Marseille 2007
Marseille 2007
Abstract book
Go Back

Abstract #518  -  Conducting Socio-economic Analysis through Cohort Follow-up : Integrated TB/VIH Care in DRC and Benin
Session:
  26.8: Posters B (Poster) on Tuesday   in  Chaired by
Authors:
  Presenting Author:   Ms Odile Ferroussier - International Union Against TB and Lung Disease, France
 
  Additional Authors:   
Aim:
The goal of the socio-economic research component of the Integrated HIV care for tuberculosis patients living with HIV/AIDS (IHC) initiative implemented by The International Union Against TB and Lung Disease is to assess the cost of integrating TB and HIV diagnostic and care from the perspective of the patients and health facilities. Is integrated TB/HIV management reaching individuals who are particularly vulnerable or generally have very limited access to care? Can this strategy also decrease patients indirect costs and provide proximity services that better meet their needs (and constraints)? How is the integrated approach affecting the work of the staff responsible for TB diagnostic and treatment? What impact does it have on other programs and on the operations of the health facility as a whole?
 
Method / Issue:
The IHC project will follow cohorts of patients for nearly two years, providing a rare opportunity to measure the evolution of costs over time. A prospective survey was designed to track the same patients every three months after enrollment in the quarterly TB/HIV cohort. The project started in 2005 and the number of patients enrolled will be sufficient to start the study in February 2007. The survey will end in December 2008. The study will be implemented in Benin and in two regions in the Democratic Republic of Congo (Nord Kivu and Bas Congo). At each of the three sites, 4 to 6 health facilities implementing IHC were selected. A minimum of 180 new patients will be administered a survey questionnaire every three months. Patients will be asked about their socioeconomic status, direct costs (for medications, visits to providers of all typesincluding traditional healers, tests, and home remedies), and indirect costs (travel time and costs, increases and decreases in income-generating activity levels, etc.). Patients will also be asked about the ways in which they cope with changes in income levels and health-related expenses (loans, assistance from family and friends, sale of assets, etc.). In addition, investigators will collect complementary data from medical charts, to factor in patients' clinical status, comorbidities and direct treatment costs borne by the program. Every 6 months, a sample of health center staff members (the IHC 3-member team plus two other clinic staff members) will also be interviewed using an open-ended questionnaire. Data reflecting facilities activity level will also be collected.
 
Results / Comments:
Preliminary results from the surveys' first two rounds will be presented.
 
Discussion:
The survey sample is relatively small and will not be statistically representative of all health facilities, but the analysis can be stratified by facility type (rural vs urban, hospital vs local health center). It will be possible to describe how patients' cost profiles, from treatment start on, evolve over time. Analyzing staff members' evolving perception of the project, as well as objective data concerning health centers' activities, will highlight the short and medium-term economic impact of the IHC approach on health facilities.
 
Go Back

  Disclaimer   |   T's & C's   |   Copyright Notice    www.AIDSImpact.com www.AIDSImpact.com