Hierarchical Resource Allocation Procedures for HIV Prevention in Botswana

Abstract

In the 1980s the world was hit by the HIV/AIDS pandemic which continues to claim a lot of lives especially in Africa. While a lot has been done since its outbreak in an effort to have it under control the need for funding continues to grow especially in developing countries. Due to economic constraints, funds intended for HIV prevention in countries such as Botswana have declined. In turn, challenges of finding an efficient way to allocate funds optimally emerged. This study intends to first understand the dynamic of the infection of the disease in the population of Botswana. Furthermore to analyse two resource allocation techniques commonly used, these being the equity based model and the cost effectiveness analysis model, in comparison to a mathematical model called hierarchical optimization allocation method. Cost effectiveness is a type of economic analysis that assesses the cost and the outcome or benefit of a program. Another resource allocation model which is commonly used is the equity-based criteria where funds are proportionally allocated across states or districts in a country according to reported cases. Optimization is a technique where the best possible solution is chosen from the available or feasible set of solutions. The focus of this study is on the bi-level optimization where the decision to get the best possible solution passes through two levels. The number of new infections and HIV prevalence is used as a measure to compare the outcome of the investment. The results in the study reveal that bi-level optimization is the best criteria to use to allocate resources as it has proven to be more efficient in terms of reducing the HIV prevalence at a faster pace, it is also more cost effective as compared to equity and CEA allocation methods. It was therefore concluded that bi-level optimization is the recommended technique for allocating HIV prevention resources and funds.