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13th International AIDS ConferenceDurban, South Africa - July 9-July 14, 2000 |
Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrC310)
Mutemi R, Forsythe S, Arthur G
R. Mutemi, National AIDS and STD Control Programme, PO Box 19361, Nairobi, Kenya, E-mail: steveforsythe@yahoo.com
BACKGROUND: Voluntary counselling and testing (VCT) has been shown to be effective in limiting the transmission of HIV. In Kenya's most recent DHS, 63% of adults indicated a willingness to be tested for HIV. However, VCT is available in only a limited number of locations. Therefore this economic analysis was performed to assess the financial feasibility of scaling-up VCT to health centres throughout Kenya.
METHODS: To develop estimates of the financial requirements necessary for scaling-up VCT to a national level, the costs of VCT at 2 rural and 1 urban health centre where VCT has recently been introduced were used. Data from these health centres was used to estimate costs for providing VCT throughout Kenya.
RESULTS: The annual recurrent cost of maintaining VCT in Kenya is approximately US$6,600 per health centre. In order to provide VCT in all 579 health centres throughout Kenya, it would cost approximately US$3.8 million per year. (This cost excludes the cost of training and other start-up costs.) Of this amount, approximately US$3.3 million would be incurred for the salaries of full-time counsellors and US$0.5 million would be incurred for materials (including rapid test kits). This total recurrent cost of VCT would consume approximately 2 percent of Kenya's health budget.
CONCLUSIONS: Scaling-up VCT so as to provide services throughout Kenya's 579 health centres appears to be a feasible option, although Kenya may need to consider a combination of financing options. These options include cost sharing, government subsidies and donor support. In order to assure the effectiveness of any intervention to scale-up VCT services in Kenya and to overcome Kenya's shortage of qualified HIV/AIDS counsellors, it is likely that additional external finances will still be required from international donors, particularly in providing initial training and retraining of HIV/AIDS cousellors.
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