国家艾滋病支出评估方法在云南德宏州某县艾滋病防治经费支出评估中的应用

摘要

Objective To calculate the actual expenditures in a county of Dehong prefecture,Yunnan province, China by using the method of National AIDS Spending Assessment (NASA) in 2010.Methods Data were collected through NASA data collection form based on adapted NASA classification in the county of Dehong prefecture from October to December,2011,and complemented by semi-structured interview with 16 well trained programmatic and financial representatives in 8 spending units.Data were entered in Resource Tracking Software (RTS) V 2009.3.0,and SPSS 13.0 was used for data processing and analysis.Results The NASA estimations showed that the county spent a total of (￥) 16 235 954 on HIV/AIDS in 2010.Public funds constituted 96.3％ of the total expenditure ( (￥) 15 630 937),followed by Global Fund which accounted for 3.0％ ( (￥) 484 585) and private sources which accounted for 0.7％ ((￥) 120 432 ).Findings based on NASA categories showed that AIDS spendings were mainly on 4 areas,and expenditure on Care & Treatment was (￥) 12 401 382 (76.4％ of total expenditure),followed by Prevention which accounted for 14.3％ ( (￥) 2 325 707 ),Program Management & Administration which accounted for 7.8％ ( (￥) 1 268 523) and human resources which accounted for 1.5％ ( (￥)240 342).The most beneficial population group was People Living with HIV (PLHIV),accounting for 84.7％ of total expenditure.((￥) 13 753 428),followed by 4.8％ for high risk population,including female sex workers and their partners ((￥) 297 333 ),injection drug users and their partners ( (￥) 293 143 ),men having sex with men and their partners ( (￥) 185 136) and 1.5％ ( (￥)241 429) for the general population.Conclusion The local funds for HIV/AIDS in this county was insufficient.The local government should increase corresponding funds based on central government funding.Care and treatment was the first spending priorityin the county and the investment of prevention services needs to be increased.Prevention and treatment and care should be combined to ensure the effectiveness of comprehensive prevention and treatment of AIDS.%目的 应用国家艾滋病支出评估( NASA)方法对我国云南省德宏州某县2010年艾滋病经费实际支出情况进行评估.方法 2011年10-12月,在优化的NASA方法分类基础上,编制统一的NASA调查问卷,由德宏州某县经过严格培训的8所经费使用机构财务负责人和业务负责人(共16名)共同填写问卷.数据录入采用RTS V 2009.3.0软件,利用SPSS 13.0对NASA数据进行描述性统计分析.结果 该县2010年艾滋病防治经费总量为16 235 954元.艾滋病筹资来源主要为政府财政投入(15 630 937元),占96.3％；其次为全球基金项目投入(484 585元),占3.0％；再次为自筹经费(120 432元),占0.7％.该县艾滋病经费支出的活动领域有4个,用于治疗与关怀领域的支出最多(12 401 382元),占76.4％,其次为预防干预领域(2 325 707元),占14.3％,再次为项目管理(1 268 523元),占7.8％,人力资源领域最少(240 342元),占1.5％.该县艾滋病经费的受益人群主要为HIV感染者和艾滋病患者(13 753 428元),占84.7％；其次为高危人群(775 612元),包括暗娼人群(FSW)及其性伴(297 333元)、注射吸毒人群(IDU)及其性伴(293 143元)和男男同性性行为人群( MSM)及其性伴(185 136元),占4.8％；一般人群(241 429元)占1.5％.结论 地方财政对该县的艾滋病经费支持较少,建议地方政府在中央财政的基础上,持续加大配套经费的投入.该县将绝大部分经费用在了治疗和关怀领域,建议当地政府适当增加预防服务的投入,并将预防、治疗和关怀有效结合,保证艾滋病综合防治效果.