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Open Access Research article

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

James G Kahn12*, Brian Harris2, Jonathan H Mermin3, Thomas Clasen4, Eric Lugada5, Mark Grabowksy6, Mikkel Vestergaard Frandsen7 and Navneet Garg8

Author Affiliations

1 Super Models for Global Health, Oakland, California, USA

2 Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, San Francisco, California, 94118, USA

3 Coordinating Office for Global Health, Centers for Disease Control and Prevention (CDC)-Kenya, KEMRI Complex, Mbagathi Road off Mbagathi Way, Nairobi, PO Box 606-00621, Kenya

4 Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

5 CHF International, P. O. Box 1661 - 00606, Nairobi, Kenya

6 UN Foundation, 1800 Massachusetts Avenue NW, Suite 400, Washington, DC, 20036, USA

7 Vestergaard Frandsen SA., Chemin de Messidor 5 - 7, CH - 1006, Lausanne, Switzerland

8 Vestergaard Asia PVT Ltd., 302 Rectangle One, Saket, New Delhi, 110 017, India

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BMC Health Services Research 2011, 11:346  doi:10.1186/1472-6963-11-346

Published: 21 December 2011

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.

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.