Program spending to increase adherence: South African cervical cancer screening

 

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dc.contributor.author Goldhaber-Fiebert, Jeremy D en_ZA
dc.contributor.author Denny, Lynette A en_ZA
dc.contributor.author De Souza, Michelle en_ZA
dc.contributor.author Kuhn, Louise en_ZA
dc.contributor.author Goldie, Sue J en_ZA
dc.date.accessioned 2016-01-11T06:53:14Z
dc.date.available 2016-01-11T06:53:14Z
dc.date.issued 2009 en_ZA
dc.identifier.citation Goldhaber-Fiebert, J. D., Denny, L. A., De Souza, M., Kuhn, L., & Goldie, S. J. (2009). Program spending to increase adherence: South African cervical cancer screening. PloS one, 4(5), e5691. doi:10.1371/journal.pone.0005691 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16266
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0005691
dc.description.abstract Background: Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW) home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa. M ethodology/Principal Findings: We conducted an observational study of 5,258 CHW home visits made in 2003-4 as part of a community-based screening program. We estimated the functional relationship between spending on these visits and increased appointment attendance (adherence). Increased adherence was noted after each subsequent CHW visit. The costs of making the CHW visits was based on resource use including both personnel time and vehicle-related expenses valued in 2004 Rand. The CHW program cost R194,018, with 1,576 additional appointments attended. Adherence increased from 74% to 90%; 55% to 87%; 48% to 77%; and 56% to 80% for 6-, 12-, 24-, and 36-month appointments. Average per-woman costs increased by R14-R47. The majority of this increase occurred with the first 2 CHW visits (90%, 83%, 74%, and 77%; additional cost: R12-R26). Conclusions/Significance: We found that study data can be used for program planning, identifying spending levels that achieve adherence targets given budgetary constraints. The results, derived from a single disease program, are retrospective, and should be prospectively replicated. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Cervical cancer en_ZA
dc.subject.other Cancer screening en_ZA
dc.subject.other Health screening en_ZA
dc.subject.other South Africa en_ZA
dc.subject.other Cell phones en_ZA
dc.subject.other Fuels en_ZA
dc.subject.other Screening guidelines en_ZA
dc.subject.other Public and occupational health en_ZA
dc.title Program spending to increase adherence: South African cervical cancer screening en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2009 Goldhaber-Fiebert et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Institute of Infectious Disease and Molecular Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.