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What Determines HIV Prevention Costs at Scale? Evidence from the Avahan Programme in India

Lepine, A; Chandrashekar, S; Shetty, G; Vickerman, P; Bradley, J; Alary, M; Moses, S; (2016) What Determines HIV Prevention Costs at Scale? Evidence from the Avahan Programme in India. Health Economics , 25 (S1) , Article Supplement: Economic evaluations in low‐and middle‐income countries: Methodological issues and challenges for priority‐setting. 10.1002/hec.3296. Green open access

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Abstract

Expanding essential health services through non‐government organisations (NGOs) is a central strategy for achieving universal health coverage in many low‐income and middle‐income countries. Human immunodeficiency virus (HIV) prevention services for key populations are commonly delivered through NGOs and have been demonstrated to be cost‐effective and of substantial global public health importance. However, funding for HIV prevention remains scarce, and there are growing calls internationally to improve the efficiency of HIV prevention programmes as a key strategy to reach global HIV targets. To date, there is limited evidence on the determinants of costs of HIV prevention delivered through NGOs; and thus, policymakers have little guidance in how best to design programmes that are both effective and efficient. We collected economic costs from the Indian Avahan initiative, the largest HIV prevention project conducted globally, during the first 4 years of its implementation. We use a fixed‐effect panel estimator and a random‐intercept model to investigate the determinants of average cost. We find that programme design choices such as NGO scale, the extent of community involvement, the way in which support is offered to NGOs and how clinical services are organised substantially impact average cost in a grant‐based payment setting. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Type: Article
Title: What Determines HIV Prevention Costs at Scale? Evidence from the Avahan Programme in India
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/hec.3296
Publisher version: https://doi.org/10.1002/hec.3296
Language: English
Additional information: © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The copyright line for this article was changed on 21 January 2016 after original online publication.
Keywords: HIV prevention; average cost; scale-up; Avahan; NGO; India
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10070170
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