Cost analyses of peer health worker and mHealth support interventions for improving AIDS care in Rakai, Uganda
Open accessAbstract
A cost analysis study calculates resources needed to deliver an intervention and can provide useful information on affordability for service providers and policy-makers. We conducted cost analyses of both a peer health worker (PHW) and a mHealth (mobile phone) support intervention. Excluding supervisory staffing costs, total yearly costs for the PHW intervention was $8475, resulting in a yearly cost per patient of $8.74, per virologic failure averted cost of $189, and per patient lost to follow-up averted cost of $1025. Including supervisory staffing costs increased total yearly costs to $14,991. Yearly costs of the mHealth intervention were an additional $1046, resulting in a yearly cost per patient of $2.35. In a threshold analysis, the PHW intervention was found to be cost saving if it was able to avert 1.50 patients per year from switching to second-line antiretroviral therapy. Other AIDS care programs may find these intervention costs affordable.
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There is promise for m-Health interventions and increased use of mobile phone technology in Uganda in both rural and urban communities despite poverty levels.
“In addition, there is promise for m-Health interventions and increased use of mobile phone technology in Uganda in both rural and urban communities despite the poverty levels.”
From Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review (2017) · cites this paper as [44]
The Discussion (page unavailable) says the mHealth support intervention would likely add minimal implementation costs, supporting its promise in the Rakai AIDS-care setting. The Methods describe phones used by peer health workers, but the paper does not establish increased mobile-phone use across both rural and urban Ugandan communities or assess use despite poverty levels. (LLM, conf=0.83)
Experimental — accuracy not yet measuredBoth the peer health worker and mHealth support interventions were found to be reasonable for the budgetary requirements of many AIDS care programs.
“Both interventions were found to be reasonable for the budgetary requirements of many AIDS care programs.”
From mHealth in Sub-Saharan Africa (2013) · cites this paper as [18]
Effectiveness in averting virologic failure and loss to follow-up was shown for the peer health worker intervention with the addition of mHealth.
“The effectiveness in averting virologic failure and loss to follow-up were shown for the PHW intervention with the addition of mHealth; however, a comparison of effectiveness of PHWs with and without mHealth was not performed.”
From mHealth in Sub-Saharan Africa (2013) · cites this paper as [18]
In Uganda, a cost analysis found costs per patient per year of $8.75 for a peer health worker program versus $2.35 for an mHealth support program.
“A cost analysis by Chang showed costs per patient per year in Uganda of $8.75 for a peer health worker (PHW) program versus $2.35 for an mHealth support program [18].”
From mHealth in Sub-Saharan Africa (2013) · cites this paper as [18]
A comparison of effectiveness of peer health workers with and without mHealth was not performed.
“The effectiveness in averting virologic failure and loss to follow-up were shown for the PHW intervention with the addition of mHealth; however, a comparison of effectiveness of PHWs with and without mHealth was not performed.”
From mHealth in Sub-Saharan Africa (2013) · cites this paper as [18]
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- Authors
- Chang, L. W., Kagaayi, J., Nakigozi, G., Serwada, D., Quinn, T. C., Gray, R. H., Bollinger, R. C., Reynolds, S. J., & Holtgrave, D.
- Affiliations
- Johns Hopkins University (US)
- Rakai Health Sciences Program (UG)
- National Institutes of Health (US)
- d Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
- Corresponding author
- Chang, Larry W.
- ORCID
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2012-09-13
- Volume
- 25
- Issue
- 5
- Pages
- 652-656
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- PMC
- PMC3773472
- OpenAlex
- W2023709198
- Cited by
- 28
- References
- 15
- Citations by year
- 2024: 5 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 1 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 1
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Doris Duke Charitable Foundation
- U.S. President’s Emergency Plan for AIDS Relief
- National Institutes of Health
- National Institute of Mental Health (K23MH086338)
- National Institute of Allergy and Infectious Diseases (2T32-AI07291, T32AI007291, ZIAAI000361)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › HIV/AIDS Impact and Responses
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- mobile health, HIV care, antiretroviral therapy, virological failure, loss to follow-up, second-line antiretroviral therapy, cost per patient, Rakai, Uganda
- MeSH terms
- Acquired Immunodeficiency Syndrome, Community Health Services, Costs and Cost Analysis, Humans, Patient Care Team, Quality of Health Care, Retrospective Studies, Uganda, Telemedicine, Cell Phone
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