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Content archived on 2024-05-29

Effects of Antiretrovirals for HIV on African health systems, Maternal and Child health (ARVMAC)

Objective

Increasing access to antiretroviral treatment (ART) in resource-poor settings is an obvious emergency but scale-up of ART poses serious challenges to the overall health system s functioning. The response of the system to these challenges may jeopardize or strengthen its response to other health priorities and will affect the feasibility of MDG 4 and 5 in Sub-Saharan Africa (SSA). HIV is inherently linked to child survival, gender inequities and reproductive health. It increases infant and child mortality wi th up to 40%. Women are 4-25 times more vulnerable to HIV transmission, on average 10 years younger than men when infected and make up the majority of people living with HIV in SSA. Donor investment in vertical ART programs equals a doubling of the current health budget in some SSA countries, thus, access is no longer constrained by drug costs. Low absorption capacity, lack of infrastructure and human resources are the major challenges to implementing the WHO 3 by 5 . Using Tanzania as an example, a redist ribution of 35-70% of the health workforce is required to increase the number on ART from 8,000 to 220,000 in 2005. Lack of integration of ART with antenatal care limits access to prevention of mother-to child transmission. Pooling of staff to ART undermin es the quality of basic care (ANC, IMCI) and reduces access to 2nd level care (e.g. caesarean section) risking to increase child and maternal mortality. How to absorb ART funds, prioritize among different types of care, correctly distribute, monitor and su stain ART in fragile health systems with weak resource allocation capacity, without harming the most vulnerable needs to be solved. We will study health policy, health services and maternal and child health consequences of ART scale-up in population-based settings with existing infrastructures for registration of vital events and diseases; 3 demographic surveillance sites in 3 different SSA countries, using both quantitative and qualitative research methods.

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Topic(s)

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Call for proposal

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FP6-2004-INCO-DEV-3
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Funding Scheme

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STREP - Specific Targeted Research Project

Coordinator

KAROLINSKA INSTITUTET
EU contribution
No data
Total cost

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No data

Participants (6)

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