Cost of Community Integrated Prevention Campaign for Malaria, HIV, and Diarrhea in Rural Kenya

BACKGROUND: Delivery of community-based prevention services for HIV, malaria, and diarrhea is a major priority and challenge in rural Africa. Integrated delivery campaigns may offer a mechanism to achieve high coverage and efficiency. METHODS: We quantified the resources and costs to implement a large-scale integrated prevention campaign in Lurambi Division, Western Province, Kenya that reached 47,133 individuals (and 83% of eligible adults) in 7 days. The campaign provided HIV testing, condoms, and prevention education materials; a long-lasting insecticide-treated bed net; and a water filter. Data were obtained primarily from logistical and expenditure data maintained by implementing partners. We estimated the projected cost of a Scaled-Up Replication (SUR), assuming reliance on local managers, potential efficiencies of scale, and other adjustments. RESULTS: The cost per person served was $41.66 for the initial campaign and was projected at$31.98 for the SUR. The SUR cost included 67% for commodities (mainly water filters and bed nets) and 20% for personnel. The SUR projected unit cost per person served, by disease, was $6.27 for malaria (nets and training),$15.80 for diarrhea (filters and training), and $9.91 for HIV (test kits, counseling, condoms, and CD4 testing at each site). CONCLUSIONS: A large-scale, rapidly implemented, integrated health campaign provided services to 80% of a rural Kenyan population with relatively low cost. Scaling up this design may provide similar services to larger populations at lower cost per person

A Qualitative Assessment of Participation in a Rapid Scale-Up, Diagonally-Integrated MDG-Related Disease Prevention Campaign in Rural Kenya

Background: Many countries face severe scale-up barriers toward achievement of MDGs. We ascertained motivational and experiential dimensions of participation in a novel, rapid, ‘‘diagonal’ ’ Integrated Prevention Campaign (IPC) in rural Kenya that provided prevention goods and services to 47,000 people within one week, aimed at rapidly moving the region toward MDG achievement. Specifically, the IPC provided interventions and commodities targeting disease burden reduction in HIV/ AIDS, malaria, and water-borne illness. Methods: Qualitative in-depth interviews (IDI) were conducted with 34 people (18 living with HIV/AIDS and 16 not HIVinfected) randomly selected from IPC attendees consenting to participate. Interviews were examined for themes and patterns to elucidate participant experience and motivation with IPC. Findings: Participants report being primarily motivated to attend IPC to learn of their HIV status (through voluntary counseling and testing), and with receipt of prevention commodities (bednets, water filters, and condoms) providing further incentive. Participants reported that they were satisfied with the IPC experience and offered suggestions to improve future campaigns. Interpretation: Learning their HIV status motivated participants along with the incentive of a wider set of commodities that were rapidly deployed through IPC in this challenging region. The critical role of wanting to know their HIV status combine

Emerging thematic areas from breast and cervical cancer reviews in low- and middle-income countries (LMICs).

<p><b>Note</b>: “Reviewed” indicates that the publication reviewed studies that pertained to this theme. “Recommended” indicates that the publication presented recommendations on the given subject.</p><p>^a Include reviews that assess technical or behavioral interventions</p><p>^b Includes reviews that discuss policy, regulation, financing, public education, needs, constraints, barriers, and partnerships.</p><p>^c Includes reviews that discuss considerations of organizational improvement would have commented on topics such as implementation, quality improvement, quality assurance, performance management, guidelines, and systems strengthening.</p><p>^d Includes reviews that discuss training, continuing education, and peer learning.</p><p>^e includes reviews that discuss considerations of community empowerment, participation, information and education, social marketing, community-managed services, public health approaches, and community mobilization</p><p>Emerging thematic areas from breast and cervical cancer reviews in low- and middle-income countries (LMICs).</p

PRISMA flow diagram for review of manuscripts.

<p>PRISMA flow diagram for review of manuscripts.</p

Reviews of cervical cancer in low- and middle-income countries (LMICs).

<p>^a P = prevention, De = detection, Di = Diagnosis, T = Treatment, S = survivorship, All = all aspects</p><p>Reviews of cervical cancer in low- and middle-income countries (LMICs).</p

Descriptive summary of breast and cervical cancer reviews in low- and middle-income countries (LMICs).

<p>Descriptive summary of breast and cervical cancer reviews in low- and middle-income countries (LMICs).</p

Reviews of breast cancer in low- and middle-income countries (LMICs).

<p>^a P = prevention, De = detection, Di = Diagnosis, T = Treatment, S = survivorship, All = all aspects</p><p>Reviews of breast cancer in low- and middle-income countries (LMICs).</p