• Am. J. Trop. Med. Hyg. · May 2012

    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, Wu Zeng, Peter Amico, Angelique K Rwiyereka, and Carlos Avila-Figueroa.
    • Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts 02454-9110, USA. shepard@brandeis.edu
    • Am. J. Trop. Med. Hyg. 2012 May 1; 86 (5): 902-7.

    AbstractBecause 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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