Moreno, AntonioÁlvarez-Rosete, ArturoLuque Nuñez, Ricardodel Carmen Moreno Chavez, TeresaRodriguez-García, RosalíaMontenegro, FernandoMoreno, Luis ÁngelSuarez Lissi, AlejandraMagne Concardo, PedroGaillard, Michel Eric2013-01-022013-01-022012-08https://hdl.handle.net/10986/12046This study on the implementation efficiency of the HIV/AIDS national response in Colombia seeks to examine how it has been implemented -- whether it has been done according to the available evidence about the epidemic and as the response was originally planned. The study approaches three specific dimensions of implementation efficiency: (i) programmatic; (ii) budgetary; and (iii) service delivery. The study uses a range of research techniques, including: (i) documentary analysis of key policies, official publications and reports; (ii) semi-structured interviews with representatives of the central government and territorial entities, international and community-based organizations, insurers, care providers, etc.; and (iii) case-study analysis to visualize the ways in which people are cared for in practice. The available data suggest that the HIV/AIDS response is succeeding in keeping the prevalence low and the epidemic concentrated. In recent years, the level of health coverage has increased and the quality of care services has improved. The identified problems in service delivery (mostly related to coverage and access) are linked to system fragmentation and integration, and to the nature of the coordination mechanisms, both at the national and the territorial level. The effectiveness of the response would benefit from re-energized leadership at both the national and local levels -- articulated through the existing programmatic framework and coordinating mechanisms. The complexity of the system and the lack of budgetary and expenditure information have impeded the evaluation of the budgetary efficiency of the HIV/AIDS response.en-USCC BY 3.0 IGOACCESS TO HEALTH CAREACCESS TO HEALTH CARE SERVICESACCESS TO HEALTH SERVICESACCOMMODATION COSTSACQUIRED IMMUNE DEFICIENCY SYNDROMEADOLESCENTSADULT LITERACYAGE GROUPSAIDS CASESAIDS MORTALITYAIDS PROGRAMALLOCATIVE EFFICIENCYANTIBODIESAT RISK GROUPSBASIC HEALTHBASIC HEALTH CAREBIG CITIESBLOOD TESTBULLETINCAPITATIONCITIZENCITIZENSCIVIL SOCIETY ORGANIZATIONSCLINICAL PROTOCOLSCLINICSCOMMUNITY PARTICIPATIONCONDOMCONDOM DISTRIBUTIONCONDOM USECONDOMSCRIMEDEATHSDEVELOPMENT POLICYDIAGNOSISDIAGNOSTICSDISEASEDISTRIBUTION OF CONDOMSDRUGSEPIDEMICEPIDEMIOLOGICAL PROFILEEXERCISESFAMILIESFAMILY SUPPORTFAMILY WELFAREFEMALE SEX WORKERSFORMAL CAREFORMAL EDUCATIONFRACTURESGENDER INEQUITIESGENERAL HEALTH SYSTEMGLOBAL DEVELOPMENTGLOBAL DEVELOPMENT FINANCEGLOBAL HIV/AIDSHEALTH CAREHEALTH CARE CENTERSHEALTH CARE SERVICESHEALTH CENTERSHEALTH FINANCINGHEALTH INFORMATIONHEALTH INFORMATION SYSTEMSHEALTH INSURANCEHEALTH PLANHEALTH PLANSHEALTH PROBLEMSHEALTH PROMOTIONHEALTH SECTORHEALTH SERVICESHEALTH SYSTEMSHEALTH SYSTEMS STRENGTHENINGHIVHIV INFECTIONHIV TESTINGHIV/AIDSHIV/AIDS CAREHOSPITALHOSPITALSHUMAN DEVELOPMENTHUMAN IMMUNODEFICIENCY VIRUSHUMAN RESOURCESIMMUNE DEFICIENCYIMMUNODEFICIENCYINCOMEINEQUITIESINFECTIONSINFORMATION CAMPAIGNSINFORMATION SYSTEMSINTEGRATIONINTERNATIONAL COOPERATIONINTERNATIONAL MIGRANTSINTERNATIONAL ORGANIZATIONSINTERVENTIONLACK OF AWARENESSLACK OF KNOWLEDGELAWSLEGAL STATUSLIFE EXPECTANCYLOCAL AUTHORITIESLOCAL POPULATIONLOCAL PUBLIC HEALTHLOW PREVALENCEMALARIAMATERNITY CAREMEDICINEMEDICINESMIGRANTSMORTALITYMORTALITY LEVELSMORTALITY RATEMULTIPLE SEXUAL PARTNERSNATIONAL AIDSNATIONAL COUNCILNATIONAL EXPENDITURESNATIONAL HEALTH SYSTEMNATIONAL LEVELNATIONAL PLANNEWBORNNUMBER OF PEOPLENUMBER OF PERSONSNURSENUTRITIONOPERATIONAL FRAMEWORKOPPORTUNISTIC DISEASESORPHANSPATIENTPATIENT SATISFACTIONPATIENTSPENSIONSPERSONAL COMMUNICATIONPHARMACYPOLICY ANALYSISPOLICY DISCUSSIONSPOLICY RESEARCHPOLICY RESEARCH WORKING PAPERPOPULATION DENSITYPOPULATION DISTRIBUTIONPOPULATION GROUPSPREGNANCYPREGNANT WOMANPREGNANT WOMENPREVALENCE RATESPREVENTION ACTIVITIESPREVENTION INTERVENTIONSPREVENTIVE ACTIONSPRIMARY CAREPROGRESSPROPHYLAXISPUBLIC HEALTHPUBLIC HEALTH SERVICESPUBLIC HOSPITALSPUBLIC POLICYQUALITY OF CAREQUALITY OF LIFEQUALITY OF SERVICESREHABILITATIONREPRODUCTIVE HEALTHRESEARCH TECHNIQUESRESOURCE ALLOCATIONSRESOURCE MOBILIZATIONRESPONSE TO AIDSRISK POPULATIONSRURAL AREASSCREENINGSERVICE DELIVERYSERVICE PROVIDERSSERVICE PROVISIONSERVICES FOR PEOPLESEXSEX WITH MENSEX WORKERSEX WORKERSSEXUAL INTERCOURSESEXUAL PARTNERSSEXUAL TRANSMISSIONSEXUALLY TRANSMITTED DISEASESSOCIAL IMPACTSOCIAL PROGRAMSSOCIAL SECURITYSOCIAL SERVICESSOCIAL SUPPORTSTDTECHNICAL ASSISTANCETHERAPYTRANSMISSIONTREATMENTTREATMENT SERVICESTUBERCULOSISUNAIDSUNFPAUNITED NATIONS POPULATION FUNDURBAN AREASUSE OF CONDOMSVULNERABILITYVULNERABLE CHILDRENVULNERABLE GROUPSVULNERABLE POPULATIONSWORLD HEALTH ORGANIZATIONWorld Bank10.1596/1813-9450-6182