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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Presentation transcript:

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) 800 DHs, of which 500 deliver ARV now ARV free/cheap

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)

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

Program Monitoring (1) KEEP IT SIMPLE

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

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

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?