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Development of NAPHA in Thailand

This development report highlights the progress of the NAPHA program in Thailand, from its inception in 2001 to its expansion in 2003 and beyond. The program focuses on providing comprehensive HIV/AIDS services, including antiretroviral treatment, to a growing number of patients. Key areas of development include VCT, physician capacity building, laboratory networking, and community and home care. The report also discusses the implementation of a computerized information system for better monitoring and reporting.

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Development of NAPHA in Thailand

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  1. Development of NAPHA in Thailand Dr Anupong Chitwarakorn Department of Disease Control Thailand

  2. NAPHA in Thailand • Start in 2001 • Shift from research based to service based • Target 3,000 patients, ARV budget 6 m$ • Service provider sites increased from 55 to 110 hospitals

  3. NAPHA in Thailand • Scaling up in 2003 • Target 10,000 patients, ARV budget increased to 9 m$, service sites increased to 400 hospitals • In 2004, target 50,000 patients, ARV budget increased to 20 m$, all 800+ public hospitals involved • In 2005, target 80,000 patients, ARV budget will increase to 30 m$ • Additional budget from GFATM 1st, 2nd

  4. Key area of development • VCT • Capacity building for physicians • Laboratory networking • Nurse, community and home care • Drug supply

  5. Key information for patients monitoring • Adherence • BW., KS • OI • Side affects • CD4 • Viral load • 4 S’s

  6. Program M/E • Monthly report, indicate which projects. • Service sites to provincial coordinators (75 plus BMA) to regional coordinators and to national level • 4 S’s: • Numbers of pt. still on drugs as of last month, number of new enrollment this month, number of pt stopping and why, number of patients died and why, number of pt. still on drugs as of this month.

  7. Latest status of NAPHAas of 31st January 2004 • No. of pts. enrolled as of 31st December 2003 was 23,158 • No. of new pts. Enrolled in January was 2,503 • No. of pts. still on ARV as of 29th February 2004 was 20,896 • Lowest achieved was region 1 (central), 20% • Highest achieved was region 10 (northern), 75%

  8. CD4 after 3TC, d4t, NVP at 6 months:study from the northern Thailand • Mean CD4 at starting: 58 cell/cu.mm • Mean CD4 increase at 2 months: 61 • Mean CD4 increase at 6 months: 118 • 95.5% of pts. had CD4 increase

  9. Computerized information • Start to develop in 2003 • All level: laboratory, facility, provincial, regional and national • Now in training process • Monthly report with diskette from hospitals to provincial coordinators to regional and to national level

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