege of Public Health and Social Justice, Saint Louis UniversityAbstract Background Community-based interventions (CBIs) are interventions aimed at improving the well-being of people in a community. CBIs for HIV testing seek to increase the availability of testing services to populations that have been identified as at high risk by reaching them in homes, schools, or community centers. However, evidence for a detailed cost analysis of these community-based interventions in sub-Saharan Africa (SSA) is limited. We conducted a systematic review of the cost analysis of HIV testing interventions in SSA. Methods Keyword search was conducted on SCOPUS, CINAHL, MEDLINE, PsycINFO, Web of Science, and Global Health databases. Three categories of key terms used were cost (implementation cost OR cost-effectiveness OR cost analysis OR cost-benefit OR marginal cost), intervention (HIV testing), and region (sub-Saharan Africa OR sub-Saharan Africa OR SSA). CBI studies were included if they primarily focused on HIV testing, was implemented in SSA, and used micro-costing or ingredients approach. Results We identified 1533 citations. After screening, ten studies were included in the review: five from East Africa and five from Southern Africa. Two studies conducted cost-effectiveness analysis, and one study was a cost-utility analysis. The remainder seven studies were cost analyses. Four intervention types were identified: HIV self-testing (HIVST), home-based, mobile, and Provider Initiated Testing and Counseling. Commonly costed resources included personnel (n = 9), materials and equipment (n = 6), and training (n = 5). Cost outcomes reported included total intervention cost (n = 9), cost per HIV test (n = 9), cost per diagnosis (n = 5), and cost per linkage to care (n = 3). Overall, interventions were implemented at a higher cost than controls, with the largest cost difference with HIVST compared to facility-based testing. Conclusion To better inform policy, there is an urgent need to evaluate the costs associated with implementing CBIs in SSA. It is important for cost reports to be detailed, uniform, and informed by economic evaluation guidelines. This approach minimizes biases that may lead decision-makers to underestimate the resources required to scale up, sustain, or reproduce successful interventions in other settings. In an evolving field of implementation research, this review contributes to current resources on implementation cost studies.https://doi.org/10.1186/s43058-021-00177-yEconomic evaluationImplementation costHIV testing |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Florida Uzoaru Ucheoma Nwaozuru Jason J. Ong Felix Obi Chisom Obiezu-Umeh Joseph D. Tucker Thembekile Shato Stacey L. Mason Victoria Carter Sunita Manu Rhonda BeLue Oliver Ezechi Juliet Iwelunmor |
spellingShingle |
Florida Uzoaru Ucheoma Nwaozuru Jason J. Ong Felix Obi Chisom Obiezu-Umeh Joseph D. Tucker Thembekile Shato Stacey L. Mason Victoria Carter Sunita Manu Rhonda BeLue Oliver Ezechi Juliet Iwelunmor Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review Implementation Science Communications Economic evaluation Implementation cost HIV testing |
author_facet |
Florida Uzoaru Ucheoma Nwaozuru Jason J. Ong Felix Obi Chisom Obiezu-Umeh Joseph D. Tucker Thembekile Shato Stacey L. Mason Victoria Carter Sunita Manu Rhonda BeLue Oliver Ezechi Juliet Iwelunmor |
author_sort |
Florida Uzoaru |
title |
Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review |
title_short |
Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review |
title_full |
Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review |
title_fullStr |
Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review |
title_full_unstemmed |
Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review |
title_sort |
costs of implementing community-based intervention for hiv testing in sub-saharan africa: a systematic review |
publisher |
BMC |
series |
Implementation Science Communications |
issn |
2662-2211 |
publishDate |
2021-07-01 |
description |
Abstract Background Community-based interventions (CBIs) are interventions aimed at improving the well-being of people in a community. CBIs for HIV testing seek to increase the availability of testing services to populations that have been identified as at high risk by reaching them in homes, schools, or community centers. However, evidence for a detailed cost analysis of these community-based interventions in sub-Saharan Africa (SSA) is limited. We conducted a systematic review of the cost analysis of HIV testing interventions in SSA. Methods Keyword search was conducted on SCOPUS, CINAHL, MEDLINE, PsycINFO, Web of Science, and Global Health databases. Three categories of key terms used were cost (implementation cost OR cost-effectiveness OR cost analysis OR cost-benefit OR marginal cost), intervention (HIV testing), and region (sub-Saharan Africa OR sub-Saharan Africa OR SSA). CBI studies were included if they primarily focused on HIV testing, was implemented in SSA, and used micro-costing or ingredients approach. Results We identified 1533 citations. After screening, ten studies were included in the review: five from East Africa and five from Southern Africa. Two studies conducted cost-effectiveness analysis, and one study was a cost-utility analysis. The remainder seven studies were cost analyses. Four intervention types were identified: HIV self-testing (HIVST), home-based, mobile, and Provider Initiated Testing and Counseling. Commonly costed resources included personnel (n = 9), materials and equipment (n = 6), and training (n = 5). Cost outcomes reported included total intervention cost (n = 9), cost per HIV test (n = 9), cost per diagnosis (n = 5), and cost per linkage to care (n = 3). Overall, interventions were implemented at a higher cost than controls, with the largest cost difference with HIVST compared to facility-based testing. Conclusion To better inform policy, there is an urgent need to evaluate the costs associated with implementing CBIs in SSA. It is important for cost reports to be detailed, uniform, and informed by economic evaluation guidelines. This approach minimizes biases that may lead decision-makers to underestimate the resources required to scale up, sustain, or reproduce successful interventions in other settings. In an evolving field of implementation research, this review contributes to current resources on implementation cost studies. |
topic |
Economic evaluation Implementation cost HIV testing |
url |
https://doi.org/10.1186/s43058-021-00177-y |
work_keys_str_mv |
AT floridauzoaru costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT ucheomanwaozuru costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT jasonjong costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT felixobi costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT chisomobiezuumeh costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT josephdtucker costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT thembekileshato costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT staceylmason costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT victoriacarter costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT sunitamanu costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT rhondabelue costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT oliverezechi costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview AT julietiwelunmor costsofimplementingcommunitybasedinterventionforhivtestinginsubsaharanafricaasystematicreview |
_version_ |
1721309305867599872 |