COST EFFECTIVENESS ON HIV TESTING AND COUNSELLING SERVICE DELIVERY STRATEGIES IN NAMIBIA

*Haoses-Gorases L., Goraseb M. and I. Pietersen

ABSTRACT

HIV Testing and Counselling (HTC) remains an important entry point to HIV prevention, treatment, care and support services. Despite the expansion of HTC service delivery strategies over the years no systematic cost and effectiveness analysis has been conducted in Namibia to inform the efficient use of the available limited resources. The study aimed to determining the costs and effectiveness of delivering different HCT service delivery strategies in Namibia to inform program implementation and efficient resource utilization. The study design was quantitative retrospective as well as descriptive. The results have shown that 72% of the HIV tests reported to the Ministry of Health and Social Services were conducted at Public Health Facilities (PHF). The highest HIV positivity rate of 21% was identified at work places, followed by PHF with 9%, and 5% for National Testing Day (NTD). The cost analysis show that the main cost drivers for Standalones and workplaces are salaries and fringe benefits for staff with 52% and 58% respectively. Whereas for Public Health facilities and National Testing days cost drivers are recurrent goods expenditures with 41% and 74% respectively. Public Health facilities present the best strategy to reach more clientele and were effective in identifying HIV infected people at a lower cost however there is a need to complement or strengthen this strategy with other service delivery strategies whose efficiency needs to be strengthened.

Keywords: Cost effectiveness, HIV testing, Counseling, Service Delivery Strategies.