RESEARCH ARTICLE HowMuch Does It Cost to Improve Access to Voluntary Medical Male Circumcision among High-Risk, Low-Income Communities in Uganda?

Background The Ugandan Ministry of Health has endorsed voluntary medical male circumcision as an HIV prevention strategy and has set ambitious goals (e.g., 4.2 million circumcisions by 2015). Innovative strategies to improve access for hard to reach, high risk, and poor popula-tions are essential for reaching such goals. In 2009, the Makerere University Walter Reed Project began the first facility-based VMMC program in Uganda in a non-research setting. In addition, a mobile clinic began providing VMMC services to more remote, rural locations in 2011. The primary objective of this study was to estimate the average cost of performing VMMCs in the mobile clinic compared to those performed in health facilities (fixed sites). The difference between such costs is the cost of improving access to VMMC. Methods Amicro-costing approach was used to estimate costs from the service provider’s perspec-tive of a circumcision. Supply chain and higher-level program support costs are not included