1. The analysis and advocacy (A2) project: Role in translating Thailand’s national AIDS strategy into provincial implementation plans
S. Pantuwatana1, S. Osiri1, W. Phoolcharoen2, W. Sittitrai3
1 Burapha University, Chonburi, Thailand
2 Thailand A2 Team, Policy Researchy and Development Institute Foundation, Bangkok, Thailand
3 Thai Red Cross Society, Bangkok, Thailand

2. Scope of Presentation From Challenging Goal to Feasible AIDS Strategy
Constraints of Pragmatic Implementation
Evolution of Governance
Transitional social context of vulnerability
The need of effective intervention to keep pace with the socio-political change
Chonburi - an eastern seaboard province voluntarily join the A2 in creating of the “AIDS Strategic Information Center” (ASI) to advocate all sectors in the province for effective HIV/AIDS prevention
Plan for Scaling Up to meet the demand of all targeted population in the province

3. Key behavioural determinants
To reduce Thailand’s HIV Incidence by half, goals of behavioral changes were set !
Key behavioural determinants
2005
2008
Female Sex workers - Condom use
82%
95%
MSM Condom use
70%
85%
Injection Drug User Condom use
76%
Casual sex Condom use
36%
60%
Discordant couple - Condom use 2%
30%
IDU Needle sharing
18%

4. Realizing the Governance evolution
1990’s
2010’s
1997 and 2007 Constitution
National AIDS Committee
National AIDS Committee
National Policy
Sectors Policy
Province Policy
Local Authority Policy

5. Analyzing Thailand’s change in mode of transmission of HIV as reflection of transformation in social context related to targeted populations’ sexual behavior and addiction

6. Strategy to cope with the change
Build effective management and technical capacity among responsible authorities
Develop appropriate coordination skills in province to facilitate and support the integrated care-prevention intervention
Strengthen the advocacy and resource mobilization skills of civil society in support the effective activities
Operational research aimed at keeping pace with changing demand of each targeted population

7. Strategic management in Chonburi Province
Chonburi is a province of Thailand’s eastern seaboard with drastic economic growth from its sea-port, tourism and industrial estate
In 2007, the President of Burapha University established the AIDS Strategic Information Center (ASI) by the endorsement of the University’s council
Thailand’s A2 committed to support and empower the analysis and advocacy capacity at the province level
The Board of ASI composes of Vice Governors, the Local Authorities, civil society and the Province AIDS committee’s secretariat

8. Strategic Information Development
ASI collated and collected HIV/AIDS related data available and analyzed to be preliminary situation analysis
Mapping targeted groups according to their accessible sites
Mapping responsible organizations of each targeted groups including province’s officers, local authorities, private sectors and NGOs
Academics with their research in each targeted group solicited to join ASI

9. Pragmatic Operation Plan Formulation
Prioritizing the targeted populations by the Provincial AIDS Committee
Assessment of existing interventions in each targeted populations by ASI’s alliances
Assessment of human resources available and capable in implementation the plan
Joint planning by the responsible agencies under government, NGOs and private sectors
Estimation of budget required for 4 - years plan

10. Classification of Intervention based on effectiveness management criterion
Evidence of Effective Management
Objective of Implementation
Aims of strategy Control and monitoring
Key Evaluative Indicators for Achievement
Known Effective Intervention
Scaling up to cover all target population in the country
Resources mobilization to ensure the quality of the implementation
Coverage of preventive implementation on the target population and its impact to reduction of new HIV infected cases
Insufficient Evidence of Effectiveness
Assessment of the effectiveness and unit-cost for implementation
Capacity building and health service systems to ensure efficiency of intervention program
Efficiency of activities in modification the target groups’ behavior to a protective conduct from HIV and STD
Innovative Intervention
Pilot project to assess the process practicality and activities’ efficacy
Appropriate design of operational research to ensure successful and productive innovation
Efficacy of the designed intervention to change the HIV risk behaviors or lifestyles to safer conducts

11. 4 Examples of 4 - years plan for scaling up
Targeted Population
Setting to access
Effectiveness Management
level
Model Development and Evaluation
Scaling up
Discordant Couples
ANC and HIV/AIDS services
Innovative Intervention
Burapha U. with hospitals
Provincial Public Health
MSM
Outreach and Drop In Centers
Known effective intervention
NGOs and health care network
Local Government
FSW
Illegal migrated labors
Workplace owners (Fisherman Boat)
Insufficient evidence of effectiveness
NGOs and Fishery Association
Province’s Fishery and Labor Authority

12. Conclusion
Burapha University and Chonburi’s experiences demonstrate the feasibility of local cooperation among technical taskforces, implementing groups and policy makers in consortia to develop effective HIV prevention programs
With decentralization placing prevention responsibility upon provincial and local government, expanded adoption of this mechanism for collaborative strategic management can empower localities to respond effectively and long-term behavioral change