Evaluation of PEPFAR's effects on Health Systems Strengthening in Sub Saharan Africa
Please find attached the above article entitled “An Evaluation of the President’s Emergency plan for AIDS Relief Effect on the Health systems strengthening in Sub-Saharan Africa”.
The study evaluates impact on proximal and distant indicators and how PEPFAR has these indicators. The study looks at the pre-PEPFAR period (1995-2002) and during PEPFAR (2004-2010) and compares PEPFAR focus countries with non focus countries during these 2 time periods. The following outcome indicators were measured:
1.TB incidence prevalence and mortality
2.IMR (infant mortality rate)
2.U5MR (under 5 mortality rate)
1.PEPFAR activities showed improvement in over HSS with improvements in both proximal and distal indicators.
2.TB: improvement in focus countries after PEPFAR more pronounced than in control countries
3.Case detection of TB higher in focus countries
4. Vaccination: focus countries showed significantly larger increase in vaccination rate after PEPFAR
5. IMR and U5MR: rates of decrease was greater pre-PEPFAR in focus countries and gap widened after PEPFAR- greater acceleration in # of infant and child deaths averted due to PEPFAR
1. Effect on IMR and U5MR not significant
2. Strong and consistent association between PEPFAR and improvements in TB indicators – PEPFAR activities had a strong impact on TB control.
3. No evidence that PEPFAR diverted resources from other public health activities but instead had a beneficial effect on overall health systems.