Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services
Background:
The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President’s Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs.
Methods and Findings:
This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections.
The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services.
Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland.
Conclusions:
Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in “Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa.” Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs.
: Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services. PLoS Med 8(11): e32767. doi:10.1371/journal.pmed.1001128
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1001128
Souhrn
Background:
The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President’s Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs.
Methods and Findings:
This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections.
The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services.
Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland.
Conclusions:
Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in “Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa.” Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs.
: Please see later in the article for the Editors' Summary
Zdroje
1. AuvertBTaljaardDLagardeESobngwi-TambekouJSittaR 2005 Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 Trial. PLoS Med 2 e298 doi:10.1371/journal.pmed.0020298
2. BaileyRCMosesSParkerCBAgotKMacleanI 2007 Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. Lancet 369 643 656
3. GrayRKigoziGSerwaddaDMakumbiFWatyaS 2007 Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 369 657 666
4. NjeuhmeliEForsytheSReedJOpuniMBollingerL 2011 Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa. PLoS Med 8 e1001132 doi:10.1371/journal.pmed.1001132
5. CurranKNjeuhmeliEMirelmanADicksonKAdamuT 2011 Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa. PLoS Med 8 e1001129 doi:10.1371/journal.pmed.1001129
6. World Health Organization, Joint United Nations Programme on HIV/AIDS 2007 New data on male circumcision and HIV prevention: policy and programme implications. Geneva World Health Organization
7. United States Agency for International Development Health Policy Initiative, Namibia Ministry of Health and Social Services 2011 Costing of voluntary medical male circumcision services and the impacts of accelerated scale-up in Namibia. Washington (District of Columbia) United States Agency for International Development Health Policy Initiative
8. United States Agency for International Development Health Policy Initiative, Joint United Nations Programme on HIV/AIDS, Kenya Ministry of Public Health and Sanitation 2011 Estimating the costs and impacts of expanding voluntary medical male circumcision services in Kenya. Washington (District of Columbia) United States Agency for International Development Health Policy Initiative
9. United States Agency for International Development Health Policy Initiative, Joint United Nations Programme on HIV/AIDS, South Africa National Department of Health 2011 Costing of voluntary medical male circumcision service and impacts of accelerated scale-up in South Africa. Washington (District of Columbia) United States Agency for International Development Health Policy Initiative
10. United States Agency for International Development Health Policy Initiative, Joint United Nations Programme on HIV/AIDS, Ugandan Department of Epidemiology and Biostatistic at Makere University, Ugandan Ministry of Health 2011 Assessing the potential impact, costs of scaling-up voluntary medical male circumcision services in Uganda. Washington (District of Columbia) United States Agency for International Development Health Policy Initiative
11. United States Agency for International Development Health Policy Initiative, Joint United Nations Programme on HIV/AIDS, Zambian Ministry of Health 2011 Costing of voluntary medical male circumcision services and the impact of accelerated scale-up in Zambia. Washington (District of Columbia) United States Agency for International Development Health Policy Initiative
12. United States Agency for International Development Health Policy Initiative, Joint United Nations Programme on HIV/AIDS, Zimbabwe Ministry of Health and Child Welfare 2011 Costing of voluntary medical male circumcision and the impact of accelerated scale-up in Zimbabwe. Washington (District of Columbia) United States Agency for International Development Health Policy Initiative
13. The United States President’s Emergency Plan for AIDS Relief 2009 PEPFAR Male Circumcision Partners’ Meeting: commodities and improved coordination of male circumcision for HIV prevention. Washington (District of Columbia) The United States President’s Emergency Plan for AIDS Relief
14. World Health Organization 2010 Considerations for implementing models for optimizing the volume and efficiency of male circumcision services. Geneva World Health Organization
15. Swaziland Male Circumcision Task Force, Government of the Kingdom of Swaziland 2010 Male circumcision for HIV prevention accelerated saturation initiative action plan for Swaziland. Mbabane Swaziland Male Circumcision Task Force
16. Partnership for Supply Chain Management 2010 Male circumcision waste management plan. Arlington (Virginia) Partnership for Supply Chain Management
17. Joint United Nations Programme on HIV/AIDS 2010 UNAIDS report on the global AIDS epidemic. Geneva Joint United Nations Programme on HIV/AIDS
18. United Nations Educational, Scientific and Cultural Organization 2009 Africa review report on waste management. Paris United Nations Educational, Scientific and Cultural Organization
19. World Health Organization, Joint United Nations Programme on HIV/AIDS, Jhpiego 2008 Manual for male circumcision under local anaesthesia. Geneva World Health Organization
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