slide1
Download
Skip this Video
Download Presentation
Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington

Loading in 2 Seconds...

play fullscreen
1 / 14

Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington - PowerPoint PPT Presentation


  • 69 Views
  • Uploaded on

Thinking Ahead: Voluntary Medical Male Circumcision Roll-Out With Non Surgical Devices: costing, global access, logistic, and training considerations. Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington' - ricky


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Thinking Ahead: Voluntary Medical Male Circumcision Roll-Out With Non Surgical Devices: costing, global access, logistic, and training considerations

Emmanuel Njeuhmeli, MD, MPH, MBA

Senior Biomedical Prevention Advisor, USAID Washington

Co-Chair PEPFAR Male Circumcision Technical Working group

voluntary medical male circumcision
Voluntary Medical Male Circumcision…
  • Effective, safe, feasible and affordable HIV prevention intervention for countries with high HIV prevalence, low MC prevalence
  • Will generate substantial cost savings in the next 5 years if roll-out reaches maximum coverage possible
    • “every dollars spend on AIDS is an investment, not an expenditure” Michel Sidibe, Executive Director UNAIDS
strategy for achieving pace and scale
Strategy for Achieving Pace and Scale
  • Political will and country ownership
  • Strong leadership and coordination from MOH
  • Effective communication strategy with strong community level buy-in
  • Enough financial resources for service delivery including some level of dedication of staff time, facilities space and commodities
    • Donor commitment
  • Excellent technical support from partners to allow a good match of demand and supply for efficient use of limited resources available to reach maximum number of men
  • Flexibility to adopt innovations as they become available --- non surgical devices
costing study research q uestions
Costing Study Research Questions
  • Unit costs of
    • surgery-only (forceps-guided, reusable kits)
    • mixed (forceps-guided surgery and PrePex)
  • Cost drivers
  • Cost impact
    • % site capacity used
    • ratio of surgery vs. device-based circumcisions at mixed site
    • range of device prices
  • Next step: additional scenario w/ Shang Ring
cost categories
Cost Categories
  • Staff
  • Training
  • Consumables
  • Device
  • Durable equipment
  • Supply chain management
  • Waste management
caveats
Caveats
  • Not possible to obtain actual costs for device under scale-up situation; costs were obtained from pilot field study
  • If data were available the modeling exercise would not be needed

Assumptions;

  • Indirect costs not included for all scenarios
  • Many costs will be higher if circumcisions are conducted in dedicated facilities rather than integrated into public facilities
  • Analysis did not look at effects of task shifting for the surgery
  • Analysis did not look at greater number of circumcisions/day with device
  • Acceptability of device unknown
  • Costs of demand creation unknown and may contribute significantly to costs
conclusions
Conclusions
  • There is not significant cost differences per procedure for surgery only programs as compared to programs that used both surgery and Prepex device
  • The most important driver of costs is demand, as underutilization of sites leads to significant unit costs
  • Other cost drivers are supply chain management, commodities including device costs and staffing
  • Acceptability of devices as estimated by % of procedures performed using devices was not a significant driver of cost
acknowledgements
Acknowledgements
  • Co-investigators of the Modeling
    • Dr Katharine Kripke, HPI/Futures Institute
    • Dr Emmanuel Njeuhmeli, USAID
    • Dr. Dianna Edgil, USAID
    • Dr. Steven Forsythe, HPI/Futures Institute
    • Dr Delivette Castor, USAID
    • Juan Jaramillo, SCMS
  • Dr Jason Reed, OGAC
  • Dr Anne Thomas, DoD
  • Dr Renee Ridzon, Consultant BMGF
  • Tim Farley, Sigma 3 Services
  • Dr Dino Rech, CHAPS
  • Robert Bailey, University of Illinois
  • Walter Obiero, NRHS Kenya
  • Dr. Karin Hatzold, PSI
  • PSI, Jhpiego, FHI, SCMS, CHAPS
  • PrepPex study team Zimbabwe:
    • Prof. MufutaTshimanga, University of Zimbabwe
    • Dr. TonderaiMangwiro, University of Zimbabwe
    • Dr. Owen Mugurungi, Zimbabwe MOHCW
    • Sinokuthemba Xaba, Zimbabwe MOHCW
    • PessanaiChikobo, ZICHIRE
ad