@article{fdi:010087014,
  title = {{E}conomic analysis of low volume interventions using real-world data : costs of {HIV} self-testing distribution and {HIV} testing services in {W}est {A}frica from the {ATLAS} project},
  author = {{T}raor{\'e}, {M}.{M}. and {B}adiane, {K}. and {V}autier, {A}. and {S}imo {F}otso, {A}. and {K}anku {K}abemba, {O}. and {R}ouveau, {N}icolas and {M}aheu-{G}iroux, {M}. and {B}oily, {M}.{C}. and {L}armarange, {J}oseph and {T}erris-{P}restholt, {F}. and {D}'{E}lb{\'e}e, {M}. and {A}tlas {T}eam},
  editor = {},
  language = {{ENG}},
  abstract = {{A}chieving the first 95 of the {UNAIDS} targets requires the implementation of innovative approaches to knowing one's {HIV} status. {A}mong these innovations is the provision of {HIV} self-testing ({HIVST}) kits in west {A}frica by the international partner organization {S}olthis ({IPO}). {I}n order to provide guidance for the optimal use of financial resources, this study aims to estimate the program and site level costs of dispensing {HIVST} as well as {HIV} testing services ({HTS})-excluding {HIVST}-in health facilities in {C}{\^o}te d'{I}voire, {M}ali and {S}enegal as part of the {ATLAS} project. {W}e estimated from the provider's perspective, {HIVST} and {HTS} incremental costs using top-down and bottom-up costing approaches and conducted a time and motion study. {W}e identified costs at the program level for {HIVST} (including {IPO} central costs) and at the site level for {HIVST} and {HTS}. {T}he economic costs of distributing {HIVST} kits were assessed in 37 health facilities between {J}uly 2019 and {M}arch 2021 (21 months). {S}ensitivity analyses were also performed on unit costs to examine the robustness of our estimates related to key assumptions. {I}n total, 16,001 {HIVST} kits were dispensed for 32,194 {HTS} sessions carried out. {P}rogram level {HIVST} average costs ranged $12-286, whereas site level costs ranged $4-26 across distribution channels and countries. {S}ite level {HTS} costs ranged $7-8 per testing session, and ranged $72-705 per {HIV} diagnosis. {A}cross countries and channels, {HIVST} costs were driven by personnel (27-68%) and {HIVST} kits (32-73%) costs. {T}he drivers of {HTS} costs were personnel costs ranging between 65 and 71% of total costs across distribution channels and countries, followed by supplies costs between 21 and 30%. {W}hile program level {HIVST} average costs were high, site level {HIVST} average costs remained comparable to {HTS} costs in all countries. {H}ealth facility-based distribution channels operating at low volume exhibit high proportion of central costs which should be considered carefully for financial planning when run alongside high volumes mobile outreach distribution channels. {HIVST} can diversify the {HIV} testing offer at health facilities, thus improving access to screening for target populations not reached by {HTS} services.},
  keywords = {{COTE} {D}'{IVOIRE} ; {MALI} ; {SENEGAL} ; {AFRIQUE} {DE} {L}'{OUEST}},
  booktitle = {},
  journal = {{F}rontiers in {H}ealth {S}ervices},
  volume = {2},
  numero = {},
  pages = {886513 [11 ]},
  ISSN = {2813-0146},
  year = {2022},
  DOI = {10.3389/frhs.2022.886513},
  URL = {https://www.documentation.ird.fr/hor/fdi:010087014},
}