MBA-HCM Theses and Dissertations (2022)

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Browsing MBA-HCM Theses and Dissertations (2022) by Subject "Cost"

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    Cost drivers for Medically Assisted Treatment in HIV control in Nairobi, Kenya
    (Strathmore University, 2022) Wangusi, Rebeccah Namalea
    An estimated 18% of people who inject drugs in Kenya are infected with HIV. Medically Assisted Treatment with methadone offers promise as a HIV prevention strategy among this population. The costs of Medically Assisted Treatment services in two Kenyan public facilities were studied from an economic health care provider perspective. The objectives included: to determine the startup costs of setting up a medically assisted treatment clinic; to determine the annual recurrent costs and; to determine the annual unit cost per patient. The study utilized the cost of production theory. Data was collected from Ngara MAT Clinic and Mathari Teaching & Referral Hospital. Data were collected at the facility level using a micro-costing approach utilizing a modified version of the Drug Abuse Treatment Cost Analysis Program tool. Results showed that the total start-up costs ranged between $213,471.64 and $533,412.99 across the two sites with the cost of setting up a subsequent clinic being 50% less. An additional $316,294.77 and $ 365,080.32 were determined as the total annual recurrent costs necessary to run the program within the existing infrastructure for the different clinics. The annual per-patient cost of providing Medically Assisted Treatment ranged from $ 532 to $590 across the 2 sites, with an average cost of $562. This was lower than costs reported in upper and middle-income countries. Consistent with other studies, the main cost driver for Medically Assisted Treatment was personnel costs accounting for 59% of the total costs. For policymakers, the results of this study offer an opportunity to revisit and strengthen policies on Drug abuse prevention and financing for HIV prevention programs and Medically Assisted Treatment in particular.