Cost and Outcome Comparisons of Safe Male Circumcision Service Delivery Models in Rural Uganda

Project Description

Male circumcision reduces HIV incidence in men by 50-60%. The United Nations Joint Programme on HIV/AIDS (UNAIDS) recommends the provision of safe male circumcision (SMC) services in countries with high HIV and low circumcision prevalence, and the Uganda Ministry of Health (MoH) has formally endorsed SMC as an HIV prevention strategy. However, the circumcision rate in Uganda (25%) remains one of the lowest in sub-Saharan Africa. Roll out of a surgical intervention to remote, impoverished HIV-affected populations faces major challenges, including how best to deliver SMC services to populations which are difficult to reach in order to safely and efficiently maximize coverage to those most at risk.

This evaluation by CGHD in partnership with Makerere University Walter Reed Project is a comparison of clinical outcomes of SMC and the costs of SMC service provision utilizing two different models of surgical delivery, using existing program data.  The two models of service delivery are: (1) at a fixed public health facility with dedicated SMC staff; and (2) a mobile surgical van with dedicated SMC staff.  For each model of service delivery, the study’s primary aims are to estimate the proportion of procedures with no adverse event and the average financial cost per patient from the provider’s perspective.  This information will inform policy makers, program managers, and funders about variation in the costs of delivery SMC in Uganda under different models of service delivery and will analyze main drivers of those costs.

Project Details

Principal Investigator Bruce Larson
Boston University Co-Investigators N/A
Collaborators Makerere University Walter Reed Project (MUWRP)
Country Uganda
Dates of Research 2011-2013
Donor/Funder Henry Jackson Foundation