A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.

There is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness o...

Full description

Bibliographic Details
Main Authors: Hanani Tabana, Lungiswa Nkonki, Charles Hongoro, Tanya Doherty, Anna Mia Ekström, Reshma Naik, Wanga Zembe-Mkabile, Debra Jackson, Anna Thorson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4537202?pdf=render
id doaj-cae1b63216d94789a9c0dc1d8aa8e55b
record_format Article
spelling doaj-cae1b63216d94789a9c0dc1d8aa8e55b2020-11-25T01:23:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01108e013504810.1371/journal.pone.0135048A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.Hanani TabanaLungiswa NkonkiCharles HongoroTanya DohertyAnna Mia EkströmReshma NaikWanga Zembe-MkabileDebra JacksonAnna ThorsonThere is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness of a home-based HIV testing intervention in rural South Africa.Two alternatives: clinic and home-based HIV counselling and testing were compared. Costs were analysed from a provider's perspective for the period of January to December 2010. The outcome, HIV counselling and testing (HCT) uptake was obtained from the Good Start home-based HIV counselling and testing (HBHCT) cluster randomised control trial undertaken in KwaZulu-Natal province. Cost-effectiveness was estimated for a target population of 22,099 versus 23,864 people for intervention and control communities respectively. Average costs were calculated as the cost per client tested, while cost-effectiveness was calculated as the cost per additional client tested through HBHCT.Based on effectiveness of 37% in the intervention (HBHCT) arm compared to 16% in control arm, home based testing costs US$29 compared to US$38 per person for clinic HCT. The incremental cost effectiveness per client tested using HBHCT was $19.HBHCT was less costly and more effective. Home-based HCT could present a cost-effective alternative for rural 'hard to reach' populations depending on affordability by the health system, and should be considered as part of community outreach programs.http://europepmc.org/articles/PMC4537202?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Hanani Tabana
Lungiswa Nkonki
Charles Hongoro
Tanya Doherty
Anna Mia Ekström
Reshma Naik
Wanga Zembe-Mkabile
Debra Jackson
Anna Thorson
spellingShingle Hanani Tabana
Lungiswa Nkonki
Charles Hongoro
Tanya Doherty
Anna Mia Ekström
Reshma Naik
Wanga Zembe-Mkabile
Debra Jackson
Anna Thorson
A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.
PLoS ONE
author_facet Hanani Tabana
Lungiswa Nkonki
Charles Hongoro
Tanya Doherty
Anna Mia Ekström
Reshma Naik
Wanga Zembe-Mkabile
Debra Jackson
Anna Thorson
author_sort Hanani Tabana
title A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.
title_short A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.
title_full A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.
title_fullStr A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.
title_full_unstemmed A Cost-Effectiveness Analysis of a Home-Based HIV Counselling and Testing Intervention versus the Standard (Facility Based) HIV Testing Strategy in Rural South Africa.
title_sort cost-effectiveness analysis of a home-based hiv counselling and testing intervention versus the standard (facility based) hiv testing strategy in rural south africa.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2015-01-01
description There is growing evidence concerning the acceptability and feasibility of home-based HIV testing. However, less is known about the cost-effectiveness of the approach yet it is a critical component to guide decisions about scaling up access to HIV testing. This study examined the cost-effectiveness of a home-based HIV testing intervention in rural South Africa.Two alternatives: clinic and home-based HIV counselling and testing were compared. Costs were analysed from a provider's perspective for the period of January to December 2010. The outcome, HIV counselling and testing (HCT) uptake was obtained from the Good Start home-based HIV counselling and testing (HBHCT) cluster randomised control trial undertaken in KwaZulu-Natal province. Cost-effectiveness was estimated for a target population of 22,099 versus 23,864 people for intervention and control communities respectively. Average costs were calculated as the cost per client tested, while cost-effectiveness was calculated as the cost per additional client tested through HBHCT.Based on effectiveness of 37% in the intervention (HBHCT) arm compared to 16% in control arm, home based testing costs US$29 compared to US$38 per person for clinic HCT. The incremental cost effectiveness per client tested using HBHCT was $19.HBHCT was less costly and more effective. Home-based HCT could present a cost-effective alternative for rural 'hard to reach' populations depending on affordability by the health system, and should be considered as part of community outreach programs.
url http://europepmc.org/articles/PMC4537202?pdf=render
work_keys_str_mv AT hananitabana acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT lungiswankonki acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT charleshongoro acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT tanyadoherty acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT annamiaekstrom acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT reshmanaik acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT wangazembemkabile acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT debrajackson acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT annathorson acosteffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT hananitabana costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT lungiswankonki costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT charleshongoro costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT tanyadoherty costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT annamiaekstrom costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT reshmanaik costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT wangazembemkabile costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT debrajackson costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
AT annathorson costeffectivenessanalysisofahomebasedhivcounsellingandtestinginterventionversusthestandardfacilitybasedhivtestingstrategyinruralsouthafrica
_version_ 1725121866762289152