Clinic consortia media advocacy capacity: partnering with the media and increasing policymaker awareness.

Media advocacy is a popular means of crafting and disseminating messages broadly and has been used by advocates to increase policymaker and public awareness of key health policy issues, such as the large number of uninsured. Some media advocacy activities are more effective than others, however, requiring increased sensitivity to the media environment and adequate resources and expertise. This article describes the results of media advocacy activities undertaken by 19 clinic consortia funded under The California Endowment's Clinic Consortia Policy and Advocacy Program from 2002 to 2006. The consortia used different media advocacy strategies and venues, including newspaper, television, radio, video, brochures, newsletters, and websites. The findings indicate that consortia may have influenced the media agenda and increased the likelihood of securing coverage of key issues, such as the role of clinics in supporting the health care safety net. There is evidence that suggests that clinic consortia media advocacy activities, such as front-page coverage in local and major daily newspapers, increased public and policymaker awareness of key clinic policy issues. Although grantees rated media advocacy overall as less effective than other advocacy activities and few reported that it had directly achieved a policy change or increased funding to clinics, nearly all thought it was effective in increasing policymaker awareness. We conclude that media advocacy is a useful tool for partnering with the media and increasing stakeholder awareness more broadly, but it should not be solely relied upon to achieve a policy change.

The cost of a rapid-test VCT clinic in South Africa.

CONTEXT: Demand for HIV voluntary counselling and testing (VCT) will increase as HIV prevention and treatment scale up in South Africa. Understanding the cost of delivering VCT will inform funding decisions. OBJECTIVE: To determine the cost per client completing VCT (pretest counselling, testing and post-test counselling) in a non-research- based programme using rapid-test technology. DESIGN: One year of expenditure and output data were collected retrospectively as part of the PANCEA (Prevent AIDS: Network for Cost-Effectiveness Analysis) study. Market prices were determined for donated resources. SETTING: An urban, church-based, non-profit organisation that offers rapid-test VCT services in KwaZulu-Natal, South Africa. RESULTS: Financial expenditure for the 2002/2003 fiscal year was 39,761 dollars (calculated using an average conversion rate for July 2003, which was 0.133). Using market prices for donated resources, the economic cost for the year was estimated at 67,248 dollars. Six hundred and sixty-two clients completed VCT, resulting in financial expenditure of 60.06 dollars per client and an economic cost of 101.58 dollars per client. Financial expenditures and economic costs per client decreased over the year by 66% because expenses remained stable as more clients were served. CONCLUSIONS: The cost of providing VCT services was higher than previously reported, but declined with expanding scale.

Assessing the efficiency of HIV prevention around the world: methods of the PANCEA project.

OBJECTIVE: To develop data collection methods suitable to obtain data to assess the costs, cost-efficiency, and cost-effectiveness of eight types of HIV prevention programs in five countries. DATA SOURCES/STUDY SETTING: Primary data collection from prevention programs for 2002-2003 and prior years, in Uganda, South Africa, India, Mexico, and Russia. STUDY DESIGN: This study consisted of a retrospective review of HIV prevention programs covering one to several years of data. Key variables include services delivered (outputs), quality indicators, and costs. DATA COLLECTION/EXTRACTION METHODS: Data were collected by trained in-country teams during week-long site visits, by reviewing service and financial records and interviewing program managers and clients. PRINCIPAL FINDINGS: Preliminary data suggest that the unit cost of HIV prevention programs may be both higher and more variable than previous studies suggest. CONCLUSIONS: A mix of standard data collection methods can be successfully implemented across different HIV prevention program types and countries. These methods can provide comprehensive services and cost data, which may carry valuable information for the allocation of HIV prevention resources.