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Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa
INTRODUCTION: In recent years, many countries have adopted evidence‐based budgeting (EBB) to encourage the best use of limited and decreasing HIV resources. The lack of data and evidence for hard to reach, marginalized and vulnerable populations could cause EBB to further disadvantage those who are...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242975/ https://www.ncbi.nlm.nih.gov/pubmed/34189873 http://dx.doi.org/10.1002/jia2.25707 |
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author | Long, Lawrence C Rosen, Sydney Nichols, Brooke Larson, Bruce A Ndlovu, Nhlanhla Meyer‐Rath, Gesine |
author_facet | Long, Lawrence C Rosen, Sydney Nichols, Brooke Larson, Bruce A Ndlovu, Nhlanhla Meyer‐Rath, Gesine |
author_sort | Long, Lawrence C |
collection | PubMed |
description | INTRODUCTION: In recent years, many countries have adopted evidence‐based budgeting (EBB) to encourage the best use of limited and decreasing HIV resources. The lack of data and evidence for hard to reach, marginalized and vulnerable populations could cause EBB to further disadvantage those who are already underserved and who carry a disproportionate HIV burden (USDB). We outline the critical data required to use EBB to support USDB people in the context of the generalized epidemics of sub‐Saharan Africa (SSA). DISCUSSION: To be considered in an EBB cycle, an intervention needs at a minimum to have an estimate of a) the average cost, typically per recipient of the intervention; b) the effectiveness of the intervention and c) the size of the intervention target population. The methods commonly used for general populations are not sufficient for generating valid estimates for USDB populations. USDB populations may require additional resources to learn about, access, and/or successfully participate in an intervention, increasing the cost per recipient. USDB populations may experience different health outcomes and/or other benefits than in general populations, influencing the effectiveness of the interventions. Finally, USDB population size estimation is critical for accurate programming but is difficult to obtain with almost no national estimates for countries in SSA. We explain these limitations and make recommendations for addressing them. CONCLUSIONS: EBB is a strong tool to achieve efficient allocation of resources, but in SSA the evidence necessary for USDB populations may be lacking. Rather than excluding USDB populations from the budgeting process, more should be invested in understanding the needs of these populations. |
format | Online Article Text |
id | pubmed-8242975 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82429752021-07-02 Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa Long, Lawrence C Rosen, Sydney Nichols, Brooke Larson, Bruce A Ndlovu, Nhlanhla Meyer‐Rath, Gesine J Int AIDS Soc Supplement: Commentary INTRODUCTION: In recent years, many countries have adopted evidence‐based budgeting (EBB) to encourage the best use of limited and decreasing HIV resources. The lack of data and evidence for hard to reach, marginalized and vulnerable populations could cause EBB to further disadvantage those who are already underserved and who carry a disproportionate HIV burden (USDB). We outline the critical data required to use EBB to support USDB people in the context of the generalized epidemics of sub‐Saharan Africa (SSA). DISCUSSION: To be considered in an EBB cycle, an intervention needs at a minimum to have an estimate of a) the average cost, typically per recipient of the intervention; b) the effectiveness of the intervention and c) the size of the intervention target population. The methods commonly used for general populations are not sufficient for generating valid estimates for USDB populations. USDB populations may require additional resources to learn about, access, and/or successfully participate in an intervention, increasing the cost per recipient. USDB populations may experience different health outcomes and/or other benefits than in general populations, influencing the effectiveness of the interventions. Finally, USDB population size estimation is critical for accurate programming but is difficult to obtain with almost no national estimates for countries in SSA. We explain these limitations and make recommendations for addressing them. CONCLUSIONS: EBB is a strong tool to achieve efficient allocation of resources, but in SSA the evidence necessary for USDB populations may be lacking. Rather than excluding USDB populations from the budgeting process, more should be invested in understanding the needs of these populations. John Wiley and Sons Inc. 2021-06-30 /pmc/articles/PMC8242975/ /pubmed/34189873 http://dx.doi.org/10.1002/jia2.25707 Text en © 2021 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Supplement: Commentary Long, Lawrence C Rosen, Sydney Nichols, Brooke Larson, Bruce A Ndlovu, Nhlanhla Meyer‐Rath, Gesine Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa |
title | Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa |
title_full | Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa |
title_fullStr | Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa |
title_full_unstemmed | Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa |
title_short | Getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐Saharan Africa |
title_sort | getting resources to those who need them: the evidence we need to budget for underserved populations in sub‐saharan africa |
topic | Supplement: Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242975/ https://www.ncbi.nlm.nih.gov/pubmed/34189873 http://dx.doi.org/10.1002/jia2.25707 |
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