Table 1.
Input parameters for modelling of VIA/cryotherapy costs per woman in Ghana
| Basic assumptions | High cost | Base case | Low cost | |
|---|---|---|---|---|
| Capital – buildings | ||||
| Size | 16 m2 | |||
| Costs per m2 (US$) | 2699 | 1350 | 1113 | |
| Percentage of effective working time | 40% | 60% | 80% | |
| Capital – equipment | ||||
| General equipment | International equipment | Locally manufactured equipment | ||
| Cryotherapy-specific equipment working-life of Cryogun (years)* | 1 | 2 | 3 | |
| Number of patients per year† | 5.1 | 45 | 60 | |
| Capital – discount rate | 5% | 3% | 0% | |
| Time requirements | ||||
| VIA (min)‡ | 45 | 17 | 15 | |
| Cryotherapy (min)§ | 60 | 50 | 45 | |
| Recurrent – staff | ||||
| Doctor salary (US$) | 1620 | 1350 | 1012 | |
| Nurse salary (US$) | 750 | 389 | 236 | |
| Assistant salary (US$) | 81 | |||
| Number of VIA per nurse per year | 1000 | 600 | 200 | |
| % effective working time¶ | 40% | 60% | 80% | |
| Supervision (for 4 nurses) | 4 doctor h/month + 1 doctor week per year | |||
| Recurrent supplies | ||||
| VIA cryotherapy | With gas for boiling of instruments | Without gas for boiling of instruments | ||
| Recurrent – mobilisation/recruitment (Church group visits (5 nurse h/month + 3.37 US$ transport), central market broadcasts, FM station broadcasts) | ||||
| Costs per mobilised woman (US$) | 1.50 | |||
| Capital – training course and initial supervision | ||||
| Trainees | 2 doctors, 4 nurses | |||
| Facilitators | 2 doctors, 2 nurses | |||
| Duration | 2 weeks | |||
| Travel allowance (for trainers) | 33.75 | |||
| Per diem (trainers) (US$) | 33.75 | |||
| Per diem (trainees) (US$) | 5 | |||
| Supervision Year 1 | 2 doctor h/day | |||
| Supervision Year 2 | 4 doctor h/week | |||
| Time before retraining** | 5 years | |||
*
At Ridge hospital, cryo guns were replaced every year. At Kumasi South hospital: every other year.
†
Ridge hospital performed 45 procedures in 2008. Based on an observed VIA positivity rate of 2.53%, assuming 200 screens at low case load facilities would yield about 5.1 positive screens per year.
‡
At Kumasi South hospital: 17 min. At Sepe Dote: 45 min. In Goldie et al. (2001): 15 min.
§
At Kumasi South hospital: 45 min. At Ridge hospital: 60 min.
¶
Estimated effective working time at Kumasi South and Komfo Anokye hospital: 60%.
**
Same as in Legood et al. (2005) and supported by Ghana findings.