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PROVINCIAL COUNCIL ON AIDS MEETING 25 AUGUST 2010

PROVINCIAL COUNCIL ON AIDS MEETING 25 AUGUST 2010. KZN HIV and AIDS Spending Assessment: Preliminary Findings Presented by Dr F. Ndlovu OFFICE OF THE PREMIER. Outline. Methodology Total HIV and AIDS spending in KZN (public, external & private but business limited) Sources Agents

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PROVINCIAL COUNCIL ON AIDS MEETING 25 AUGUST 2010

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  1. PROVINCIAL COUNCIL ON AIDS MEETING25 AUGUST 2010 KZN HIV and AIDS Spending Assessment: Preliminary FindingsPresented by Dr F. NdlovuOFFICE OF THE PREMIER .

  2. Outline • Methodology • Total HIV and AIDS spending in KZN (public, external & private but business limited) • Sources • Agents • Activities • Providers • Beneficiaries • DOH spending on HIV and AIDS • DOH voted funds for HIV and AIDS • DOH CG for HIV and AIDS

  3. Objectives of NASA in KZN • To identify all the sources of financing for HIV and AIDS and TB in KZN, for the years 2007/08 and 2008/09. • To measure all the public, external and private financial resources allocated/ committed and spent for HIV and AIDS and TB activities in KZN, for the years 2007/08 and 2008/09. • To identify the providers of the HIV and AIDS and TB services in KZN, for the years 2007/08 and 2008/09. • To identify the activities on which the funds were spent, according to the NASA classifications and the PSP priorities, for the years 2007/08 and 2008/09. • To identify the beneficiaries of the spending on HIV and AIDS and TB activities in KZN, for the years 2007/08 and 2008/09. • To make recommendations for the improved targeting of funds and efficiency of spending, according to the provincial priorities.

  4. Methodology • Aimed to include data from all sources, from all agents and from sampled service providers. • All DOH & PPSD& NHLS expenditure by activity and service provider – from BAS records • Verified with small sample of clinics / hospitals / pharmacists / NGOs receiving DOH and /or DSD grants • DOE – provided detailed expenditure of lifeskills CG • DSD – did not provide BAS expenditure, so had to use the audited expenditure amounts from budget documents and split between OVC, HBC, M&E, planning & coord, training, social services – excludes the payments made on grants (national level analysis).

  5. Methodology cont. • Other govt departments were interviewed: agriculture, OP, treasury – they were unable to provide any HIV-specific spending. • Public wellness programme - there was no HIV-specific spending in the study years, they are creating it currently. • External sources – data obtained from EU, GF & donors to DOH only. • Missing all other external partners since they indicated that their expenditure would be obtained from Head Offices. • Missing private medical aid & insurances indicated that their expenditure would be obtained from Head Offices. • Missing: spending of most municipalities, mortuaries & C. Sections.

  6. Methodology cont. • Business sector – only DCC & SABCOAH & McCarthy provided data, many did not respond and some indicated that their Head Offices would have to provide the data. • NGOs: were sampled from 911 database – many were not contactable, and eventually only about 60 provided data. • Research institutions – contacted: MRC, HSRC, HST, HEARD, HIVAN, RHRU, PASCA, McCord Hospt, Nelson Mandela Med.School – only got data from MRC & HEARD. • To be collected at national level – blood safety, condoms (the numbers of condoms distributed were not obtained from HAST so could not be estimated), correctional health services, private medical insurances, businesses & external funders. DRAFT - DO NOT DISSEMINATE.

  7. Methodology cont • Data collection through interviews & expenditure record verification. • Data triangulation to ensure correct actual expenditure. • Also avoided double counting through triangulation & creating transactions. • Data cleaned and captured in Excel. • Exported to NASA RTS where aggregated and matrices produced. • All analysis & graphs generated in excel.

  8. Total Spending on HIV and AIDS in KZN All public, external & some private (business limited)

  9. Total Funding & Sources for HIV and AIDS in KZN DRAFT - DO NOT DISSEMINATE.

  10. Sources of all HIV spending in KZN – further disaggregated 2007/08 & 2008/09

  11. Funding Levels & Sources in the SADC Region and 1 West African Country Source Data: individual Country NASA reports, complied by Guthrie, 2009.

  12. Comparison with Spending in SADC Source Data: individual Country NASA reports, complied by Guthrie, 2009.

  13. Multilateral AID for HIV and AIDS in KZN 2007/08 & 2008/09

  14. Bilateral AID For HIV and AIDS in KZN 2007/08 & 2008/09

  15. External Foundation AID for HIV and AIDS in KZN 2007/08 & 2008/09

  16. Agents of Spending • The managers of funds – receive and send on to providers. • Decide programmatic spending. • Eg. GF – CCM assumed principal recipient is the agent • But for EU funds, EU is the agent DRAFT - DO NOT DISSEMINATE.

  17. Financing Agents of HIV spending 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.

  18. Public sources by Agents for HIV and AIDS spending 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.

  19. External Sources by Agents for HIV spending in KZN 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.

  20. HIV and AIDS Spending Activities • NASA classifications: • Prevention • Treatment and care • OVCs • Policy, management and coordination • Human Resources • Social services & Protection • Enabling environment • Research • Each have several sub-components

  21. Total KZN HIV and AIDS Spending Activities

  22. Comparison with Activities in SADC

  23. Public Spending Activities

  24. Private Spending Activities

  25. External Spending Activities

  26. Prevention Activities

  27. Treatment Activities DRAFT - DO NOT DISSEMINATE.

  28. OVC Spending DRAFT - DO NOT DISSEMINATE.

  29. Programme Management etc. DRAFT - DO NOT DISSEMINATE.

  30. HIV and AIDS Service Providers – 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.

  31. Beneficiaries of Total HIV and AIDS Spending DRAFT - DO NOT DISSEMINATE.

  32. Beneficiaries of HIV and AIDS Services 2007/08 DRAFT - DO NOT DISSEMINATE.

  33. Beneficiaries by Activity (2008/09) DRAFT - DO NOT DISSEMINATE.

  34. MARP Spending MARPS in KZN (2007/08)

  35. OVCs & Vulnerable Groups

  36. Access.Pops. 2008/09 2007/08

  37. DOH HIV and AIDS Spending in KZN

  38. DOH Comprehensive Conditional Grant for HIV and AIDS DRAFT - DO NOT DISSEMINATE.

  39. Total DOH ES & CG for HIV and AIDS (2007/08-2009/10)

  40. DOH Absorption of ES & CG Funds (07/08) DRAFT - DO NOT DISSEMINATE.

  41. DOH Absorption of ES & CG Funds (2008/09) DRAFT - DO NOT DISSEMINATE.

  42. DOH Absorption of ES & CG Funds (2009/10) DRAFT - DO NOT DISSEMINATE.

  43. KZN DOH CG Spending by Activity 2007/08 & 08/09 DRAFT - DO NOT DISSEMINATE.

  44. KZN DOH Spending on ART (2007/09 – 2009/10)

  45. DOH Programme Costs in ART Delivery

  46. Public ART Unit Costs in KZN DRAFT - DO NOT DISSEMINATE.

  47. KZN DOH Voted Funds for HIV and AIDS DRAFT - DO NOT DISSEMINATE.

  48. KZN Total Voted Funds by Activity, 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.

  49. KZN Voted Funds Service Provider (2008/09) DRAFT - DO NOT DISSEMINATE.

  50. KZN District Service Delivery Voted Funds for HIV and AIDS (%) (2007/08-2008/09) DRAFT - DO NOT DISSEMINATE.

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