Submission ID 129815
| Issue/Objective | ART teen clubs are an adolescent-focused service delivery model with demonstrated potential to improve HIV treatment outcomes; however, their relatively high implementation costs raise important questions about efficiency and long-term sustainability, particularly in resource-limited settings. Despite growing evidence of effectiveness, there remains a critical gap in cost-effectiveness data to inform scale-up and policy decisions. This study aimed to evaluate the cost-effectiveness of ART teen clubs in HIV management among adolescents in Nkhotakota, Malawi, by estimating total and incremental costs per 1% increase in viral suppression compared to the standard of care. Generating this evidence is essential to support the translation of research into practice, inform health system strengthening through optimized service delivery models, and guide sustainable financing decisions for adolescent HIV programs. |
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| Methodology/Approach | A decision tree model was used to estimate the costs and effectiveness of ART Teen Clubs using published literature for viral suppression rates. Cost data were sourced from implementing partners' budgets and expenditure reports, and a cost analysis estimated two-year(2021-2023) start-up and operational costs. Incremental Cost-Effectiveness Ratios (ICERs) were calculated as the additional cost per 1% increase in adolescents achieving viral suppression and interpreted descriptively to compare relative efficiency across study sites. |
| Results | ART teen clubs achieved higher viral suppression compared to the standard of care, at an additional cost. The overall ICER was $632 per additional 1% increase in adolescents virally suppressed, with site-specific ICERs ranging from $179 to $263, indicating variability in efficiency across implementation settings |
| Discussion/Conclusion | Compared with the standard of care, the ART Teen Club model is associated with higher costs but improved virologic outcomes among adolescents on ART. These findings provide critical efficiency metrics to inform priority setting and resource allocation, supporting evidence-based decision-making for adolescent HIV programs. By translating effectiveness into cost-effectiveness, this study bridges the gap between research and implementation, contributing to health systems strengthening through optimized service delivery models. Furthermore, the results offer valuable insights for sustainable financing by guiding investment decisions and identifying pathways for strategic scale-up of adolescent-friendly HIV interventions in resource-limited settings. |
| Presenters and Affiliations | Rehema Simika Kamuzu University of Health Sciences,School of Global and Public Health, Department of Health Systems and Policy. Jobiba Chinkhumba Kamuzu University of Health Sciences,School of Global and Public Health, Department of Health Systems and Policy. |
