Is there an association between PEPFAR funding and improvement in national health indicators in Africa? A retrospective study

Table 2 Comparison of changes in health indicators in PEPFAR focus and non-focus countries

Health indicator	Fractional change from 2000 to 2006*				p value**
	PEPFAR focus countries†		Non-focus countries‡
Adult mortality rate	-0.029	(-0.111, 0.046)	0.002	(-0.058, 0.069)	0.348
Deaths due to TB, HIV negative	0.057	(-0.048, 0.178)	0.000	(-0.111, 0.146)	0.576
Deaths due to TB, HIV positive	-0.109	(-0.220, 0.236)	0.050	(-0.037, 0.333)	0.139
Incidence of TB	0.153	(-0.082, 0.156)	0.137	(0.012, 0.155)	0.920
Infant mortality rate	-0.079	(-0.139, 0.013)	-0.041	(-0.108, 0.000)	0.616
Life expectancy at birth	-0.021	(-0.048, 0.000)	-0.007	(-0.035, 0.019)	0.187
Neonates PAB against neonatal tetanus	-0.099	(-0.157, -0.037)	-0.328	(-0.486, -0.078)	0.011
One year olds immunized with MCV	-0.094	(-0.248, 0.000)	-0.157	(-0.490, 0.000)	0.507
One year olds immunized with 3 doses of DTP	-0.085	(-0.269, -0.042)	-0.173	(-0.578, -0.010)	0.460
Population with sustainable access to improved drinking water sources	-0.060	(-0.130, -0.017)	-0.022	(-0.111, 0.000)	0.367
Populations with sustainable access to improved sanitation	-0.053	(-0.092, -0.028)	-0.085	(-0.207, 0.000)	0.597
Prevalence of TB	0.064	(-0.066, 0.162)	0.038	(-0.079, 0.153)	0.851
TB detection rate under DOTS	-0.056	(-0.190, 0.072)	0.000	(-0.097, 0.000)	0.659
Under-5 mortality rate	-0.077	(-0.144, 0.017)	-0.038	(-0.130, 0.000)	0.698
All indicators	0.038	(-0.073, 0.148)	0.033	(-0.033, 0.167)	0.301

* Each fractional change is normalized to the reported value in 2000. Values are shown as medians with interquartile ranges (IQRs).
† PEPFAR focus countries are Botswana, Cote d'Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Uganda, United Republic of Tanzania, Zambia. All PEPFAR focus countries reported each of the above health indicators.
‡ The non-focus countries are Algeria, Angola, Benin, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Niger, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Swaziland, Togo, Zimbabwe. The number of non-focus countries reporting each health indicator varies from 31 to 34.
** The p value addresses the question of whether the median fractional change for each health indicator is statistically significantly different in PEPFAR focus and non-focus countries, as assessed by the Wilcoxon rank sum test.