Department or Resource Economics and Environmental Sociology, University of Alberta, Edmonton, Alberta, Canada.
PLoS One. 2013 Jun 20;8(6):e65625. doi: 10.1371/journal.pone.0065625. Print 2013.
Though health benefits to households in developing countries from antiretroviral treatment (ART) programs are widely reported in the literature, specific estimates regarding impacts of treatments on household incomes are rare. This type of information is important to governments and donors, as it is an indication of returns to their ART investments, and to better understand the role of HIV/AIDS in development. The objective of this study is to estimate the impact of a community-based ART program on household incomes in a previously underserved rural region of Uganda. A community-based ART program, based largely on labor contributions from community volunteers, was implemented and evaluated. All households with HIV/AIDS patients enrolled in the treatment programme (n = 134 households) were surveyed five times; once at the beginning of the treatment and every three months thereafter for a period of one year. Data were collected on household income from cash earnings and value of own production. The analysis, using ordinary least squares and quantile regressions, identifies the impact of the ART program on household incomes over the first year of the treatment, while controlling for heterogeneity in household characteristics and temporal changes. As a result of the treatment, health conditions of virtually all patients improved, and household incomes increased by approximately 30% to 40%, regardless of household income quantile. These increases in income, however, varied significantly depending on socio-demographic and socio-economic control variables. Overall, results show large and significant impacts of the ART program on household incomes, suggesting large returns to public investments in ART, and that treating HIV/AIDS is an important precondition for development. Moreover, development programs that invest in human capital and build wealth are important complements that can increase the returns to ART programs.
虽然文献中广泛报道了抗逆转录病毒治疗 (ART) 方案为发展中国家的家庭带来的健康益处,但关于治疗对家庭收入影响的具体估计却很少。这类信息对政府和捐助者很重要,因为它表明了他们在 ART 投资方面的回报,也有助于更好地了解 HIV/AIDS 在发展中的作用。本研究的目的是评估在乌干达一个以前服务不足的农村地区开展的基于社区的 ART 方案对家庭收入的影响。实施并评估了一个主要依靠社区志愿者劳动贡献的基于社区的 ART 方案。对所有入组治疗方案的 HIV/AIDS 患者家庭(n=134 户)进行了五次调查;在开始治疗时进行一次调查,此后每三个月进行一次,为期一年。通过现金收入和自有生产价值收集家庭收入数据。使用普通最小二乘法和分位数回归进行分析,确定了在治疗的第一年中,ART 方案对家庭收入的影响,同时控制了家庭特征和时间变化的异质性。由于治疗,几乎所有患者的健康状况都有所改善,家庭收入增加了约 30%至 40%,而与家庭收入分位数无关。然而,这些收入的增加在很大程度上取决于社会人口和社会经济控制变量。总体而言,结果表明,ART 方案对家庭收入有很大且显著的影响,表明公共 ART 投资有很高的回报,而且治疗 HIV/AIDS 是发展的重要前提。此外,投资于人力资本和创造财富的发展方案是重要的补充,可以增加对 ART 方案的回报。