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Thailand. Well-developed health care system 200,000 need ARV Target 50,000 on ARV 50% in Northern Thailand 50% rest of Thailand, including Bangkok. Thailand. Min of Public Health and BMA responsible for scaling up ARV Major target: district hospital (DH)

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Thailand l.jpg
Thailand

  • Well-developed health care system

  • 200,000 need ARV

  • Target 50,000 on ARV

  • 50% in Northern Thailand

  • 50% rest of Thailand, including Bangkok


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Thailand

  • Min of Public Health and BMA responsible for scaling up ARV

  • Major target: district hospital (DH)

  • 800 DHs, of which 500 deliver ARV now

  • ARV free/cheap


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General remarks

  • M&E info comes from different sources:

    • Continuous monitoring

    • Surveillance

    • Surveys

  • Unified M&E system is possible in Thailand, while the following issues are important to keep in mind:

    • patient referral between hospitals

    • patient migration

    • stigma on ARV (no smartcards)


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Needs, resources,access

  • Available: national level guidelines for doctors, nurses, counselors

  • Needed: training in comprehensive treatment, including OIs and pediatrics

  • Lab infrastructure + QA system

  • Better pediatric formulation

  • Policies to ensure equal access

  • Better access for children


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Program Monitoring (1)

  • KEEP IT SIMPLE


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Program Monitoring (2)

  • Start of treatment

  • Body weight

  • CD4

  • Side-effects

  • Regimen + regimen change + reason

  • Termination + reason

  • Electronic, 1 page, once a month


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Program Monitoring (3)

  • Data can be used at all levels

  • Feedback of results important

  • Drug resistance: now going from research to surveillance (1000 patients)

  • Cost/Cost-effectiveness: important to measure, monitor


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Research Issues

  • Evaluations of the ongoing program

  • Research on program improvement, additions to program

  • Step-by-step-improvement model

  • Adherence very important issue

    • Effects of training?

    • Effects of peer support?

    • Relation quality of program and adherence?


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