Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 10050
Country/Region: Thailand
Year: 2011
Main Partner: Ministry of Public Health - Thailand
Main Partner Program: NA
Organizational Type: Host Country Government Agency
Funding Agency: HHS/CDC
Total Funding: $1,556,000

MOPH Implementing Mechanism Narrative

HHS/CDC funds the Thai MOPH through a five-year cooperative agreement (CoAg). Currently, CDC's Global AIDS Program (GAP) is entering the fourth year of the second five-year CoAg with MOPH. The goals of this collaboration are to provide technical support to the Thai MOPH for HIV prevention, care, and treatment programs as determined by MOPH leadership and GAP/ Thailand and in accordance with the national HIV/AIDS strategy. The expected outcomes of the collaboration include: 1) strengthening health systems, human capacity, guidelines and protocols, and quality systems in order for the government of Thailand to finance and manage in-country programs; 2) supporting replicable models for prevention and care; 3) improving the quality of prevention and care programs; 4) increasing the collection and use of strategic information; and, 5) sharing successful models and providing TA to other PEPFAR countries.

Models may include service delivery models, surveillance methodologies, or laboratory systems. Support for model development typically proceeds through phases: 1) model development, implementation, and evaluation; 2) scale-up through leveraging of other donor or government funds; 3) integration to routine services; and 4) technical support to ensure quality of national programs and for national-level program M&E.

Support through this implementing mechanism is national. Technical areas and target populations include HIV prevention, care, and support for FSW, IDU, MSM, and prisoners; PMTCT monitoring and early infant diagnosis; national HIV testing and counseling guidelines and monitoring systems; quality of adult and pediatric HIV care and laboratory systems, including EQA programs and laboratory accreditation; positive prevention for HIV-infected MSM, youth, and general population PLHA; surveillance for FSW, IDU, and MSM; and, ARV resistance monitoring, threshold surveys, and early warning indicators. In addition, experts in Thailand receive support through this implementing mechanism to provide TA to other PEPFAR programs (i.e., "Global TA" activity), building on the experience and expertise in Thailand.

Contributions to health systems strengthening are made through all aspects of USG Thailand's TA-based program. Health information systems, laboratory infrastructure, and human resources for health are all areas of emphasis in the Thailand PEPFAR program. USG provides technical support for a) existing surveillance systems in MOPH, b) the development of new surveillance methodologies that are subsequently integrated into routine systems, c) M&E of prevention, care, and treatment programs administered by MOPH, NHSO, or GFATM, and d) data management systems, data analysis, and reporting and use of data for program improvement.

The USG team supports laboratory accreditation programs and quality systems at a national and sub-national level by strengthening the existing organizational structure and the technical capacity of government partners. The USG team supports human resources for health through in-service training in specific technical areas, adoption of new concepts or programs as part of national curricula and guidelines, specific models for task-shifting in HIV care and support, and development of decentralized referral networks that allow patients to receive services at the community level. The USG team supports model and curriculum development with government partners, and provides training of trainers so that national curricula can be used by government staff to provide trainings at different regional, provincial, and district levels, thereby ensuring that programs and technical capacity are integrated into routine government programs.

All USG Thailand technical support to MOPH is for programs that are, or have a plan to be, fully integrated into routine public health programs. Technical support and capacity building are provided to MOPH staff for development, implementation, evaluation, and expansion of programs that are funded by the national government. If a new program, method, or service delivery strategy is developed, it is developed jointly with MOPH, and training and technical capacity building support are provided at all stages of the process, including for fully expanded national programs in the form of M&E and support for quality systems. M&E is conducted for new program models of service delivery and new quality systems, as well as for national programs or systems to identify gaps or areas that need strengthening. M&E serves to identify the effectiveness or success of a program, and build the M&E capacity of MOPH counterparts. USG heath systems strengthening support to MOPH includes development of M&E and database systems, increased technical knowledge and capacity, policy change, development and evaluation of quality systems and programs, and Global Fund technical support.

As a TA-based program, costs are low for this implementing mechanism, and will continue to be low. Model development and evaluation are supported for a time-limited period, and then other donor or government funding is leveraged for program expansion and integration. This CoAg may be a model for countries that are transitioning to reduced programmatic funding, or are moving to a TA-based system.

Funding for Care: Adult Care and Support (HBHC): $163,351

08-HBHC Care:

Adult Care and Support

Budget Code Narrative for MOPH

With USG assistance, MOPH will finalize and provide training on a comprehensive performance measurement system which integrates HIVQUAL-T and the NAP databases. MOPH will conduct a TOT on the QI curriculum for the HIV quality national committee, including representatives from all 12 regions. The USG team will provide TA for development of a post-scale-up program evaluation plan.

MOPH will support implementation and evaluation of advanced counseling tools for risk reduction counseling, HIV disclosure, and partner testing. The counseling modules will be tested at three hospitals. Results from the evaluation will be presented to MOPH stakeholders for possible use of the counseling materials in other settings.

Through MOPH, CDC will support model development of positive prevention for MSM in four provinces (Bangkok, Khon Kaen, Phuket, and Udon Thani). This will complement USAID support in two additional provinces. The model includes improved linkages for prevention through outreach activities, and promotion of HIV TC to increase early access to HIV care. Development of a network of MSM peers in the community, HIV-positive MSM, and ARV clinic staff, as well as a referral system, will be part of the model. Capacity building for both MSM peers and ARV clinic staff will be provided. Program monitoring tools have been developed, and linkages between HIV TC and comprehensive health care and health promotion among HIV-positive MSM (including prevention of transmission and behavioral risk assessments and counseling) will be monitored.

These activities will be developed and implemented with input from the MSM technical advisory board, which also serves as the technical advisory board for GFATM activities for MSM. Successful activities will be expanded to MSM sites in other GFATM-supported provinces, and technical support will be provided for similar activities in GFATM-supported sites and to GFATM partners.

Funding for Testing: HIV Testing and Counseling (HVCT): $75,583

None

Funding for Care: Pediatric Care and Support (PDCS): $165,334

None

Funding for Strategic Information (HVSI): $205,334

None

Funding for Health Systems Strengthening (OHSS): $74,768

None

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $357,696

03-HVOP Sexual Prevention:

Other Sexual Prevention

Budget Code Narrative for MOPH

With USG assistance, MOPH has supported provincial health offices in major areas of Thailand to implement peer outreach education for MSM since 2004. In FY 2010, MOPH will continue to support to MSM peer outreach activities, including capacity building, outreach trainings, and M&E activities.

Together with the USG team, MOPH has developed curricula for sensitivity training and health care management training for health care providers who will work with MSM. In FY 2010, MOPH will organize a Training of Trainers on sensitivity and health care management to be funded by GFATM. The USG team will support MOPH to monitor these trainers to ensure that quality trainings are provided.

To promote testing and counseling for MARPs, MOPH will work with GFATM and the USG team to develop work and budget plans to harmonize the work of MOPH and USG.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $19,685

None

Funding for Laboratory Infrastructure (HLAB): $464,249

None

Funding for Care: TB/HIV (HVTB): $30,000

None

Cross Cutting Budget Categories and Known Amounts Total: $614,755
Gender: Gender Based Violence (GBV) $25,958
Human Resources for Health $588,797
Key Issues Identified in Mechanism
Addressing male norms and behaviors
End-of-Program Evaluation
Increasing gender equity in HIV/AIDS activities and services
Child Survival Activities
Military Populations
Safe Motherhood
Tuberculosis
Workplace Programs
Family Planning