Application of the National Health Accounts Framework to HIV/AIDS in Rwanda. Special Initiatives Report No. 31

摘要

This paper describes how a National Health Accounts exercise on HIV/AIDS in Rwanda was designed and implemented, what data was captured, and how HIV/AIDS-specific expenditures were determined. The findings regarding expenditures on HIV in Rwanda are both critical and informative, and the process by which data was gathered is also significant. This documentation of the process, challenges, shortcomings, and successes of HIV/AIDS funding in Rwanda will be useful for others seeking to replicate the study elsewhere. The comparison of HIV/AIDS-related costs (prevention, treatment, and mitigation) within overall health expenditures reveals that AIDS prevention is primarily financed by donor funds, whereas treatment costs place the heaviest financial burden on households. This is because no financial support system exists to facilitate patients access to care. Thus, the patients socioeconomic background and ability to pay user fees define access to treatment of HIV/AIDS-related diseases. Based on this analysis, the report makes recommendations for policies to improve the financial information process, the sustainability and affordability of health care, and the equity of access to health care in the Rwandan health sector in general and in the HIV/AIDS sector in particular.