title: Spillover effect of HIV-specific foreign aid on immunization services in Nigeria.
abstract: BACKGROUND
  Health aid to Nigeria increased tremendously in the last decade and a significant portion of the funds were earmarked for HIV-associated programs. Studies on the impact of HIV-specific aid on the delivery of non-HIV health services in sub-Saharan Africa have yielded mixed results. This study assessed if there is a spillover effect of HIV-specific aid on childhood vaccinations in Nigeria.
  
  
  METHODS
  Multivariate logistic regression models were used to estimate the effect of aid disbursements in a previous year on the receipt of vaccines at the individual level in a given year. Estimations were done for approximately 11 700 children using data from demographic and health surveys conducted in Nigeria in 2003 and 2008.
  
  
  RESULTS
  US$1 increase in HIV aid per capita was associated with a decrease in the probability of receipt of vaccines by 8-31%: polio first dose decreased by 8%; polio final dose by 9%; diphtheria-pertussis-tetanus (DPT) first dose by 11%; DPT final dose by 19%; measles by 31%; final doses of polio and DPT plus measles vaccine by 8%.
  
  
  CONCLUSIONS
  HIV-specific aid had a negative spillover effect on immunization services in Nigeria over the study period. Donors may need to rethink their funding strategies in favour of more horizontal approaches.
authors.affiliation: Division of Management, Policy and Community Health, The University of Texas School of Public Health, 1200 Pressler Street, Houston, Texas 77030, USA chimacharles@gmail.com.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Chima
authors.affiliation: Division of Management, Policy and Community Health, The University of Texas School of Public Health, 1200 Pressler Street, Houston, Texas 77030, USA.
authors.forename: Luisa
authors.initials: L
authors.lastname: Franzini
mesh_terms: D017954:Africa South of the Sahara; D002648:Child; D003906:Developing Countries; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000628:therapy*; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007223:Infant; D007391:International Cooperation; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage; D009549:Nigeria / Q000453:epidemiology; D023321:Poliovirus Vaccines / Q000008:administration & dosage
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D008458:Measles Vaccine; D023321:Poliovirus Vaccines
keywords: Foreign aid; HIV; Health systems; Immunization; Nigeria; Spillover effect