Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
Mwenge et al.
Type of approach
Type of assistance
General population: General population in urban, peri-urban and rural settings
UNAIDS HIV prevalence (2017)
Micro-costing analysis of facility-based HIV self-testing (HIVST) from 15 health facilities in Malawi, 10 in Zambia and 29 in Zimbabwe. Routinely-collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs.
Summary of findings
Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. Health facility based HIV testing remains an essential service to meet HIV universal access goal. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggest that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services.
Willingness to pay
Willingness to pay details
Linkage to prevention, care and treatment