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Thailand

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

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  1. 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

  2. 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

  3. 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)

  4. 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

  5. Program Monitoring (1) • KEEP IT SIMPLE

  6. Program Monitoring (2) • Start of treatment • Body weight • CD4 • Side-effects • Regimen + regimen change + reason • Termination + reason • Electronic, 1 page, once a month

  7. 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

  8. 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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