Horizons Projects | An Assessment of the Provision of Antiretroviral Drugs to Persons Living with HIV and AIDS in Northern Thailand

HORIZONS PROJECT
An Assessment of the Provision of Antiretroviral Drugs to Persons Living with HIV and AIDS in Northern Thailand

In 2000 the Thailand Ministry of Public Health began providing antiretroviral therapy (ART) to people living with HIV/AIDS through its Access to Care (ATC) Project. As ART became more widely available in Thailand, it was necessary to have a better understanding of operational issues related to expansion of existing programs. A rapid situation analysis was therefore undertaken to understand the strengths and weaknesses of the ATC Project in northern Thailand. The ultimate aim of the study was to make recommendations for action that would improve the quality of services that clients receive and to enhance their adherence to ART.

Data were collected from 15 ATC clinics operating in the provincial hospital (the largest hospital in the province) and two district hospitals in each of five northern provinces: Chiang Mai, Chiang Rai, Lampang, Lampoon, and Phayao.

The analysis showed high levels of support for the ATC Project from health providers, ART clients, their relatives, and even those who had dropped out of the program. Strengths of the program included:

Clear guidelines on how the program should be run.
The successful involvement of the ATC committees that were established to select clients into the program, which allowed for community participation.
Good coordination between the provincial health office and the hospitals.
Having a person in charge of the logistics system at each hospital.
Improved health among clients receiving ART.

However, the study also found a high dropout rate and that a substantial number of the clients receiving ART have had difficulties maintaining adherence. Improvements need to be made to the system to reduce dropouts and increase adherence among new clients.

Location

Chiang Mai, Chiang Rai, Lampang, Lampoon, and Phayao provinces, Thailand

Duration

May 2002–July 2002

Horizons and Population Council researchers

Simon Baker, Patchara Rumakom

(For more information about this study, please contact horizons@popcouncil.org.)

Non-Council collaborators

Ratana Panpanich, Penpak Sornchai, Khun Jiraporn Suwanteerangkul, Somsak Thamthitiwat, Khun Kannika Vitsupakorn (Department of Community Medicine, Chiang Mai University)

Praweena Sounthisombut (Faculty of Pharmacy, Nalaysorn University)

Tasana Leusaree, Kriengkrai Srithanaviboonchai (Office of Disease Prevention and Control–Region 10, Chiang Mai)

Panumas Yaranawejsakul (Office of Disease Prevention and Control–Region 11, Nakhon-Srithamarat)

Isara Chiawiriyabunya, Khun Pimjai Sarasit, Khun Chiraporn Yachompoo, Khun Liza Kantamara, Khun Chitra Onnom (Thailand Ministry of Public Health, AIDS Section)

Khanchit Limpakarnjanarat (Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration)

AIDSNet

Program for HIV Prevention and Treatment

Médecins Sans Frontières

Donor

US Agency for International Development

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2004
Panpanich, Ratana et al. 2004. “A rapid situation analysis of the Access to Care Project in northern Thailand,” Horizons Final Report. Washington, DC: Population Council. (PDF)

Related Project

Reducing Drop-outs and Increasing Adherence Rates Among People Living with HIV/AIDS on Highly Active Antiretroviral Therapy in Northern Thailand