Follow-up visits and AE management
The rural costing model included the estimation of transportation fuel cost, transportation time cost, and nurse review time cost per visit. In urban settings, we estimated reception time cost and nurse review time cost per visit. We used the average number of follow-up visits per client by location. Transportation cost was paid by the program in rural settings whereas patients paid for transportation in urban settings. In the rural setting, an enrolled nurse interacted with clients via 2wT and usually drove out to meet clients at their homes or workplaces to conduct any requested post-VMMC reviews. In urban settings, clients interacted with clients via 2wT and typically returned to the clinic on their own for visits when needed or desired. Reception time cost only applied to urban settings as the rural settings did not have reception.Cumulative moderate and severe AEs as defined by global VMMC standards [Rural visit cost = # of visits * (transportation fuel cost + transportation time cost + review time cost)Urban visit cost = # of visits * (reception time cost + review time cost)In rural settings, transportation fuel cost = Round trip distance to client home (km) * Litres of petrol (per km) * Price of petrol (per litre)AE management = probability of AE * AE material cost