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Multicenter Study
. 2012 May;86(5):902-907.
doi: 10.4269/ajtmh.2012.11-0202.

A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda

Donald S Shepard, Wu Zeng, Peter Amico, Angelique K Rwiyereka, Carlos Avila-Figueroa
Multicenter Study

A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda

Donald S Shepard et al. Am J Trop Med Hyg. 2012 May.

Abstract

Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda.

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Figures

Figure 1.
Figure 1.
Average score of preventive care index between acquired immunodeficiency syndrome (AIDS) AIDS centers and Non-AIDS centers in Rwanda, 2002–2007.
Figure 2.
Figure 2.
Average score of curative care index between acquired immunodeficiency syndrome (AIDS) AIDS centers and Non-AIDS centers in Rwanda, 2002–2007.
See this image and copyright information in PMC

Comment in

  • Does HIV/AIDS funding undermine health systems?
    Fan VY, Silverman R, Glassman A. Fan VY, et al. Am J Trop Med Hyg. 2012 Sep;87(3):579-580. doi: 10.4269/ajtmh.2012.12-0291a. Am J Trop Med Hyg. 2012. PMID: 22956718 Free PMC article. No abstract available.

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