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Funding for HIV and AIDS

Explore the allocation and impact of funds for HIV/AIDS programs in South Africa, focusing on effectiveness, flow of resources, and service delivery efficiency through PETS and QSDS methodologies.

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Funding for HIV and AIDS

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  1. Assessment of Public Expenditures and Service Delivery for HIV and AIDS Programs using PETS and QSDSKwa-Zulu Natal, Province of South AfricaMarch 2, 2011

  2. Funding for HIV and AIDS • Public sector allocations for HIV and AIDS have doubled over the last 3 years (MTEF) • However, increased funding has not resulted in reduction in new infections • Concern that funds allocated for HIV and AIDS are not reaching intended beneficiaries and are not spent efficiently and effectively

  3. National AIDS Spending Assessment for KZN (January-March 2010) • Public funds were the main source of HIV/AIDS spending in 2007/08 and 2008/09 (approx. 84%) with the donor contribution approx. 14% • Funds skewed towards treatment activities, consuming 66% in 2008/09 • Prevention activities took up 37% and 30% of funding in 2007/08 and 2008/09, respectively

  4. Objectives of current study • Follow the flow of resources from the source (Treasury) to the final destination (core frontline service delivery facilities) • Assess the efficiency and effectiveness of public spending on HIV/AIDS programmes.

  5. Study methods: PETS PETS (Public Expenditure Tracking Survey) • Quantitative survey • Collects information on facility characteristics, financial flows, outputs (services delivered), accountability arrangements, etc • PETS will assist in determining whether funds allocated for HIV/AIDS programmes in KZN are being spent on the intended priorities (e.g. HIV/AIDS programmes and interventions) and on the intended beneficiaries.

  6. Study methods: QSDS QSDS (Quantitative Service Delivery Survey) • Used to investigate incentives to provider organizations including frontline service providers. • Examine the efficiency of public spending and incentives (for HIV/AIDS programmes) and various elements of service delivery by frontline providers.

  7. Key benefits of PETS-QSDS

  8. Key benefits of PETS-QSDS cont.

  9. Clustered objectives of the PETS-QSDS study • 1. Flow of funds • assess the efficiency of how funds flow from origin to destination • Do funds earmarked for HIV and AIDS reach the intended beneficiaries? • Are there delays in funds reaching frontline service delivery facilities? • To generate estimates of leakage (magnitude of funds redirected for unintended uses)

  10. Clustered objectives of the PETS-QSDS study • 2. Appropriate targeting • Do funds earmarked for HIV and AIDS target the right prevention priorities as defined in the NSP? • Do funds follow success? (interventions that have proven to work)?

  11. Clustered objectives of the PETS-QSDS study • 3. Efficiency and effectiveness of spending • assess the absorptive capacity of officials to spend allocated resources • To assess the variation in select qualitative variables between institutions and the incentives governing performance

  12. Sources of funding to be assessed • Comprehensive HIV and AIDS Conditional Grant • Provincial Top-up funding for the conditional grant • Department of Education • Department of Social Development • Department of Transport • Cross-cutting flagship programs • Municipal funding for HIV and AIDS • NB: Analysis of all these sources depends on appropriate data being available in a useable format

  13. Methodology This study requires an analysis of both resource tracking and service delivery quality related to cost efficiency.

  14. Capacity building and training • Structured workshops • Development of tools • Fieldwork 4. Ongoing mentoring 5. Dissemination

  15. Study timetable

  16. Task Team • Patrick Osewe Task Team Leader, AFTHE • RitvaReinkka Team Member, AFTHE • Julian Naidoo Senior Health Economist • Gert van derLinde Public Financial Management • Hannah Brown Senior Public Health and Communication Specialist • Survey Company Data Collection and Quantitative Analysis

  17. Recommendations • Concept note as requested in the last meeting has been presented today • PCA to guide on the selection of a task team to work with DPSA and World Bank to conduct the study • PCA to approve that the task should share experience with other provinces • Progress report will be reported during the next meeting

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