Comparative Analysis: Cost of Two Community ART Delivery Models In the Urban Settings In Zambia

Keywords: RBF;, standard of care;, door to door and adherence clubs;, ART;


In the quest to improve and address the bottle necks of ART services to the affected population, Zambia has implemented three models of delivering this service which are; Standard of Care, Door to Door and Adherence Clubs. The aim of this study was to identify and cost the provision of ART services using the three models. A quantitative retrospective cross-sectional study was done to compare the cost of delivering two models, adherence clubs and door to door in relation to the standard facility-based model. The 2018 costing data for ART was collected retrospectively in the Kanyama and Chipata Health Urban Centers in Lusaka, Zambia. A checklist and a data costing tool was developed to help identify and cost all the costs items attached to the provision of ART services in the two Health Centers. The study shows that the total cost of delivering ART services to 11,225 patients at Chipata Health center was 53,087,649.54 ZMW ($ 4,994,134.48) translating into 21,802.49 ($2,051.03) per patient. Furthermore, providing the same services at Kanyama to 12,293 clients costed 35,823,354.87 ZMW ($ 3,370,023.98) and cost per patient was 24989.65 ZMW ($2,350.86).The study concluded that it was more expensive to deliver ART through health facility model than community-based models. The major costs of ART services using three models of care were ARV drugs followed capital and personnel costs. In order to reduce barriers and costs ART services must be brought close to people as much as possible.