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Grépin, Karen 2012. IV Donor Funding Has Both Boosted And Curbed The Delivery Of Different Non-HIV Health Services In Sub-Saharan Africa. Health Affairs July 2012 31:1406-1414.
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.
Objectives: To investigate trends in official development assistance for health, HIV and non-HIV activities over time and to discuss the efficiency implications of these trends in the context of achieving universal access to treatment and health systems.
Grépin, Karen A, Leach-Kemon, Katherine , Schneider, Matthew, Sridhar, Devi. 2011. How to do (or not to do) ... Tracking data on development assistance for health. Health Policy Plan. (2011)doi: 10.1093/heapol/czr076First published online: December 8, 2011.
Development assistance for health (DAH) has increased substantially in recent years and is seen as important to the improvement of health and health systems in developing countries. As a result, there has been increasing interest in tracking and understanding these resource flows from the global health community. A number of datasets, each with its own strengths and weaknesses, are available to track DAH. In this article we review the available datasets on DAH and summarize the strengths and weaknesses of each of these datasets to help researchers make the best choice of which to use to inform their analysis. Finally, we also provide recommendations about how each of these datasets could be improved.
Kishore, S.P. et al. 2011. Youth Manifesto on Non-Communicable Diseases. Global Heart, 6(4): 201-210.
Grépin, Karen. 2011. Leveraging HIV Programs to Deliver an Integrated Package of Health Services: Some Words of Caution.
JAIDS Journal of Acquired Immune Deficiency Syndromes:
1 August 2011 - Volume 57 - Issue - pp S77-S79
Over the past decade, HIV programs have been successfully scaled up in many developing countries, leading some to wonder how the investments made into HIV infrastructure could be leveraged to deliver additional health services. Although the concept is appealing from many perspectives, integrating additional health services into existing vertical HIV infrastructure may not mitigate some of the challenges these programs have introduced in implementing countries. In addition, this approach to integration may countervail parallel efforts of the global health community to strengthen health systems and improve aid effectiveness. It might also undermine the HIV programs themselves. International donors and health system planners should carefully consider whether the benefits outweigh the potential costs of these well-intentioned integration efforts.
Whether newer pharmaceuticals justify their higher costs by reducing other health expenditures has generated significant debate. We replicate a frequently cited paper by Lichtenberg on drug “offsets” and find the results disappear using a more appropriate model or updated dataset. Further, we test the suitability of similar methods using newer hypertension drugs. We find our observational results run counter to well-established clinical evidence on comparative efficacy and conclude that our model, as well as other studies that do not adequately control for unobserved characteristics that jointly determine drug choice and health expenditures, are likely subject to significant bias.
Savedoff, W. & Grépin, K.A. 2009. Chapter 3: Assessing Health Sector Corruption in Ethiopia.
In Assessing Corruption in Ethiopia, forthcoming from the World Bank (ed. Janelle Plummer)
Grépin, K.A. & Reich, MR. 2008. Conceptualizing Integration: A framework for analysis applied to neglected tropical disease control programs. PLoS Neglected Tropical Diseases, 2(4): e174.
Hodgkin, C, Abiose, A, Philippon, B, Reich, M, Remme, HJ, Thylefors, B, Traoré, M, Grépin, K. 2007. The Future of Onchocerciasis Control in Africa. PLoS Neglected Tropical Diseases, 1(1): e74.
Berndt, E.R., Cockburn, I.M. & Grépin, K.A. 2006. The Impact of Incremental Innovation in Biopharmaceuticals: Drug Utilization in Original and Supplemental Indications. Pharmacoeonomics, 24 (supp 2): 69-86.
Stabinski L., Pelley(Grepin), K., Jacob, S.T., Long, J.M. & Leaning, J. 2003. Reframing HIV/AIDS. British Medical Journal, 327(7423): 1101-3.