Operational and Economic Evaluation of an NGO-led Sexually Transmitted Infections Intervention: North-Western Cambodia

Hdl Handle:
http://hdl.handle.net/10144/17722
Title:
Operational and Economic Evaluation of an NGO-led Sexually Transmitted Infections Intervention: North-Western Cambodia
Authors:
Carrara, V; Terris-Prestholt, F; Kumaranayake, L; Mayaud, P
Journal:
Bulletin of the World Health Organization
Abstract:
OBJECTIVE: Sexually transmitted infection (STI) services were offered by the nongovernmental organization Médecins Sans Frontières-Holland in Banteay Meanchey province, Cambodia, between 1997 and 1999. These services targeted female sex workers but were available to the general population. We conducted an evaluation of the operational performance and costs of this real-life project. METHODS: Effectiveness outcomes (syndromic cure rates of STIs) were obtained by retrospectively analysing patients' records. Annual financial and economic costs were estimated from the provider's perspective. Unit costs for the cost-effectiveness analysis included the cost per visit, per partner treated, and per syndrome treated and cured. FINDINGS: Over 30 months, 11,330 patients attended the clinics; of these, 7776 (69%) were STI index patients and only 1012 (13%) were female sex workers. A total of 15 269 disease episodes and 30 488 visits were recorded. Syndromic cure rates ranged from 39% among female sex workers with genital ulcers to 74% among men with genital discharge; there were variations over time. Combined rates of syndromes classified as cured or improved were around 84-95% for all syndromes. The total economic costs of the project were US 766,046 dollars. The average cost per visit over 30 months was US 25.12 dollars and the cost per partner treated for an STI was US 50.79 dollars. The average cost per STI syndrome treated was US 48.43 dollars, of which US 4.92 dollars was for drug treatment. The costs per syndrome cured or improved ranged from US 46.95-153.00 dollars for men with genital ulcers to US 57.85-251.98 dollars for female sex workers with genital discharge. CONCLUSION: This programme was only partly successful in reaching its intended target population of sex workers and their male partners. Decreasing cure rates among sex workers led to relatively poor cost-effectiveness outcomes overall despite decreasing unit costs.
Affiliation:
Banteay Meanchey Projects, Cambodia/Médecins Sans Frontières, Amsterdam, The Netherlands.
Publisher:
Published by WHO
Issue Date:
Jun-2005
URI:
http://hdl.handle.net/10144/17722
DOI:
/S0042-96862005000600011
PubMed ID:
15976894
Additional Links:
http://www.who.int/bulletin/en
Language:
en
ISSN:
0042-9686
Appears in Collections:
STDs

Full metadata record

DC FieldValue Language
dc.contributor.authorCarrara, V-
dc.contributor.authorTerris-Prestholt, F-
dc.contributor.authorKumaranayake, L-
dc.contributor.authorMayaud, P-
dc.date.accessioned2008-02-07T16:26:26Z-
dc.date.available2008-02-07T16:26:26Z-
dc.date.issued2005-06-
dc.identifier.citationOperational and Economic Evaluation of an NGO-led Sexually Transmitted Infections Intervention: North-Western Cambodia. 2005, 83 (6):434-42 Bull. World Health Organ.en
dc.identifier.issn0042-9686-
dc.identifier.pmid15976894-
dc.identifier.doi/S0042-96862005000600011-
dc.identifier.urihttp://hdl.handle.net/10144/17722-
dc.description.abstractOBJECTIVE: Sexually transmitted infection (STI) services were offered by the nongovernmental organization Médecins Sans Frontières-Holland in Banteay Meanchey province, Cambodia, between 1997 and 1999. These services targeted female sex workers but were available to the general population. We conducted an evaluation of the operational performance and costs of this real-life project. METHODS: Effectiveness outcomes (syndromic cure rates of STIs) were obtained by retrospectively analysing patients' records. Annual financial and economic costs were estimated from the provider's perspective. Unit costs for the cost-effectiveness analysis included the cost per visit, per partner treated, and per syndrome treated and cured. FINDINGS: Over 30 months, 11,330 patients attended the clinics; of these, 7776 (69%) were STI index patients and only 1012 (13%) were female sex workers. A total of 15 269 disease episodes and 30 488 visits were recorded. Syndromic cure rates ranged from 39% among female sex workers with genital ulcers to 74% among men with genital discharge; there were variations over time. Combined rates of syndromes classified as cured or improved were around 84-95% for all syndromes. The total economic costs of the project were US 766,046 dollars. The average cost per visit over 30 months was US 25.12 dollars and the cost per partner treated for an STI was US 50.79 dollars. The average cost per STI syndrome treated was US 48.43 dollars, of which US 4.92 dollars was for drug treatment. The costs per syndrome cured or improved ranged from US 46.95-153.00 dollars for men with genital ulcers to US 57.85-251.98 dollars for female sex workers with genital discharge. CONCLUSION: This programme was only partly successful in reaching its intended target population of sex workers and their male partners. Decreasing cure rates among sex workers led to relatively poor cost-effectiveness outcomes overall despite decreasing unit costs.en
dc.language.isoenen
dc.publisherPublished by WHO-
dc.relation.urlhttp://www.who.int/bulletin/en-
dc.rightsArchived on this site with permission of WHOen
dc.subject.meshCambodiaen
dc.subject.meshCommunity Health Centersen
dc.subject.meshCooperative Behavioren
dc.subject.meshCost-Benefit Analysisen
dc.subject.meshFemaleen
dc.subject.meshHealth Care Costsen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshModels, Organizationalen
dc.subject.meshOutcome and Process Assessment (Health Care)en
dc.subject.meshProgram Evaluationen
dc.subject.meshProstitutionen
dc.subject.meshRetrospective Studiesen
dc.subject.meshSexually Transmitted Diseasesen
dc.subject.meshSyndromeen
dc.subject.meshVoluntary Health Agenciesen
dc.titleOperational and Economic Evaluation of an NGO-led Sexually Transmitted Infections Intervention: North-Western Cambodiaen
dc.contributor.departmentBanteay Meanchey Projects, Cambodia/Médecins Sans Frontières, Amsterdam, The Netherlands.en
dc.identifier.journalBulletin of the World Health Organizationen

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