Princeton University, Princeton, NJ, USA.
Demography. 2011 May;48(2):675-97. doi: 10.1007/s13524-011-0026-3.
We document the impact of the AIDS crisis on non-AIDS-related health services in 14 sub-Saharan African countries. Using multiple waves of Demographic and Health Surveys (DHS) for each country, we examine antenatal care, birth deliveries, and rates of immunization for children born between 1988 and 2005. We find deterioration in nearly all these dimensions of health care over this period. The most recent DHS survey for each country collected data on HIV prevalence, which allows us to examine the association between HIV burden and health care. We find that erosion of health services is the largest in regions that have developed the highest rates of HIV. Regions of countries that have light AIDS burdens have witnessed small or no declines in health care, using the measures noted above, while those regions shouldering the heaviest burdens have seen the largest erosion in non-HIV-related health services for pregnant women and children. Using semiparametric techniques, we can date the beginning of the divergence in the use of antenatal care and in children's immunizations between high- and low-HIV regions to the mid-1990s.
我们记录了艾滋病危机对撒哈拉以南非洲 14 个国家非艾滋病相关卫生服务的影响。我们使用每个国家的多轮人口与健康调查（DHS）数据，考察了 1988 年至 2005 年间出生的儿童的产前护理、分娩和免疫接种率。我们发现，在此期间，这些卫生保健服务的几乎所有方面都有所恶化。每个国家最近的 DHS 调查都收集了关于艾滋病毒流行率的数据，这使我们能够检验艾滋病毒负担与卫生保健之间的关联。我们发现，在艾滋病毒发病率最高的地区，卫生服务的恶化程度最大。在艾滋病毒负担较轻的国家地区，上述措施所衡量的卫生保健几乎没有下降或没有下降，而承担最重负担的地区则出现了孕妇和儿童非艾滋病毒相关卫生服务的最大侵蚀。我们使用半参数技术，可以将高艾滋病毒和低艾滋病毒地区在产前护理和儿童免疫接种方面的使用情况出现差异的时间追溯到 20 世纪 90 年代中期。
