How to allocate limited healthcare resources: Lessons from the introduction of antiretroviral therapy in rural Mozambique

•The way 'need' is defined matters for allocating limited healthcare resources.•The initial allocation of antiretroviral therapy is sub-optimally distributed.•Proper allocation of health services is an integral part of investing in human capital.

Proper allocation of limited healthcare resources is a challenging task for policymakers in developing countries. Allocation of and access to these resources typically varies based on how need is defined, thus determining how individuals access and acquire healthcare. Using the introduction of antiretroviral therapy in southern Mozambique as an example, we examine alternative definitions of need for rural populations and how they might impact the allocation of this vital health service. Our results show that how need is defined matters when allocating limited healthcare resources and the use of need-based metrics can help ensure more optimal distribution of services.