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This is an open access article distributed under the terms of the Creative Commons Attribution License http: This article has been cited by other articles in PMC. Abstract 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. 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 SURassuming reliance on local managers, potential efficiencies of scale, and other adjustments.
Scaling up this design may provide similar services to larger populations at lower cost per person. Simple interventions such as the provision of safe drinking water, bed nets, and HIV voluntary counseling and testing, offer the prospect of substantial reductions in disease incidence, morbidity, and mortality[ 2 - 4 ].
The World Health Organization and national governments, including the Government of Kenya, have endorsed principles of universal access to these interventions. Wide access will advance progress toward health targets in the millennium development goals[ 5 ]. However, achieving high access is challenging, and has thus far been elusive.
Use of "improved" water i. Efforts so far have focused mainly on providing ongoing services at health facilities e.
However, delivering multiple interventions in a single program is increasingly seen as effective and efficient for children; for example, mass immunization campaigns are serving as a platform for providing other child services such as bed nets, deworming medicine and vitamin A[ 910 ].
However, no comparable strategy exists for adults.
The potential to quickly reach high coverage for multiple prevention interventions - HIV testing, condoms, and counseling; bed nets; and water filters - was recently demonstrated in a community integrated prevention campaign in Western Province, Kenya, implemented by our group[ 11 ].
This campaign was designed to address HIV, malaria, and diarrheal disease, to overcome possible resistance to VCT by offering material goods nets and filters that offer an additional health incentive for participation, and reduce potential stigma associated with HIV testing.
The campaign was based in village centers, where it distributed and instructed on use of bed nets and filters, and offered opt-out VCT.
Our goals for the present analysis were to a document the resources and costs expended by the initial community integrated prevention campaign, and b project the cost of scaled-up replication. The latter is based on our observations on operation of the initial campaign and likely efficiencies with routine and larger scale operation, and is supported by data from subsequent community integrated prevention campaign efforts.
Recruitment was accomplished with community mobilization. Activities were conducted simultaneously at 30 village sites, administered as five zones. The campaign used both existing facilities e.
It provided each participant with HIV VCT; a 'CarePack' containing a long-lasting insecticide treated bed net, a LifeStraw brand water filter, 60 condoms, and educational materials; health education sessions with lecture and demonstrations; and a starter pack of cotrimoxazole trimethoprim-sulfamethoxazole prophylaxis for individuals who tested HIV positive.
VF is a privately-owned manufacturer of health products, including the bed nets and filters distributed during the campaign. We first determined the cost of the IPC as implemented in the initial demonstration. We employed micro-costing methods, quantifying all provider program costs excluding participant transportation and time costsand adopting an "economic" perspective assigning a fair market value to all resources, whether purchased or donated.
We quantified resources and unit costs from planning, logistical, and expenditure reports from VF, CHF, and EXP, clarified by discussions with campaign managers and observation of implementation.McCarthy is a national construction company known for operational excellence and maximizing client outcomes with lasting results and superior value.
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