NASA REPORT 2019
Uganda has been affected by the HIV and AIDS epidemic since 1980’s. The HIV prevalence is still high at 6.2% (UPHIA 2017). A lot of efforts have been put in the response to reduce the HIV/AIDS prevalence from the previous higher levels, but more resources are still needed to achieve the 2030 targets of having HIV and AIDS as no longer a public health threat. This needs concerted funding, planning and coordination of efforts from different stakeholders. This National AIDS Spending Assessment (NASA) applied the Joint United Nations Programme on HIV and AIDS (UNAIDS) internationally developed resource tracking methodology that set out to inform stakeholders about the funders of HIV and AIDS activities, the amount of resources available, how much was spent on HIV activities, decision makers involved in the allocation of HIV resources, HIV activities funded, implementers of such activities and the populations who benefited from the HIV goods and services provided. The resource tracking methodology followed the money from the source up to the beneficiaries receiving goods and services. Findings from this study will be used for resource mobilization, planning, resource allocation and management of the national HIV response. Another benefit expected of this NASA was to assess whether the implementation of HIV activities is aligned to the HIV and AIDS National Strategic Plan for the country. This is the second NASA conducted in Uganda after the first one which happened in 2012 that considered financial years 2008/09 and 2009/10. This second NASA was conducted in 2018 and considered financial years 2014/15, 2015/16 and 2016/17. The methodology applied in the first NASA was slightly different from the approach used in the second NASA. While data collection was done from all perspectives i.e. from sources, agents and providers of services and triangulation done from different stakeholders to avoid double counting in the first NASA, this second NASA majorly collected data from the national level (sources of funds) and from a few providers with triangulation done to avoid double counting. Where a source mentioned a provider as recipient of their funds and we had all details from the source, the data from the provider was excluded to avoid double counting. In the first NASA, funding from all sectors such as public, private and external was considered. For instance, a proportion of business entities were sampled and the data was extrapolated to cover all business entities. Out of pocket expenditure was calculated using expert opinion on per capita in-patient and outpatient department utilization. Attribution factor index for HIV and AIDS spending was estimated as well as cost factors. Since these estimations used secondary data, certain spending e.g. on nutrition, psychosocial support and burial costs were excluded. Data was collected using hard copies of the questionnaire or in excel formats used by funders and the data coded to the NASA categorization. The second step involved data entry into the Data Processing (DP) sheets for processing, coding and cleaning before it was Executive Summary x Report of National AIDS Spending Assessment Study for Financial Years 2014/15, 2015/16 and 2016/17 transferred to the Resource Tracking Tool (RTT) system, integrated and analyzed. The RTT could give some analysis on a yearly basis but for comparison of findings across the three years, data was exported into excel from which all the graphs and tables for the 3 years were generated. The preliminary findings presented in this report are mainly from the public sector, external funds and sampled Private Not For Profit organizations. This study did not include Private For Profit businesses, workplace programmes and out of pocket expenditures. A separate comprehensive study for the Private for Profit and out of pocket expenditures will be conducted.