The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys
The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys
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DOI：
10.1007/s13524-011-0026-3
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发表时间：
2011-05-01
期刊：
影响因子：
3.5
通讯作者：
Paxson, Christina
中科院分区：
文献类型：
--
作者：
Case, Anne;Paxson, Christina
我们记录了艾滋病危机对撒哈拉以南非洲14个国家与艾滋病无关的卫生服务的影响。利用每个国家的多波人口与健康调查(DHS)，我们检查了1988年至2005年出生的儿童的产前护理、分娩和免疫接种率。我们发现，在这段时间里，几乎所有这些方面的医疗保健都在恶化。国土安全部对每个国家的最新调查收集了艾滋病毒流行率的数据，这使我们能够检查艾滋病毒负担和医疗保健之间的联系。我们发现，在艾滋病毒感染率最高的地区，卫生服务的侵蚀最严重。使用上述措施，艾滋病负担较轻的国家区域的保健下降幅度很小或没有下降，而负担最重的区域对孕妇和儿童的非艾滋病毒相关保健服务的侵蚀最大。使用半参数技术，我们可以确定从20世纪90年代中期开始，在产前护理和儿童免疫接种方面，艾滋病毒高和低地区之间的差异开始出现。
We document the impact of the AIDS crisis on non-AIDS-related health services in 14 sub-Saharan African countries. Using multiple waves of Demographic and Health Surveys (DHS) for each country, we examine antenatal care, birth deliveries, and rates of immunization for children born between 1988 and 2005. We find deterioration in nearly all these dimensions of health care over this period. The most recent DHS survey for each country collected data on HIV prevalence, which allows us to examine the association between HIV burden and health care. We find that erosion of health services is the largest in regions that have developed the highest rates of HIV. Regions of countries that have light AIDS burdens have witnessed small or no declines in health care, using the measures noted above, while those regions shouldering the heaviest burdens have seen the largest erosion in non-HIV-related health services for pregnant women and children. Using semiparametric techniques, we can date the beginning of the divergence in the use of antenatal care and in children's immunizations between high- and low-HIV regions to the mid-1990s.