Comparative Analysis: Cost of Two Community ART Delivery Models In the Urban Settings In Zambia
Abstract
In the quest to improve and address the bottle necks of ART services to the affected population, Zambia has implemented three models of delivering this service which are; Standard of Care, Door to Door and Adherence Clubs. The aim of this study was to identify and cost the provision of ART services using the three models. A quantitative retrospective cross-sectional study was done to compare the cost of delivering two models, adherence clubs and door to door in relation to the standard facility-based model. The 2018 costing data for ART was collected retrospectively in the Kanyama and Chipata Health Urban Centers in Lusaka, Zambia. A checklist and a data costing tool was developed to help identify and cost all the costs items attached to the provision of ART services in the two Health Centers. The study shows that the total cost of delivering ART services to 11,225 patients at Chipata Health center was 53,087,649.54 ZMW ($ 4,994,134.48) translating into 21,802.49 ($2,051.03) per patient. Furthermore, providing the same services at Kanyama to 12,293 clients costed 35,823,354.87 ZMW ($ 3,370,023.98) and cost per patient was 24989.65 ZMW ($2,350.86).The study concluded that it was more expensive to deliver ART through health facility model than community-based models. The major costs of ART services using three models of care were ARV drugs followed capital and personnel costs. In order to reduce barriers and costs ART services must be brought close to people as much as possible.All authors who submit their paper for publication will abide by following provisions of the copyright transfer: 1. The copyright of the paper rests with the authors. And they are transferring the copyright to publish the article and used the article for indexing and storing for public use with due reference to published matter in the name of concerned authors. 2. The authors reserve all proprietary rights such as patent rights and the right to use all or part of the article in future works of their own such as lectures, press releases, and reviews of textbooks. 3. In the case of republication of the whole, part, or parts thereof, in periodicals or reprint publications by a third party, written permission must be obtained from the Managing Editor of JPRM. 4. The authors declare that the material being presented by them in this paper is their original work, and does not contain or include material taken from other copyrighted sources. Wherever such material has been included, it has been clearly indented or/and identified by quotation marks and due and proper acknowledgements given by citing the source at appropriate places. 5. The paper, the final version of which they submit, is not substantially the same as any that they had already published elsewhere. 6. They declare that they have not sent the paper or any paper substantially the same as the submitted one, for publication anywhere else. 7. Furthermore, the author may only post his/her version provided acknowledgement is given to the original source of publication in this journal and a link is inserted wherever published. 8. All contents, Parts, written matters, publications are under copyright act taken by JPRM. 9. Published articles will be available for use by scholars and researchers. 10. IJPRM is not responsible in any type of claim on publication in our Journal. .