Spending Assessment In AIDS Response At A District In Hubei Province

Background:According to the information provided in UNAIDS report on the Global AIDS epidemic2010, number of new HIV infections and HIV-related deaths were presenting in a declined trend. This contributed to the increased resources in Global AIDS response which leading the reduction of risk behavior and increased number of under-ART. In spite of many resources invested, there is still a gap between resources need and resources available. Explore the actual spending in current AIDS response can help to mobilize, allocate and use limited resources reasonably in the future and acquire more benefits with less cost invested. National AIDS Spending Assessment(NASA) was developed by UNAIDS in2006, providing a method to measure and track the actual expenditure in AIDS response.Objective:Explore a district’s2010actual spending in AIDS response, provide information for the future’s plan making and resources allocation in this district.1) To analyze the financing sources and allocation of this district in2010AIDS response2) To analyze the actual expenditures in different activities of this district in2010AIDS response3) To analyze the actual spending on production factor and beneficiary population of this district in2010AIDS response4) To provide information for the establishment of AIDS spending assessment in our country.Method: A district in Hubei was selected as the site of this study. Cross-sectional and qualitative method was used to investigate all the institutions that managed or spent the money from central government, local government and international donors. Acquire the information about the work plan making, resources allocation, use and activities carried out in2010AIDS response in this district through consulting materials and interview key persons. Collect the data about the money on production factor and beneficiary population in each activity according to the information acquired above. Three ways to calculate the expenditure:1) For the activities supported by central and local government, acquire the information about the unit cost of one production factor and workload of each activity each provider finished in2010. Thus, the actual spending of each activity=E (unit cost of each production factor*workload finished)2) For the activities supported by Global Fund, consulted materials which recorded the activities carried out in2010combined with consulting the Global Fund account in financial department to acquire the actual spending in each activity3) For the activities that we can acquire the total expenditure but can’t divide it in different production factor, measure the proportion of each production factor to acquire the actual spending.Data collected above were input into the Excel. Database was established. Analyzethe data with Pivot Table after being sorted.Results:1. There were4financing sources which were central government, provincial government, local government and Global Fund, respectively, in this district in their AIDS response in2010. Total amount of the spending in2010was598092RMB.2. There were2financing agents which were Bureau of Public Health and CDC, respectively, in this district in2010.3. There were5categories with15providers in this district, which were CDC, Maternity and Child Health Hospital, Population and Family Planning Commission, hospital and11community hospitals.4. Expenditure on prevention had the largest proportion at54.31%among total expenditure. Money from different sources had different spending proportions in different activities. There was difference between budget and actual spending. 5. The top expenditure term of all production factors was materials, at37.32%. Followed by human resources at24.03%, others were equipment, ARV, reagent, spending on gas, meetings etc.6. Among beneficiary populations, CSWs represented the largest expenditure category, accounting for30.03%. Followed by mobile population, at29.39%. others were general population, patients, pregnant women, PLHTV and others.Conclusion:1. From financing source perspective, mobilization pattern need to be improved further, institutions at every level should strengthen their ability on mobilization.2. From financing agent perspective, FA should strengthen their conscious on the importance of making budget and ability on making budget. FA should also value the importance of multi-sector and NGO in AIDS response and provide them necessary financial support.3. From provider perspective, inaccurate investment in certain activities, relatively lower ability of providing services, low conscious of materials preserve, heavy work load on CDC, such those problems above need to be improved.4. Production factor and beneficiary population kept accordance with local AIDS epidemic5. NASA method was used in this study for measuring the actual spending in a district. Expected output was achieved. The principle of NASA fit for AIDS response in our country. It is feasible for edited NASA method being carried out in China.