International Health
Volume 8 Issue 2 March 2016
http://inthealth.oxfordjournals.org/content/current

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Spillover effect of HIV-specific foreign aid on immunization services in Nigeria
Charles C. Chima* and Luisa Franzini
Author Affiliations
Division of Management, Policy and Community Health, The University of Texas School of Public Health, 1200 Pressler Street, Houston, Texas 77030, USA
*Corresponding author: Present address: Healthcare Transformation Initiatives, The University of Texas Health Science Center at Houston, 1200 Binz Street Houston TX 77004, USA; Tel: +1 832-231-4955; E-mail: chimacharles@gmail.com
Received December 13, 2014.
Revision received April 20, 2015.
Accepted April 20, 2015.
Abstract
Background
Health aid to Nigeria increased tremendously in the last decade and a significant portion of the funds were earmarked for HIV-associated programs. Studies on the impact of HIV-specific aid on the delivery of non-HIV health services in sub-Saharan Africa have yielded mixed results. This study assessed if there is a spillover effect of HIV-specific aid on childhood vaccinations in Nigeria.
Methods
Multivariate logistic regression models were used to estimate the effect of aid disbursements in a previous year on the receipt of vaccines at the individual level in a given year. Estimations were done for approximately 11 700 children using data from demographic and health surveys conducted in Nigeria in 2003 and 2008.
Results
US$1 increase in HIV aid per capita was associated with a decrease in the probability of receipt of vaccines by 8–31%: polio first dose decreased by 8%; polio final dose by 9%; diphtheria-pertussis-tetanus (DPT) first dose by 11%; DPT final dose by 19%; measles by 31%; final doses of polio and DPT plus measles vaccine by 8%.
Conclusions
HIV-specific aid had a negative spillover effect on immunization services in Nigeria over the study period. Donors may need to rethink their funding strategies in favour of more horizontal approaches.