Cost-effectiveness analysis of home care services in the mass circumcision program: A qualitative study
Keywords:
cost-effectiveness, home care, mass circumcision, circumcision, qualitative studyAbstract
Mass circumcision programs are a form of community-based health service aimed at improving access to safe, affordable, and high-quality circumcision services. Home care services offer potential clinical benefits while simultaneously reducing indirect costs borne by families. This study aimed to explore the perceptions and experiences of healthcare workers, program managers, and participants' parents regarding the cost-effectiveness of home care services within mass circumcision programs. A descriptive qualitative design with an exploratory approach was employed. Informants were selected via purposive sampling and included participants' parents, healthcare workers, home care staff, and program managers. Data were collected through in-depth interviews, observation, and document review, and subsequently analyzed using Braun and Clarke’s thematic analysis. The analysis revealed that home care facilitates access, reduces transportation costs and the time commitment required from families, and aids in the early detection of complications. However, challenges included staff transportation costs, geographical distances, workforce limitations, and coordination requirements. A hybrid home care model incorporating telemonitoring and risk-based visits was perceived as the most efficient approach. In conclusion, while home care has the potential to enhance the efficiency of mass circumcision programs, quantitative economic research is needed to objectively measure costs, outcomes, and the incremental cost-effectiveness ratio.
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