Recorded presentation

Catherine Chanfreau, MD, MPH, Susna R. De, MSc, MPH, Tania Dmytraczenko, PhD, Gilbert Kombe, MD, MPH, and Marie Tien, MHS. Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-913-0500, catherine_chanfreau@abtassoc.com

Little is known about expenditures for care and support, or infrastructure costs for current or planned HIV/AIDS programs. Such information can be useful to answer critical policy questions such as ‘how much is spent by public, private, and donor sources on HIV/AIDS services?’ and ‘what is the level and equity of current resource flows?’

In these studies, four countries, Kenya, Rwanda, Uganda and Zambia, used the internationally recognized National Health Accounts (NHA) methodology to track country health expenditures on HIV/AIDS services for the year 2002. The NHA HIV/AIDS subanalysis uses a standardized approach to produce comparable data. Country governments implemented, targeted facility-based and HIV/AIDS population-based surveys in addition to issuing supplemental HIV/AIDS questions to ongoing NHA surveys.

Preliminary findings from the four countries show that the share of private expenditures, namely household out-of-pocket spending, is significantly higher than public spending on HIV/AIDS services. Moreover, as ARV treatment was not introduced to a significant extent during the year of estimation, much of the spending was directed at treating opportunistic infections. The findings from the study have also been used to examine equity implications and even HIV/AIDS funding flows to non-allopathic providers. On average, patients who went to traditional healers spent a sizeable amount of funds on consultations and medications.

As the findings show, the inclusion of all healthcare stakeholders, including traditional healers, should be incorporated in the design of strategies to fight the epidemic. The sub-analysis’ also demonstrate the financial burden on households and patients.

Learning Objectives:

• Describe the comparative results and findings of HIV/AIDS spending patterns from four sub-Saharan African countries

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation