New York University, New York, NY, USA.
Health Aff (Millwood). 2012 Jul;31(7):1406-14. doi: 10.1377/hlthaff.2012.0279.
Donor funding for HIV programs has increased rapidly over the past decade, raising questions about whether other health services in recipient-country health systems are being crowded out or strengthened. This article--an investigation of the impacts of increased HIV donor funding on non-HIV health services in sub-Saharan Africa during 2003-10--provides evidence of both effects. HIV aid in some countries has crowded out the delivery of childhood immunizations, especially in countries with the lowest density of health care providers. At the same time, HIV aid may have positively affected some maternal health services, such as prenatal blood testing. These mixed results suggest that donors should be more attentive to domestic resource constraints, such as limited numbers of health workers; should integrate more fully with existing health systems; and should address these constraints up front to limit possible negative effects on the delivery of other health services.
在过去的十年中，艾滋病规划署的捐款迅速增加，这引发了人们的担忧，即受援国卫生系统中的其他卫生服务是否会因此受到排挤或得到加强。本文调查了 2003 年至 2010 年期间，艾滋病规划署捐款增加对撒哈拉以南非洲非艾滋病卫生服务的影响，结果表明这两种情况都存在。在一些国家，艾滋病毒援助排挤了儿童免疫接种的提供，特别是在医疗服务提供者密度最低的国家。与此同时，艾滋病毒援助可能对一些产妇保健服务产生了积极影响，例如产前血液检查。这些混合的结果表明，捐助者应该更加关注国内资源的限制，例如卫生工作者人数有限；应该更充分地融入现有卫生系统；并应预先解决这些限制，以限制对其他卫生服务提供的可能的负面影响。
