Transcript Thailand ppt, 47kb

Thailand
• Well-developed health care system
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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)
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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?