Table 3 Inputs used in cervical cancer prevention and control services
Variable name | Assumption | Source | Variable name | Assumption | Source |
|---|---|---|---|---|---|
Vaccination | Screening and treatment | ||||
Target population | 14-year-old girls; 670,905 | National Bureau of Statistics | Target population | Women living with HIV aged 15–49 years: 7,852,280 Women in the general population aged 30–49 years: 5,802,963 | World Population Prospects 2019 |
Vaccination site | Health facility: 40% At school: 55% Mobile outreach: 5% | Programme managers | % women assumed to be living with HIV | 15–29 years: 3.1% 30–49 years: 10.5% | Tanzania HIV Impact Survey 2016–17 [9] |
Coverage (second dose of 2-dose vaccine) | 2020: 70% 2021: 72% 2022: 75% 2023: 80% 2024: 85% | Workshop expert opinion | Screening coverage | 2020: 15% 2021: 20% 2022: 25% 2023: 30% 2024: 35% | Workshop expert opinion |
Training | Council cascade and annual refreshers | Expert opinion | Epidemiology evaluation/quality assurance of the programme | HPV−: 90.2% HPV+/none: 1.6% Small lesions: 4.8% Large lesions: 0.4% Invasive cancer: 3.0% | Programme managers |
Cold chain | No additional cold chain required | Programme managers | Rescreening # of years | HIV+: 3.0 years HIV−: 5.0 years | Programme managers |
Health staff time | 5 min nurse or medical attendant per vaccination | Workshop expert opinion | Health staff time | Workshop expert opinion | |
HPV-DNA test | 15 min (RN) | ||||
VIA | 20 min each (RN, EN) | ||||
Cryotherapy | 20 min each (RN, EN) | ||||
LEEP | 35 min (specialist, MO, AMO) | ||||
CSDR | 40 min each (oncologist, EN) | ||||
Chemotherapy | 720 min oncologist, 2520 min (RN, EN) | ||||
Radiotherapy | 135 min MO, 180 min (RN, PH), 280 min RO, 500 min RT | ||||
Palliative out/in | 15 min AMO | ||||
Local school visit transport | Per diem allowance of US$13 (30,000 TZA) and transport allowance | Programme managers | Existing equipment with excess capacity (not costed) | Waiting area, examination area, gynaecological examination couch | Workshop interviews |
Vaccine price per dose | US$4.50 per dose | Gavi | Laboratory test prices | Not applicable | NHIF price schedule |
Donations | 80% of vaccine, injection supplies and shipping donated by Gavi | Gavi | Equipment prices | Not applicable | MDA, UNFPA, UNICEF, WHO |
Assumptions relevant to both prevention and control services | |||||
Exchange rate | 2304 TZA to US$1 | Oanda | Discount rate | 7.0% (Bank of Tanzania) | Central bank rate |