The HIV/AIDS pandemic has dealt a body blow to the delivery of health care services in countries hard hit by the disease, new research has found.
The National Bureau of Economic Research at Princeton University in the United States compared data from national Demographic and Health Surveys (DHS) in 14 sub-Saharan African countries – eight in relatively low-prevalence west African countries and the remainder in higher-prevalence east and southern African countries.
Data on antenatal care, birth deliveries and rates of immunization for children born between 1988 and 2005 revealed that in countries with a high HIV/AIDS burden, health care for mothers and children started deteriorating in the mid-1990s and kept declining as HIV prevalence rose.
In 2005, women who attended antenatal clinics in east and southern Africa received significantly fewer diagnostic tests than 10 years earlier, and those who delivered at a health facility were much less likely to be attended by a trained health care professional.
The researchers calculated that where HIV prevalence increased by 10 percent between 1995 and 2005, a woman's likelihood of having her blood pressure taken when visiting an antenatal facility decreased by 21 percent, while the probability of a trained attendant being present when she gave birth fell by 14 percent.
Similarly, as regions with low HIV prevalence were vaccinating more children against polio shortly after birth, children in high-prevalence regions were increasingly less likely to be vaccinated.
The authors suggest that non-HIV health services deteriorated in high-prevalence regions because the pandemic reduced the number of trained health personnel, and shifted health budgets and other resources towards caring for HIV patients.
Data revealing the effects of significant increases in foreign aid earmarked for HIV/AIDS and the expansion of antiretroviral (ARV) treatment in recent years are not yet available, but the authors note that: "Women and children in sub-Saharan Africa cannot wait for another round of DHS surveys to come online – we must find alternative ways to investigate the roots of this erosion in services."