Susna R De, MSc, MPH¹, Catherine Chanfreau, MD, MPH¹, Owen Smith, MPA¹, Pia Schneider, MA², and Desire Ndushabandi, MD³. (1) Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301 347 5608, susna_de@abtassoc.com, (2) Abt Associates, 4800 Montgomery Lane Suite 600, Bethesda, MD 20814, (3) Secretary General, Ministry of Health, Rwanda, Kigali, Rwanda

With the influx of sizeable donor contributions and renewed government commitment to addressing the HIV/AIDS crisis, there is a need to track the allocation of HIV/AIDS funds through country health systems to ensure appropriate use. However, comprehensive information on the flow of HIV/AIDS funds is generally lacking. Without such information, policymakers face difficulties in determining the effectiveness of their HIV/AIDS interventions. To date, Rwanda is the only sub-Saharan African country to have conducted two detailed reviews of HIV/AIDS spending. This paper describes the trend data generated from these two studies (1998 and 2003), called National Health Accounts (NHA) subanalyses - having been implemented using a methodological approach derived from NHA, a globally accepted tool for tracking health expenditures. Use of a standard approach allows for inter-country comparisons and temporal analysis. Comparison of findings from both studies show that funds for HIV/AIDS health care has significantly increased. Government spending has more than doubled in recent years. Moreover, in comparison to the first HIV/AIDS subanalysis, where donors financed only 6% of HIV/AIDS expenditures, the donor community has now tripled their contribution. However, household financing for HIV/AIDS services, particularly for purchasing drugs, remains high. Rwanda’s experience with HIV/AIDS subanalyses allowed for better monitoring and targeting of resource flows for HIV/AIDS. Moreover, its inclusion of household spending provides key information for equity analyses. Due to its standard and feasible approach, it is recommended that such subanalyses be used as baseline data, particularly, for monitoring new donor contributions, such as the Global Fund.

Learning Objectives:

1)To understand the value of health expenditure data to the disbursement process of large donor HIV/AIDS funds, such as PEPFAR and the Global Fund.
• To articulate the major methodological features of the National Health Accounts process for monitoring HIV/AIDS resource flows

Keywords: Financing, Accountability

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.