John H Bratt1, Zude Zyambo. 1. FHI 360, Research Triangle Park, NC 27709, USA. jbratt@fhi360.org
Abstract
BACKGROUND:Rapid scale-up of voluntary medical male circumcision (VMMC) is needed to realize potential reductions in HIV incidence in sub-Saharan Africa. New disposable VMMC devices such as the Shang Ring may offer several advantages over standard surgery, including lower costs. METHODS: We compared direct costs of the Shang Ring and dorsal slit techniques for delivery of VMMC in the context of a randomized-controlled trial carried out in Zambia in 2011. Information on direct costs of clinician time, disposable supplies, and reusable medical instruments were collected by study staff. RESULTS: During the trial, the direct cost of 1 VMMC procedure using the Shang Ring device was US $18.21, whereas the direct cost of using dorsal slit was US $17.67. Higher costs of clinician time related to dorsal slit VMMC were offset by higher costs of disposable supplies with the Shang Ring approach. DISCUSSION: Although direct costs were roughly equivalent during this small-scale trial, with the increased demand from scaling up VMMC, a Shang Ring team could provide services at a substantially lower average total cost due to the potential for more intensive use of staff and other fixed resources.
RCT Entities:
BACKGROUND: Rapid scale-up of voluntary medical male circumcision (VMMC) is needed to realize potential reductions in HIV incidence in sub-Saharan Africa. New disposable VMMC devices such as the Shang Ring may offer several advantages over standard surgery, including lower costs. METHODS: We compared direct costs of the Shang Ring and dorsal slit techniques for delivery of VMMC in the context of a randomized-controlled trial carried out in Zambia in 2011. Information on direct costs of clinician time, disposable supplies, and reusable medical instruments were collected by study staff. RESULTS: During the trial, the direct cost of 1 VMMC procedure using the Shang Ring device was US $18.21, whereas the direct cost of using dorsal slit was US $17.67. Higher costs of clinician time related to dorsal slit VMMC were offset by higher costs of disposable supplies with the Shang Ring approach. DISCUSSION: Although direct costs were roughly equivalent during this small-scale trial, with the increased demand from scaling up VMMC, a Shang Ring team could provide services at a substantially lower average total cost due to the potential for more intensive use of staff and other fixed resources.
Authors: Richard Lee; E Charles Osterberg; Philip S Li; Marc Goldstein; Mark Barone; Stephanie L Combes; David Sokal; Ron Gray; Godfrey Kigozi; Stephen Watya Journal: J Acquir Immune Defic Syndr Date: 2013-10-01 Impact factor: 3.731
Authors: Han-Zhu Qian; Yuhua Ruan; Yu Liu; Douglas F Milam; Hans M L Spiegel; Lu Yin; Dongliang Li; Bryan E Shepherd; Yiming Shao; Sten H Vermund Journal: J Acquir Immune Defic Syndr Date: 2016-04-01 Impact factor: 3.731