Getting resources to those who need them: the evidence we need to budget for underserved populations in sub-Saharan Africa.
Getting resources to those who need them: the evidence we need to budget for underserved populations in sub-Saharan Africa.
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DOI：
10.1002/jia2.25707
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发表时间：
2021-07
影响因子：
6
通讯作者：
Meyer-Rath G
中科院分区：
文献类型：
--
作者：
Long LC;Rosen S;Nichols B;Larson BA;Ndlovu N;Meyer-Rath G
近年来，许多国家采用了循证预算（EBB），以鼓励最佳利用有限且不断减少的艾滋病毒资源。由于缺乏针对难以接触、边缘化和脆弱人群的数据和证据，EBB可能会使那些已经得不到充分服务和艾滋病毒负担过重的人群进一步处于不利地位（USDB）。我们概述了在撒哈拉以南非洲（SSA）普遍流行病的背景下使用EBB支持USDB人员所需的关键数据。要在EB B周期中加以考虑，一项干预措施至少需要对以下方面作出估计：a）平均成本，通常是干预措施的每个接受者的平均成本; B）干预措施的有效性;以及c）干预措施目标人口的规模。通常用于一般人群的方法不足以生成USDB人群的有效估计值。USDB人群可能需要额外的资源来了解、访问和/或成功参与干预，从而增加了每个接受者的成本。USDB人群可能会经历与一般人群不同的健康结果和/或其他益处，从而影响干预措施的有效性。最后，美银的人口规模估计对于准确的方案编制至关重要，但由于撒南非洲国家几乎没有国家估计数，因此很难获得。我们解释这些限制，并提出解决这些问题的建议。EBB是实现资源有效分配的有力工具，但在SSA中，可能缺乏USDB人群所需的证据。与其将USDB人口排除在预算过程之外，不如更多地投资于了解这些人口的需求。
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). 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. 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.
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影响因子：
1.7
作者：
Bekker, Linda-Gail;Rebe, Kevin;Eakles, Robyn
通讯作者：
Eakles, Robyn
影响因子：
4.4
作者：
Konstant, Tracey L.;Rangasami, Jerushah;Nogoduka, Coceka
通讯作者：
Nogoduka, Coceka
DOI：
10.1097/ede.0000000000000906
发表时间：
2018-11
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Edwards JK;Hileman S;Donastorg Y;Zadrozny S;Baral S;Hargreaves JR;Fearon E;Zhao J;Datta A;Weir SS
通讯作者：
Weir SS
影响因子：
3.3
作者：
Lamontagne, Erik;Over, Mead;Stover, John
通讯作者：
Stover, John
影响因子：
168.9
作者：
Bekker, Linda-Gail;Johnson, Leigh;Cates, Willard, Jr.
通讯作者：
Cates, Willard, Jr.