The integrated care costs of HIV and non-communicable diseases in South Africa

Abstract

SETTING: In sub-Saharan Africa, the syndemic of HIV and non-communicable diseases (NCDs) poses a significant challenge. To address this, leading global think tanks like the WHO advocate for integrated HIV/NCD care at primary healthcare levels. However, comparative empirical data on the costs of integrated care are limited. South Africa, with the largest HIV programme globally, was purposively selected for our comparative case study. OBJECTIVE: To determine the cost of integrated HIV/ NCD care from the providers’ perspective at two ‘ideal status’ public healthcare facilities in South Africa as case studies. DESIGN: A multi-pronged methodology was used to collect provider cost data via retrospective documentary sources or records and a question-and-answer session with facility managers who provided key information on costrelated data. Data analysis utilised an activity-based costing (ABC) method. RESULTS: Despite the difference in the size of the clinics, the cost per patient in terms of ABC is similar between the two primary healthcare facilities, USD261.60 and USD226.30, respectively. CONCLUSION: The ABC method can be utilised to cost integrated care, foster health economic data availability for future research, and inform health policymakers.