Browsing by Author "Korir, julius k."

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    An Analysis of Patients’ Spinal Injury Costs at the National Spinal Injury Hospital in Nairobi County, Kenya
    (Global scientific journal, 2024) Korir, julius k.; Karanja, Lorna Wangari; Yitambe, Andre
    Global statistics indicate that based on the extent of spinal cord injury, the first-year cost ranges between $300,000 and $1,000,000. [1]. A review of 68 studies [2], indicated the cost of injury varied widely with mean costs ranging from $14 to $17, 400 and the cost per disability-adjusted life year averted for injury-prevention interventions ranged from $10.90 for speed bump installation to $17,000 for drunk driving and breath testing campaigns in Africa. Health economists are interested in evaluating spinal cord treatment interventions as economic investments. For these stakeholders, a key question is the relationship between the reduction of spinal cord injuries and national income growth as measured by GDP metrics. Public health officials are more focused on promoting health, preventing spinal injuries and related mortalities as well as reducing their health and social burden. The general objective of this study was to analyze the patient costs of spinal cord injury at the National Spinal Injury Hospital, Nairobi County, Kenya. The four specific objectives of the study were to determine the total costs of spinal cord injury in the first year of diagnosis and treatment at the National Spinal Injury Hospital, to determine the variations in total costs of spinal cord injury due to ownership of health insurance, to establish the variations in total costs of spinal cord injury based on extent of the injury and to establish the variations in total costs of spinal cord injury based on the employment status of the patients at National Spinal Injury Hospital.This was an analytical cross-sectional study utilizing quantitative methods on a sample of n=169. Purposive sampling was also employed to recruit participants comprising spinal injury patients in the first year of diagnosis and data were collected using structured questionnaires and secondary data review. Data was analyzed using SPSS version 25 where descriptive statistics were used to show frequencies and percentages for variables. ANOVA test was used to test the statistical mean differences in the total SCI costs among the SCI patients at NSIH based on their employment status and extent of the spinal injury while paired t-test was used for health insurance status. Findings indicate that it average costs the spinal cord injury patient KSh. 928,326.73 in treatment costs in the first year of diagnosis. The average of sum of the annual direct medical costs, direct non-medical costs and indirect costs of productivity losses for the 169 patients was KSh 187,048, KSh 173,541 and KSh 567,738 per patient respectively. Further, it shows that the employment status of the patients do result in significant differences in the total SCI costs among the different groups ( P=0.000) while the extent of injury and health insurance status does not result in significant differences in the total SCI costs( P=0.6617 and t=-0.6129 respectively). This study will inform the National Spinal Injury Hospital on the importance of health economic studies in the management of SCI patients.
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    Assessing the cost implications of integrating and scaling up HIV services for key populations in Kenya and Malawi
    (Oxford University Press, 2025-10) Andrea Salas-Ortiz; Marjorie Opuni; Figueroa ,José Luis; Sánchez-Morales,Jorge Eduardo; Banda, Louis Masankha; Olawo, alice; Munthali, Spy; Korir, julius k.; Meghan DiCarlo; Sergio Bautista-Arredondo
    imited research has been conducted on strategies to improve the efficiency of HIV services for key populations (KPs). This study investigates ways to enhance healthcare delivery efficiency, focusing on HIV services for KPs. We explore two strategies: expanding service volume and offering multiple HIV services within a single health facility. Using data from the Linkages Across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) program in Kenya and Malawi, we exploit the variation in services provided to assess correlations between different service delivery configurations and their costs. We apply log-log fixed-effects regression models to analyze relationships between the total costs of four HIV services and the volume and range of services delivered. We find that service volume increases correlate with higher total costs, albeit less than proportionally, consistent with possible economies of scale. Negative correlations between service integration and total costs suggest that integrating HIV services for KPs could lead to reduced total costs for some service combinations. These results indicate potential strategies to increase the efficiency of HIV services for KPs, which can inform strategic planning and program execution in Kenya, Malawi, and similar countries