title: Efficiency of HIV/AIDS health centers and effect of community-based health insurance and performance-based financing on HIV/AIDS service delivery in Rwanda.
abstract: This study evaluates the efficiency of rural health centers in Rwanda in delivering the three key human immunodeficiency virus/acquired immunodeficiency syndrome services: antiretroviral treatment, prevention of mother-to-child transmission, and voluntary counseling and testing using data envelopment analysis, and assesses the impact of community-based health insurance (CBHI) and performance-based financing on improving the delivery of the three services. Results show that health centers average efficiency of 78%, and despite the observed variation, the performance increased by 15.6% from 2006 through 2007. When the services are examined separately, each 1% growth of CBHI use was associated with 3.7% more prevention of mother-to-child transmission and 2.5% more voluntary counseling and testing services. Although more health centers would have been needed to evaluate performance-based financing, we found that high use of CBHI in Rwanda was an important contributor to improving human immunodeficiency virus/acquired immunodeficiency syndrome services in rural health centers in Rwanda.
authors: Wu
authors: W
authors: Zeng
authors: Angelique K
authors: AK
authors: Rwiyereka
authors: Peter R
authors: PR
authors: Amico
authors: Carlos
authors: C
authors: Ávila-Figueroa
authors: Donald S
authors: DS
authors: Shepard
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000635:transmission; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002648:Child; D003153:Community Health Services / Q000191:economics / Q000379:methods*; D003376:Counseling; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007348:Insurance, Health / Q000191:economics; D008297:Male; D011247:Pregnancy; D012044:Regression Analysis; D012052:Reimbursement, Incentive / Q000191:economics; D012111:Residence Characteristics; D019035:Rural Health Services / Q000191:economics; D012432:Rwanda