Table 3.
Chronic care management
| Cambodia | Myanmar | Nepal | PNG | Thailand | Vietnam | |
|---|---|---|---|---|---|---|
| Service availability | ||||||
| Total no. of ART sites | 51 | 90 | 36 | 61 | 1014 | 217 |
| Provinces with ART | 21/24 provinces | 13/14 provinces | 13/14 zones | 20/20 provinces | 76/76 provinces | 63/63 provinces |
| Districts with ART | 44/77 districts | 59/325 townships | 30/75 districts | 61/89 districts | 878/878 districts | 167/697 districts |
| Districts having ART (%) | 57 | 18 | 40 | 69 | 100 | 24 |
| Districts with VCT having ART (%) | 57 | 28 | 40 | 69 | 100 | 95 |
| District with CHBC /District with ART |
44/44 (848/997 health center) | 15 or more/59 | 13/30 | 2/61 | 400 or more/878 | (185 teams)/167 |
| Linking approach | ||||||
| Testing and counseling (post-test counseling) to pre-ART care linkage | PLHIV referred to pre-ART care, but often in distant location. CHBC team offering referral support | PLHIV referred to pre-ART care, but often in distant location | PLHIV referred to pre-ART care, but often in distant location | PLHIV referred to pre-ART care, but often in distant location | PLHIV referred to pre-ART care. VCT and Pre-ART care located in the same facility | PLHIV referred to pre-ART care, but often in distant location |
| Generating a daily patient appointment list for ART | 32 sites electronic, 19 sites paper-based system | Most sites paper-based system | Most sites paper-based system | 4 sites electronic, 57 paper-based system | All sites electronic system | Most sites paper-based system |
| Performance monitoring | ||||||
| Monitoring of pre-ART care through national program reporting | Enrolment: 7,391 | Enrolment: 30,615 | Enrolment: 15,443 | Enrolment 2,541 | Enrolment 28,264 | Enrolment: 8,729 |
| Attrition: 2,249 (Lost and died monitored from 4th quarter of 2010) | Attrition: not available | Attrition: not available | Attrition 414 | Attrition 11,185 | Attrition: Available only from selected sites | |
| −Lost 278 | −Lost 6,892 | |||||
| −Died 136 | −Died 4,293 | |||||
| Monitoring of appointment keeping for ART | Annual facility survey in 42 sites, Local quality improvement in 16 sites. | Not yet operational | Not yet operational | Not yet operational | Annual facility survey in 38 sites | Annual facility survey in 30 sites |
| ART retention at 12-month (%) | 93 | 87 | N/A | 78 | 83 | 82 |
Source: National HIV programs of 6 countries, AIDS Progress Report 2012 of Cambodia [19], Myanmar [20], Nepal [21], PNG [22], Thailand [23], Vietnam [24].
Remark: Province refers to the health administration, one level higher than so called district. District refers to the health administration level with the first referral-hospital (Operational district in Cambodia, Township in Myanmar, District in Nepal, PNG, Thailand, and Vietnam). CHBC: Community- and home-based care.