From trial intervention to scale-up: costs of an adolescent sexual health program in Mwanza, Tanzania.
OBJECTIVE
To estimate annual costs of a multifaceted adolescent sexual health intervention in Mwanza, Tanzania, by input (capital and recurrent), component (in-school, community activities, youth-friendly health services, condom distribution), and phase (development, startup, trial implementation, scale-up).


METHODS
Financial and economic providers' costs and intervention outputs were collected to estimate annual total and unit costs (1999-2001). The incremental financial budget projects funding requirements for scale-up within an integrated model.


RESULTS
The 3-year economic costs of trial implementation were US dollars 879,032, of which approximately 70% were for the school-based component. Costs of initial development and startup were relatively substantial ( approximately 21% of total costs); however, annual costs per school child dropped from US dollars 16 in 1999 to US dollars 10 in 2001. The incremental scale-up cost is approximately 1/5 of ward trial implementation running costs.


CONCLUSIONS
Annual costs can reduce by almost 40% as project implementation matures. When scaled up, only an additional US dollars 1.54 is needed per pupil per year to continue the intervention.
Terris-Prestholt
Fern
F
London School of Hygiene and Tropical Medicine, London, UK. fern.terris-prestholt@lshtm.ac.uk
Kumaranayake
Lilani
L
Obasi
Angela I N
AI
Cleophas-Mazige
Bernadette
B
Makokha
Maende
M
Todd
Jim
J
Ross
David A
DA
Hayes
Richard J
RJ
D000293:Adolescent; D003256:Community Participation; D017280:Condoms / Q000600:supply & distribution; D003365:Costs and Cost Analysis; D004493:Education; D015658:HIV Infections / Q000191:economics* / Q000517:prevention & control; D006266:Health Education; D006801:Humans; D009313:National Health Programs; D021841:Safe Sex; D012725:Sexual Behavior; D013334:Students; D013636:Tanzania