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Costs and cost drivers of comprehensive sexual reproductive health services to female sex workers in Kenya.
Manguro, Griffins O; Kioko, Urbanus Mutuku; Githinji, Gerald; Owira, Patricia; Langat, Lillian; Okoro, Dan; Temmerman, Marleen; Luchters, Stanley.
Afiliación
  • Manguro GO; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. gmanguro@gmail.com.
  • Kioko UM; University of Nairobi School of Economics, Nairobi, Kenya.
  • Githinji G; Monitoring and Evaluation, International Centre for Reproductive Health Kenya, Mombasa, Kenya.
  • Owira P; Monitoring and Evaluation, International Centre for Reproductive Health Kenya, Mombasa, Kenya.
  • Langat L; UNFPA Kenya Office, Nairobi, Kenya.
  • Okoro D; UNFPA Kenya Office, Nairobi, Kenya.
  • Temmerman M; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
  • Luchters S; Monitoring and Evaluation, International Centre for Reproductive Health Kenya, Mombasa, Kenya.
BMC Health Serv Res ; 24(1): 822, 2024 Jul 17.
Article en En | MEDLINE | ID: mdl-39014381
ABSTRACT

BACKGROUND:

Comprehensive sexual reproductive health (SRH) programs for female sex workers (FSW) offering clinical, behavioural, and structural interventions have contributed to declining rates of HIV in this population. However, data on costs and cost drivers is needed to support programs and their donors to better allocate resources, make an investment case for continued funding, and to identify areas of improvement in program design and implementation. We aimed to estimate the annual per-FSW costs of comprehensive services for a standalone FSW program in Kenya.

METHODS:

We implemented a top-bottom and activity-based costing study of comprehensive FSW services at two drop-in centres (DICs), Mtwapa and Kilifi town, in Kilifi County, Kenya. Service costs were obtained from routinely collected patient data during FSW scheduled and unscheduled visits using Kenyan Ministry of Health records. Costing data were from the program and organization's expenditure reports, cross checked against bank documents and supported by information from in-depth interviews. Data were collected retrospectively for the fiscal year 2019. We obtained approval from the AMREF Research Ethics Committee (AMREF-ESRC P862/2020).

RESULTS:

In 2019, the unit cost of comprehensive services was 105.93 USD per FSW per year, roughly equivalent to 10,593 Kenya shillings. Costs were higher at Mtwapa DICs compared to Kilifi town DIC; 121.90 USD and 89.90 USD respectively. HIV counselling and testing cost 63.90 USD per person, PrEP was 34.20 USD and family planning was 9.93 USD. Of the total costs, staff salaries accounted for about 60%. Adjusted for inflation, costs in 2024 would be approximately 146.60.

CONCLUSION:

Programs should strive to maximize the number of FSW served to benefit from economies of scale. Given that personnel costs contribute most to the unit costs, programs should consider alternative designs which reduce personnel and other costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios de Salud Reproductiva / Trabajadores Sexuales Límite: Adult / Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios de Salud Reproductiva / Trabajadores Sexuales Límite: Adult / Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido