The cost of a rapid-test VCT clinic in South Africa : original article

• Published in: South African medical journal Vol. 95; no. 12; pp. 968 - 971
• Main Authors: Abdulla, Fathima, Du Plessis, Jo-Ann, Marseille, Elliot, Pitter, Christian S., Kahn, James G., McConnel, Coline E., Stanley, Nicci, Coovadia, Hoosen M.
• Format: Journal Article
• Language: English
• Published: Health and Medical Publishing Group (HMPG) 01-12-2005
• Subjects: Cost per client; Non-research-based programme; Rapid-test technology; South Africa; Voluntary counseling and testing
• ISSN: 0256-9574; 2078-5135

Context. Demand for HIV voluntary counselling and testing (VCT) will increase as HIV prevention and treatment scale up in South Africa. Understanding the cost of delivering VCT will inform funding decisions. Objective. To determine the cost per client completing VCT (pretest counselling, testing and post-test counselling) in a nonresearch- based programme using rapid-test technology. Design. One year of expenditure and output data were collected retrospectively as part of the PANCEA (Prevent AIDS: Network for Cost-Effectiveness Analysis) study. Market prices were determined for donated resources. Setting. An urban, church-based, non-profit organisation that offers rapid-test VCT services in KwaZulu-Natal, South Africa. Results. Financial expenditure for the 2002/2003 fiscal year was $39 761 (calculated using an average conversion rate for July 2003, which was 0.133). Using market prices for donated resources, the economic cost for the year was estimated at $67 248. Six hundred and sixty-two clients completed VCT, resulting in financial expenditure of $60.06 per client and an economic cost of $101.58 per client. Financial expenditures and economic costs per client decreased over the year by 66% because expenses remained stable as more clients were served. Conclusions. The cost of providing VCT services was higher than previously reported, but declined with expanding scale.