school of public health an d community medicine
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School of Public Health an d Community Medicine . Analysis of political governance as a determinant of ART coverage using country level data. Man, W.Y.N. 1 , Worth, H 1 . Kelly, A. 2 , Wilson, D. 3 & Siba, P. 2 , - PowerPoint PPT PresentationTRANSCRIPT
School of Public Health an d Community Medicine
Analysis of political governance as a determinant of ART
coverage using country level data
Man, W.Y.N. 1, Worth, H1. Kelly, A. 2, Wilson, D. 3 & Siba, P. 2,
1 International HIV Research Group, University of New South Wales, Sydney, Australia
2 Papua New Guinea Institute of Medical Research, Papua New Guinea
3 Kirby Institute, University of New South Wales, Australia
Rationale and Method• Considerable interest arisen in the role of governance
or political commitment in determining success or failure of HIV/AIDS policies and programs, including roll-out of ART
• Aim of this project was to investigate governance as a determinant of ART roll-out in PNG (using country-level data) but grew bigger than that
• Collection of (low to middle income) country-level data on:• Health burden and resources; socio-demography;
economy; development; equality• HIV prevalence; ART coverage (from UNAIDS/WHO
databases, UNGASS reports)• Indicators of political governance (World Bank)- political
voice and accountability; political stability; control of corruption; government effectiveness; rule of law; regulatory quality; democracy scores (Polity IV Project)
• Study funded by the PNG AIDS Council
Statistical Model/Analysis/Results• Outcome variables: ART coverage 2009 as % persons
needing it (UNGASS Indicator 4)• Baseline multi-level model for univariate analyses of each
potential predictor of ART coverage. Variables with p<0.10 tested in multivariate multi-level model, and again in final model.
Results show:• Countries with higher levels of voice, accountability, lower
regulatory quality, more political stability, better control of corruption have higher levels of ART coverage
• Control of corruption strongly associated with ART coverage • Indicators of economic development dropped out when
control of corruption was included in multivariate regression model
• Somalia, Myanmar, DR Congo, Chad, PNG,and Angola (with high levels of corruption) had relatively poor ART coverage
• Countries with better control of corruption (e.g. Chile, Uruguay and Botswana) had relatively better ART coverage
Predictors of percentage of ART coverage (logit-transformed; based on UNAIDS estimates; N=678).
a Rescaled so that the plausible range is from 0 to10 (original plausible range was from 0 to 1). b χ2 statistic is estimated from (F statistic)X(numerator degrees of freedom).