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HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

Abstract：

:Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems.

journal_name

Reprod Health Matters

journal_title

Reproductive health matters

authors

Windisch R,de Savigny D,Onadja G,Somda A,Wyss K,Sié A,Kouyaté B

doi

10.1016/S0968-8080(11)38587-4

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

163-75

issue

38

eissn

0968-8080

issn

1460-9576

pii

S0968-8080(11)38587-4

journal_volume

19

pub_type

杂志文章

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