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Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa

Schnippel, Kathryn ; Lince-Deroche, Naomi ; van den Handel, Theo ; Molefi, Seithati ; Bruce, Suann ; Firnhaber, Cynthia Griffiths, Ulla Kou

PloS one, 2015-03, Vol.10 (3), p.e0119236-e0119236 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa
Autor: Schnippel, Kathryn ; Lince-Deroche, Naomi ; van den Handel, Theo ; Molefi, Seithati ; Bruce, Suann ; Firnhaber, Cynthia
Griffiths, Ulla Kou
Assuntos: Acquired immune deficiency syndrome ; AIDS ; Cancer ; Cancer screening ; Cervical cancer ; Cervix ; Condoms ; Contraceptives ; Costs ; Costs and Cost Analysis ; Delivery of Health Care - economics ; Delivery of Health Care - organization & administration ; Economic aspects ; Equipment costs ; Evaluation ; Female ; Finance ; Health care ; Health care costs ; Health Services Accessibility - organization & administration ; HIV ; HIV Infections - diagnosis ; HIV Infections - prevention & control ; Human immunodeficiency virus ; Human papillomavirus ; Humans ; Mass Screening - methods ; Medical care, Cost of ; Medical screening ; Mobile Health Units - economics ; Mobile Health Units - organization & administration ; NGOs ; Non-governmental organizations ; Nongovernmental organizations ; Nursing ; Operating costs ; Oral contraceptives ; Primary health care ; Primary Health Care - economics ; Primary Health Care - organization & administration ; Public sector ; Retrospective Studies ; Rural areas ; Rural Health Services - economics ; Rural Health Services - organization & administration ; Screening ; Sexually transmitted diseases ; Sexually Transmitted Diseases - diagnosis ; Sexually Transmitted Diseases - prevention & control ; South Africa ; STD ; Tuberculosis ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - prevention & control ; Wages & salaries ; Women's Health Services - economics ; Women's Health Services - organization & administration ; Womens health
É parte de: PloS one, 2015-03, Vol.10 (3), p.e0119236-e0119236
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: KS CF. Performed the experiments: TvdH SM CF SB. Analyzed the data: KS NLD. Contributed reagents/materials/analysis tools: KS. Wrote the paper: KS CF NLD TvdH SM SB.
Descrição: Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model. The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district) and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs), breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD. Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts); the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost. Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to health care without added costs.
Editor: United States: Public Library of Science
Idioma: Inglês

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Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa

Schnippel, Kathryn ; Lince-Deroche, Naomi ; van den Handel, Theo ; Molefi, Seithati ; Bruce, Suann ; Firnhaber, Cynthia Griffiths, Ulla Kou

United States: Public Library of Science

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