costs to implement a 3-condition, substance use and sexual risk prevention program in Cape Town, South Africa

Open Access
Doyle, Mary Claire
Area of Honors:
Human Development and Family Studies
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Linda L Caldwell, Thesis Supervisor
  • Charles Geier, Honors Advisor
  • human service
  • prevention
  • health
  • leisure
  • economic cost analysis
Human service prevention programs are critical for mitigating risk factors in populations that are put at a disadvantage due to circumstance. In the Province of the Western Cape, South Africa, HealthWise South Africa: Life Skills for Young Adults is an intervention program geared toward minimizing risky sexual behaviors, HIV/AIDS transmission, and substance use by teaching them how to use their free time in healthy ways, coping skills, relationship skills, and knowledge about using substances and avoiding risky sexual behavior. A previous HealthWise randomized controlled trial (HW1) provided insight into the effectiveness of the intervention. The next study about HealthWise (HW2) focused on ways to help teachers teach the curriculum with implementation fidelity using three experimental conditions hypothesized to promote implementation fidelity, and study which of the conditions proved to be most effective. This thesis examines the costs and inputs associated with implementing HW2 as well as the costs association with implementing the three experimental conditions in isolation and combination, using data from the 2012 academic year. The analysis utilizes a six-step social cost analysis framework. The results point to both the importance and difficulty of monitoring expenditures in human service interventions. Despite these limitations, the cost per learner of HW2, in all of its varying degrees of intensity, is low enough that an even larger-scale of dissemination would be a low-cost (and potentially high-yield) prevention program in South Africa and elsewhere. Final considerations are made regarding the usefulness of the results as they appear and how they can be built upon in future analyses determining multi-year costs as well as effectiveness.