title: A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda.
abstract: Because 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.
authors.forename: Donald S
authors.initials: DS
authors.lastname: Shepard
authors.forename: Wu
authors.initials: W
authors.lastname: Zeng
authors.forename: Peter
authors.initials: P
authors.lastname: Amico
authors.forename: Angelique K
authors.initials: AK
authors.lastname: Rwiyereka
authors.forename: Carlos
authors.initials: C
authors.lastname: Avila-Figueroa
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000191:economics* / Q000453:epidemiology; D000293:Adolescent; D057191:Capacity Building; D002648:Child; D003695:Delivery of Health Care / Q000191:economics*; D036262:Empirical Research; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology; D006295:Health Resources / Q000191:economics; D006801:Humans; D011320:Primary Health Care / Q000191:economics*; D012044:Regression Analysis; D012107:Research Design; D019035:Rural Health Services / Q000191:economics*; D012432:Rwanda / Q000453:epidemiology; D013997:Time Factors