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HIV/AIDS Expenditures in Sub-Saharan Africa: Observations from Kenya, Rwanda and Zambia

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Title: HIV/AIDS Expenditures in Sub-Saharan Africa: Observations from Kenya, Rwanda and Zambia


1
HIV/AIDS Expenditures in Sub-Saharan
Africa Observations from Kenya, Rwanda and Zambia
  • S. Muchiri, Wellington Godo, K Chebet,Ministry of
    Health, Nairobi, Kenya
  • C. Kabago, P. Kayabotsi, D. Ndushabandi,
    Government of Rwanda, Kigali, Rwanda
  • F. Phiri, Ministry of Health, Lusaka, Zambia
  • T. Dmytraczenko, S. De, C. Chanfreau, M. Tien and
    G. Kombe, Abt Associates Inc., Bethesda MD USA

2
Impact of the HIV/AIDS Epidemic
Kenya Rwanda Zambia
Adult prevalence 6.7 5.1 15.6
HIV infected adults 982,685 199,279 1.2M
Declining life expectancy
1990 62 50 54
2002 47 44 40
GDP per capita USD 371 USD 196 USD 354
3
Providing HIV/AIDS Prevention, Treatment and
Care A Heavy Toll on the Health Sector
  • HIV/AIDS is the single largest contributor to the
    burden of disease in Africa
  • 19 of the total years of life lost due to
    disability or premature mortality

PPP 141
45
PPP 433
In percentages
24
PPP 306
14
HIV/AIDS as a share of total health expenditures
4
Household and Donors Finance a Large Share of
HIV/AIDS Expenditures
Kenya
Rwanda
Zambia
5
Treatment and Care Absorb the Majority of Health
Funds
KENYA
75
6
Is HIV/AIDS a Priority in Resource Allocation?
Rwanda
Kenya
Zambia
75
5
21
33
57
19
7
Dependence on external resources
Global Fund and PEPFAR funds relative to health
expenditures
Source PHRplus analysis of Global Fund data
8
The Burden on HIV Households Is Considerable
General Out-of-pocket spending 3.70 per capita
HIV/AIDS Out-of-pocket spending 31.62 per
HIV individual
A person living with HIV/AIDS spends
approximately 9 times more out-of-pocket than the
average Zambian on health care
Preliminary results
9
The Burden on HIV Households Is Considerable
  • HIV/AIDS Out-of-pocket spending
  • 60.84 per HIV individual
  • General Out-of-pocket
  • Spending
  • 8.90 per capita

A person living with HIV/AIDS spends
approximately 7 times more out-of-pocket than the
average Kenyan on health care
Preliminary results
10
The Burden on HIV Households Is Considerable
  • HIV/AIDS Out-of
  • pocket spending
  • 4.97 per HIV
  • individual
  • General Out-of-pocket
  • Spending
  • 2.13 per capita

A person living with HIV/AIDS spends
approximately 2 times more out-of-pocket than the
average Rwandan on health care
Preliminary results
11
Meeting basic needs in Rwanda
  • 58 of HIV households received assistance,
    borrowed or sold assets
  • 34 received assistance
  • 29 borrowed
  • 21 sold assets

12
Inequities in Zambia
USD
13
Policy Issues
  • Sustainability of donor funding in view of
    long-term challenges posed by HIV/AIDS
  • Equity issues related to substantial household
    out-of-pocket HIV/AIDS spending
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