Cost-effectiveness of improving services to people with HIV in Nicaragua

A 2009 evaluation found that 13% of HIV patients in Nicaragua were lost to follow-up, 16.5% died while on ART and only 45% reported good clinical outcomes. Following this evaluation, with technical assistance provided through the USAID Health Care Improvement Project (HCI), seven hospitals and two health centers providing care for people with HIV set out with a vision to improve comprehensive care in all health services, with a focus on the decentralization of antiretroviral therapy (ART). Utilizing the collaborative process, the main objectives of the work was to improve the quality of care for patients on ART and achieve a successful program in each of the hospitals through uninterrupted ART service to all patients and to promote good clinical outcomes. The objective of this study was to determine the cost-effectiveness of the intervention by comparing costs and outcomes before the intervention to costs and outcomes afterwards. This short report describes the methods used, results achieved and lessons learned.

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