scholarly journals The Cost of Community Outreach HIV Interventions in Thailand: A Cohort Study

2021 ◽  
Author(s):  
Kyaw Min Soe ◽  
Katharina Hauck ◽  
Sukhum Jiamton ◽  
Sukhontha Kongsin
Keyword(s):  
Economies Of Scale ◽  
Linear Trend ◽  
Unit Cost ◽  
Community Outreach ◽  
People Living With Hiv ◽  
Community Based ◽  
Sex Worker ◽  
Hiv Interventions ◽  
Hiv Epidemic ◽  
Non Governmental Organizations

Abstract Background Despite having an estimation of 440000 people living with HIV in 2018, the HIV epidemic in Thailand has become mature and new cases reported have been rapidly declining thanks to its successful prevention programs and scaling up of anti-retroviral therapy (ART). Thailand aimed to achieve its commitment to end the HIV epidemic by 2030 and implemented a cascade of HIV interventions through Reach-Recruit-Test-Treat-Retain (RRTTR) program. Methods This study focused on community-based HIV interventions implemented by Non-Governmental Organizations (NGOs) under RRTTR program in the provinces highly affected by HIV epidemic. We calculated unit cost per person reached for HIV interventions tailored for key-affected populations (KAPs) including men who have sex with men/ transgender (MSM/TG), male sex worker (MSW), female sex worker (FSW), people who inject drug (PWID) and migrant (MW). We studied program outputs, costs, and unit costs in variations across different HIV interventions and geographic locations in Thailand. We used these estimates to evaluate the economies of scale and scope of implementing community-based HIV interventions. Results We analysed a total of 38 community-based HIV interventions in 27 provinces. The average unit cost for a person to received HIV services was 29.7 USD for MSM/TG program, 33.1 USD for MW program, 31.9 USD for FSW program, 36.3 USD for MSW program and 179.1 USD for PWID program. The lowest unit cost per person reached was 21.6 USD for Migrant in Samut Sakhon province while the highest was 324.5 USD for PWID in Samut Prakan. The scattered plots of unit cost per person with polynomial and linear trend line shows the presence of economies of scales. Conclusions This study suggested that community-based HIV interventions led by NGOs in Thailand will only become less costly as they are scaled-up overtime.

scholarly journals The cost of community outreach HIV interventions: a case study in Thailand

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Kyaw Min Soe ◽  
Katharina Hauck ◽  
Sukhum Jiamton ◽  
Sukhontha Kongsin
Keyword(s):  
Sex Workers ◽  
Economies Of Scale ◽  
Unit Cost ◽  
Community Outreach ◽  
People Living With Hiv ◽  
Hiv Interventions ◽  
Prevention Services ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Sex With Men

Abstract Background There was an estimated 440,000 people living with HIV in Thailand in 2018. New cases are declining rapidly thanks to successful prevention programs and scaling up of anti-retroviral therapy (ART). Thailand aims to achieve its commitment to end the HIV epidemic by 2030 and implemented a cascade of HIV interventions through the Reach-Recruit-Test-Treat-Retain (RRTTR) program. Methods This study focused on community outreach HIV interventions implemented by Non-Governmental Organizations (NGOs) under the RRTTR program in 27 provinces. We calculated unit cost per person reached for HIV interventions targeted at key-affected populations (KAPs) including men who have sex with men/ transgender (MSM/TG), male sex workers (MSW), female sex workers (FSW), people who inject drugs (PWID) and migrants (MW). We studied program key outputs, costs, and unit costs in variations across different HIV interventions and geographic locations in Thailand. We used these estimates to determine costs of HIV interventions and evaluate economies of scale. Results The interventions for migrants in Samut Sakhon was the least costly with a unit cost of 21.6 USD per person to receive services, followed by interventions for migrants in Samut Prakan 23.2 USD per person reached, MSM/TG in Pratum Thani 26.5USD per person reached, MSM/TG in Nonthaburi 26.6 USD per person reached and, MSM/TG in Chon Buri with 26.7 USD per person. The interventions yielded higher efficiency in large metropolitan and surrounding provinces. Harm reduction programs were the costliest compare with other interventions. There was association between unit cost and scale of among interventions indicating the presence of economies scale. Implementing HIV and TB interventions jointly increased efficiency for both cases. Conclusion This study suggested that unit cost of community outreach HIV and TB interventions led by CSOs will decrease as they are scaled up. Further studies are suggested to follow up with these ongoing interventions for identifying potential contextual factors to improve efficiency of HIV prevention services in Thailand.

Marginal assessment of the cost and benefits of aphasia treatment: Evidence from community-based telerehabilitation treatment for aphasia

2021 ◽  
pp. 1357633X2098277
Author(s):  
Molly Jacobs ◽  
Patrick M Briley ◽  
Heather Harris Wright ◽  
Charles Ellis
Keyword(s):  
Cost Effectiveness ◽  
Economies Of Scale ◽  
Reference Group ◽  
Unit Cost ◽  
Community Based ◽  
Face To Face ◽  
Conduction Aphasia ◽  
Aphasia Treatment ◽  
The Cost ◽  
The Relationship

Introduction Few studies have reported information related to the cost-effectiveness of traditional face-to-face treatments for aphasia. The emergence and demand for telepractice approaches to aphasia treatment has resulted in an urgent need to understand the costs and cost-benefits of this approach. Methods Eighteen stroke survivors with aphasia completed community-based aphasia telerehabilitation treatment, utilizing the Language-Oriented Treatment (LOT) delivered via Webex videoconferencing program. Marginal benefits to treatment were calculated as the change in Western Aphasia Battery-Revised (WAB-R) score pre- and post-treatment and marginal cost of treatment was calculated as the relationship between change in WAB-R aphasia quotient (AQ) and the average cost per treatment. Controlling for demographic variables, Bayesian estimation evaluated the primary contributors to WAB-R change and assessed cost-effectiveness of treatment by aphasia type. Results Thirteen out of 18 participants experienced significant improvement in WAB-R AQ following telerehabilitation delivered therapy. Compared to anomic aphasia (reference group), those with conduction aphasia had relatively similar levels of improvement whereas those with Broca’s aphasia had smaller improvement. Those with global aphasia had the largest improvement. Each one-point of improvement cost between US$89 and US$864 for those who improved (mean = US$200) depending on aphasia type/severity. Discussion Individuals with severe aphasia may have the greatest gains per unit cost from treatment. Both improvement magnitude and the cost per unit of improvement were driven by aphasia type, severity and race. Economies of scale to aphasia treatment–cost may be minimized by treating a variety of types of aphasia at various levels of severity.

Community Based 3R Waste Management Strategy (Reduce, Reuse, Recycle) Bantas Village, Selemadeg Timur District, Tabanan Regency

2018 ◽  
Vol 9 (09) ◽  
pp. 21041-21049 ◽  
Author(s):  
I Putu Sudana Satria Artha ◽  
Nyoman Utari Vipriyanti ◽  
I Putu Sujana
Keyword(s):  
Waste Management ◽  
Management Strategy ◽  
Swot Analysis ◽  
Human Life ◽  
Economic Value ◽  
Community Based ◽  
Waste Products ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Inorganic Waste

Garbage can be interpreted as a consequence of the activities of human life. It is undeniable, garbage will always be there as long as life activities continue to run. Every year, it can be ascertained that the volume of waste will always increase along with the increasing pattern of public consumerism. The landfill which is increasingly polluting the environment requires a technique and management to manage waste into something useful and of economic value, Bantas Village, Selemadeg Timur District, Tabanan Regency currently has a Waste Management Site (TPS3R) managed by Non-Governmental Organizations (KSM ) The source of waste comes from Households, Stalls, Restaurant Entrepreneurs, Schools, Offices and Ceremonies which are organic and inorganic waste. The waste management system at Bantas Lestari TPS with 3R system is Reduce (reduction of waste products starts from the source), Reuse (reuse for waste that can be reused) and Recycle (recycling waste) to date it is still running but not optimal. The method used in this research is descriptive quantitative with data analysis using SWOT analysis. This study produces a Waste Management Strategy which is the result of research from the management aspect, aspects of human resources and aspects of infrastructure facilities.

scholarly journals Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  
Keyword(s):  
Experimental Study ◽  
Antiretroviral Therapy ◽  
Scale Up ◽  
Economic Evaluations ◽  
People Living With Hiv ◽  
Cad Model ◽  
Community Based ◽  
Quasi Experimental ◽  
Living With Hiv ◽  
Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

scholarly journals Barriers and Facilitators of Smoking Cessation among Latinos Living with HIV: Perspectives from Key Leaders of Community-Based Organizations and Clinics

2021 ◽  
Vol 18 (7) ◽  
pp. 3437
Author(s):  
Francisco Cartujano-Barrera ◽  
Michelle Lee D’Abundo ◽  
Evelyn Arana-Chicas ◽  
Surina Chock ◽  
Pamela Valera ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Barriers And Facilitators ◽  
Mental Health Stigma ◽  
People Living With Hiv ◽  
Community Based ◽  
Care Community ◽  
Targeted Interventions ◽  
Community Based Organizations ◽  
The Individual ◽  
Living With Hiv

The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.

scholarly journals The essential role of physiotherapists in providing rehabilitation services to people living with HIV in South Africa

2013 ◽  
Vol 69 (1) ◽  
Author(s):  
S. Cobbing ◽  
V. Chetty ◽  
J. Hanass-Hancock ◽  
J. Jelsma ◽  
H. Myezwa ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Policy Formulation ◽  
People Living With Hiv ◽  
Highly Active ◽  
Hiv Epidemic ◽  
Wide Range ◽  
Living With Hiv ◽  
Education Courses

Despite increased access to highly active anti-retroviral therapy (HAART) in South Africa, there remains a high risk of people living with HIV (PLHIV) developing a wide range of disabilities. Physiotherapists are trained to rehabilitate individuals with the disabilities related to HIV. Not only can South African physiotherapists play a significant role in improving the lives of PLHIV, but by responding proactively to the HIV epidemic they can reinforce the relevance and value of the profession in this country at a time when many newly qualified therapists are unable to secure employment. This paper offers recommendations that may help to fuel this response. These ideas include enhancing HIV curricula at a tertiary level, designing and attending continuing education courses on HIV and researching Southern African rehabilitation interventions for HIV at all levels of practice. furthermore, it is vital that physiotherapists are at the forefront of directing multi-disciplinary responses to the rehabilitation of PLHIV in order to influence stakeholders who are responsible for health policy formulation. it is hoped that this paper stimulates discussion and further ideas amongst physiotherapists and other health professionals in order to improve the quality and access to care available to PLHIV in South Africa.

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