Cost analyses of peer health worker and mHealth support interventions for improving AIDS care in Rakai, Uganda

Abstract

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.

Keywords:

• cost analysis
• mHealth
• community health workers
• Uganda
• antiretroviral treatment

Acknowledgements

This study was supported by the Doris Duke Charitable Foundation, The Division of Intramural Research, The National Institute for Allergy and Infectious Diseases, National Institutes of Health, and National Institutes of Health Training (2T32-AI07291) and Career Development (1K23MH086338-01A2) Grants. PEPFAR funded provision of drugs and HIV care to study participants. Authors thank the patients and staff of the Rakai Health Sciences Program for their dedication, support, and compassion.