Vol. 3 No. 1 (2024)

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A Methodological Framework for the Economic Evaluation of Integrated Cervical Cancer Screening and HIV Care in Tanzania's High-Burden Districts

Grace Mwaiselage, Department of Public Health, State University of Zanzibar (SUZA) Juma Mfinanga, Department of Pediatrics, Tanzania Wildlife Research Institute (TAWIRI) Amina J. Mwakyoma, Tanzania Wildlife Research Institute (TAWIRI)
DOI: 10.5281/zenodo.18364631
Published: January 25, 2026

Abstract

This methodology article presents a novel framework for conducting a full economic evaluation of integrating cervical cancer screening into existing HIV care programmes in Tanzania’s high-burden districts. The urgent need is underscored by the disproportionate cervical cancer burden among women living with HIV in sub-Saharan Africa and the imperative for cost-effective, scalable interventions within constrained health systems. To address this, the proposed methodology employs a pragmatic hybrid design. This combines a prospective micro-costing study (2024-2025) within selected care and treatment clinics to capture real-world resource utilisation with a Markov cohort model to project long-term costs and health outcomes. The model will compare integrated services against a counterfactual of stand-alone care from both health system and societal perspectives, estimating incremental cost-effectiveness ratios (ICERs) in terms of cost per disability-adjusted life year (DALY) averted over a 20-year time horizon. Methodological rigour is strengthened through the use of locally validated epidemiological parameters, the explicit valuation of patient-incurred costs, and a comprehensive probabilistic sensitivity analysis to quantify parameter uncertainty. The framework is designed to generate crucial, context-specific evidence for Tanzanian and regional policymakers, directly informing investment decisions to optimise limited resources and accelerate progress towards the WHO’s cervical cancer elimination goals within high HIV prevalence settings.

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Grace Mwaiselage, Juma Mfinanga, Amina J. Mwakyoma (2026). A Methodological Framework for the Economic Evaluation of Integrated Cervical Cancer Screening and HIV Care in Tanzania's High-Burden Districts. African Journal of Public Health and Health Systems, Vol. 3 No. 1 (2024), 15-23. https://doi.org/10.5281/zenodo.18364631
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Keywords

Economic evaluationSub-Saharan AfricaImplementation scienceCervical cancer screeningHIV care integrationHealth systems strengtheningCost-effectiveness analysis

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Vol. 3 No. 1 (2024)
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