HIV Donor Funding Has Both Boosted And Curbed The Delivery Of Different Non-HIV Health Services In Sub-Saharan Africa

Donor funding for HIV programs has increased rapidly over the past decade, raising questions about whether other health services in recipient-country health systems are being crowded out or strengthened. This article—an investigation of the impacts of increased HIV donor funding on non-HIV health services in sub-Saharan Africa during 2003–10—provides evidence of both effects. HIV aid in some countries has crowded out the delivery of childhood immunizations, especially in countries with the lowest density of health care providers. At the same time, HIV aid may have positively affected some maternal health services, such as prenatal blood testing. These mixed results suggest that donors should be more attentive to domestic resource constraints, such as limited numbers of health workers; should integrate more fully with existing health systems; and should address these constraints up front to limit possible negative effects on the delivery of other health services.