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PROVINCIAL COUNCIL ON AIDS MEETING 25 AUGUST 2010. KZN HIV and AIDS Spending Assessment: Preliminary Findings Presented by Dr F. Ndlovu OFFICE OF THE PREMIER. Outline. Methodology Total HIV and AIDS spending in KZN (public, external & private but business limited) Sources Agents
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PROVINCIAL COUNCIL ON AIDS MEETING25 AUGUST 2010 KZN HIV and AIDS Spending Assessment: Preliminary FindingsPresented by Dr F. NdlovuOFFICE OF THE PREMIER .
Outline • Methodology • Total HIV and AIDS spending in KZN (public, external & private but business limited) • Sources • Agents • Activities • Providers • Beneficiaries • DOH spending on HIV and AIDS • DOH voted funds for HIV and AIDS • DOH CG for HIV and AIDS
Objectives of NASA in KZN • To identify all the sources of financing for HIV and AIDS and TB in KZN, for the years 2007/08 and 2008/09. • To measure all the public, external and private financial resources allocated/ committed and spent for HIV and AIDS and TB activities in KZN, for the years 2007/08 and 2008/09. • To identify the providers of the HIV and AIDS and TB services in KZN, for the years 2007/08 and 2008/09. • To identify the activities on which the funds were spent, according to the NASA classifications and the PSP priorities, for the years 2007/08 and 2008/09. • To identify the beneficiaries of the spending on HIV and AIDS and TB activities in KZN, for the years 2007/08 and 2008/09. • To make recommendations for the improved targeting of funds and efficiency of spending, according to the provincial priorities.
Methodology • Aimed to include data from all sources, from all agents and from sampled service providers. • All DOH & PPSD& NHLS expenditure by activity and service provider – from BAS records • Verified with small sample of clinics / hospitals / pharmacists / NGOs receiving DOH and /or DSD grants • DOE – provided detailed expenditure of lifeskills CG • DSD – did not provide BAS expenditure, so had to use the audited expenditure amounts from budget documents and split between OVC, HBC, M&E, planning & coord, training, social services – excludes the payments made on grants (national level analysis).
Methodology cont. • Other govt departments were interviewed: agriculture, OP, treasury – they were unable to provide any HIV-specific spending. • Public wellness programme - there was no HIV-specific spending in the study years, they are creating it currently. • External sources – data obtained from EU, GF & donors to DOH only. • Missing all other external partners since they indicated that their expenditure would be obtained from Head Offices. • Missing private medical aid & insurances indicated that their expenditure would be obtained from Head Offices. • Missing: spending of most municipalities, mortuaries & C. Sections.
Methodology cont. • Business sector – only DCC & SABCOAH & McCarthy provided data, many did not respond and some indicated that their Head Offices would have to provide the data. • NGOs: were sampled from 911 database – many were not contactable, and eventually only about 60 provided data. • Research institutions – contacted: MRC, HSRC, HST, HEARD, HIVAN, RHRU, PASCA, McCord Hospt, Nelson Mandela Med.School – only got data from MRC & HEARD. • To be collected at national level – blood safety, condoms (the numbers of condoms distributed were not obtained from HAST so could not be estimated), correctional health services, private medical insurances, businesses & external funders. DRAFT - DO NOT DISSEMINATE.
Methodology cont • Data collection through interviews & expenditure record verification. • Data triangulation to ensure correct actual expenditure. • Also avoided double counting through triangulation & creating transactions. • Data cleaned and captured in Excel. • Exported to NASA RTS where aggregated and matrices produced. • All analysis & graphs generated in excel.
Total Spending on HIV and AIDS in KZN All public, external & some private (business limited)
Total Funding & Sources for HIV and AIDS in KZN DRAFT - DO NOT DISSEMINATE.
Sources of all HIV spending in KZN – further disaggregated 2007/08 & 2008/09
Funding Levels & Sources in the SADC Region and 1 West African Country Source Data: individual Country NASA reports, complied by Guthrie, 2009.
Comparison with Spending in SADC Source Data: individual Country NASA reports, complied by Guthrie, 2009.
External Foundation AID for HIV and AIDS in KZN 2007/08 & 2008/09
Agents of Spending • The managers of funds – receive and send on to providers. • Decide programmatic spending. • Eg. GF – CCM assumed principal recipient is the agent • But for EU funds, EU is the agent DRAFT - DO NOT DISSEMINATE.
Financing Agents of HIV spending 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.
Public sources by Agents for HIV and AIDS spending 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.
External Sources by Agents for HIV spending in KZN 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.
HIV and AIDS Spending Activities • NASA classifications: • Prevention • Treatment and care • OVCs • Policy, management and coordination • Human Resources • Social services & Protection • Enabling environment • Research • Each have several sub-components
Treatment Activities DRAFT - DO NOT DISSEMINATE.
OVC Spending DRAFT - DO NOT DISSEMINATE.
Programme Management etc. DRAFT - DO NOT DISSEMINATE.
HIV and AIDS Service Providers – 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.
Beneficiaries of Total HIV and AIDS Spending DRAFT - DO NOT DISSEMINATE.
Beneficiaries of HIV and AIDS Services 2007/08 DRAFT - DO NOT DISSEMINATE.
Beneficiaries by Activity (2008/09) DRAFT - DO NOT DISSEMINATE.
MARP Spending MARPS in KZN (2007/08)
Access.Pops. 2008/09 2007/08
DOH Comprehensive Conditional Grant for HIV and AIDS DRAFT - DO NOT DISSEMINATE.
DOH Absorption of ES & CG Funds (07/08) DRAFT - DO NOT DISSEMINATE.
DOH Absorption of ES & CG Funds (2008/09) DRAFT - DO NOT DISSEMINATE.
DOH Absorption of ES & CG Funds (2009/10) DRAFT - DO NOT DISSEMINATE.
KZN DOH CG Spending by Activity 2007/08 & 08/09 DRAFT - DO NOT DISSEMINATE.
Public ART Unit Costs in KZN DRAFT - DO NOT DISSEMINATE.
KZN DOH Voted Funds for HIV and AIDS DRAFT - DO NOT DISSEMINATE.
KZN Total Voted Funds by Activity, 2007/08 & 2008/09 DRAFT - DO NOT DISSEMINATE.
KZN Voted Funds Service Provider (2008/09) DRAFT - DO NOT DISSEMINATE.
KZN District Service Delivery Voted Funds for HIV and AIDS (%) (2007/08-2008/09) DRAFT - DO NOT DISSEMINATE.