HIV/AIDs Patient Care Development in Saisaket Hospital
Sisaket Hospital

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
Problems and former working condition In the past HIV/AIDs was a major problem affecting people around the world, which was required cooperation from every part of society. This led to The National HIV and AIDS Strategic Plan. Sisaket Hospital is the provincial hospital with 680 beds and located on the border between two countries. This has caused more medical burdens for the hospital. Apart from the native population which is estimated about 1,468,798 persons, there is passive population. Hospitals in the border region have different problems from other hospitals. It is necessary that the national conference on problems faced by hospitals in border region be held to improve the work quality and encourage the medical teams. Although Sisaket Hospital is now facing several problems, we are willing to get the best out of our services. In the past there were many HIV/AIDs patients coming to hospital for medical services accounting for 40 persons a day. Moreover, universal health coveragehas caused many financial burdens to public hospitals and reduced hospital revenue. All health promoting hospitals were then developed to provide general medical services. Home Care and Home Ward were also developed to look after bedridden patients, disable patients, and patients with a terminal illnessat their home. Multidisciplinary team was trained and was supposed to attend case conferences. Patient’s relatives were trained to be qualified care givers. Village health volunteers and volunteers are trained to give good care for patients. Due to such processes number of HIV/AIDs patients decreased by half. For several years Sisaket Hospital has been cooperating with Affiliated Party and Network Group creating many community health promotion projects. we began the project with hiring disabled persons, then search for more HIV/AIDs patients to teach them how to take good care of themselves. It is now found that HIV/AIDs patients who tended to suffered by drug resistance have recovered. There are many problems faced by staff and patients in Sisaket Hospital, especially medical expenses and inadequate staffs, so HIV/AIDs patients were planned to take care of at their home, which required cooperation between multidisciplinary team, patients and communities.

B. Strategic Approach

 2. What was the solution?
We have implemented many strategies to improve life quality of HIV/AIDs patients such as “Mor Lum against Aids” , prepare a patient for antiretroviral treatment and the participation of HIV/AIDs patients in being volunteers providing home visits in their communities.

 3. How did the initiative solve the problem and improve people’s lives?
There are many organizations taking part in solving the problems such as Department of Disease Control - Provided financial support to screen HIV/AIDs patients - Hold an assembly for departments in the Ministry of Public Health to carry out the same improvement The Office of Disease Prevention and Control 10 Ubonratchathani - Provided financial support on conferences about preventing transmission of HIV - Hold a training course to train staffs to screen for sexually transmitted diseases. National Health Security Office 10 Ubonratchathani - Provided financial support on conferences to educate HIV prevention Sisaket Provincial Health Office - Participate in publicizing the conferences and the latest status of the AIDS epidemic Public sectors - Provided partial financial support on conferences and campaigns for education of HIV and other sexually transmitted diseases. Educational institution - Carry out a campaign in educational institutions and educate students on HIV/AIDS and other sexually transmitted diseases. Community leaders/ Village Health Volunteers - Take care of their communities and educate people in community on diseases. Private sectors - Participate in a campaign, educate people in HIV/AIDS, take care of and offer a consult to HIV/AIDS patients.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
“Mor Lum against Aids” Prepare a patient for antiretroviral treatment The model of service development 1. Patient logbooks were introduced to record medication diaries. 2. Patients are advised by registered nurses. 3. Patients’ information are registered with NAP and HIVQUL, STIQuality, VCT Quality 3 4. Patients are educated in antiretroviral drugs by registered nurses, pharmacists and physicians. They are supposed to remember how the drugs look like and how many drugs they take a day. 5. There is the holistic center, a group of patients with HIV/AIDS in Sisaket Province, working for HIV/AIDS patients in cooperation with Sisaket Hospital. They have been trained by public sectors to be able to work with hospitals. Their job are offering a consult and a home visit before and during the treatment, sending medicine by post, offering a consult in Hot Line, etc. 6. AIDS campaign in 1993, “Mor Lum against AIDS” invited to perform in German in 2004, etc. 7. It won the second prize in the organization of AIDS care at office contest by Department of Disease Control in 2014. 8. It was the Red Ribbon Award Winners for 2006, held by the United Nations in Toronto, Canada. 9. It was held training on AIDS education to students in 2010 10. It was conducted a campaign against AIDS on February 14, 2010 11. We participated in Innovation Award in 2010 and 2015

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
Strategic method According to national plan for strategic and integrated HIV and AIDS prevention and alleviation (2011-2016) and plan for Preventing and Solving AIDS Problems in Sisaket Province, Sisaket Hospital has established a medical clinic to serve HIV/AIDs patients for 21 years. It is clear that we have succeeded in reducing the number of HIV/AIDs patients and HIV-exposed infants by 90 percent. Six practical strategies for meeting Getting to zero goals; 1. Social justice, the process of ensuring that individuals fulfill their societal roles and receive what was their due from society. 2. a paradigm for HIV/AIDs prevention 3. Emphasis on work, efficiency, and effect 4. Leadership, cooperation, and sustainable resources 5. Empowering people and gave them self-appreciation. 6. Cooperating with Affiliated Party and Network Group of disabled to improve efficiency.
 6. How was the strategy implemented and what resources were mobilized?
The model of service development 1. Patient logbooks were introduced to record medication diaries. 2. Patients are advised by registered nurses. 3. Patients’ information are registered with NAP and HIVQUL, STIQuality, VCT Quality 3 4. Patients are educated in antiretroviral drugs by registered nurses, pharmacists and physicians. They are supposed to remember how the drugs look like and how many drugs they take a day. 5. There is the holistic center, a group of patients with HIV/AIDS in Sisaket Province, working for HIV/AIDS patients in cooperation with Sisaket Hospital. They have been trained by public sectors to be able to work with hospitals. Their job are offering a consult and a home visit before and during the treatment, sending medicine by post, offering a consult in Hot Line, etc. 6. AIDS campaign in 1993, “Mor Lum against AIDS” invited to perform in German in 2004, etc. 7. It won the second prize in the organization of AIDS care at office contest by Department of Disease Control in 2014. 8. It was the Red Ribbon Award Winners for 2006, held by the United Nations in Toronto, Canada. 9. It was held training on AIDS education to students in 2010 10. It was conducted a campaign against AIDS on February 14, 2010 11. We participated in Innovation Award in 2010 and 2015 Resources used in the improvement process Financial support - A budget funded by National Health Security Office (NHSO) together with hospital subsidies Technical support - There has been a computer program that is being executed Human resources - A staff shortage solved by the assistance of the holistic center and budget from National Health Security Office

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
There are many organizations taking part in solving the problems such as Department of Disease Control - Provided financial support to screen HIV/AIDs patients - Hold an assembly for departments in the Ministry of Public Health to carry out the same improvement The Office of Disease Prevention and Control 10 Ubonratchathani - Provided financial support on conferences about preventing transmission of HIV - Hold a training course to train staffs to screen for sexually transmitted diseases. National Health Security Office 10 Ubonratchathani - Provided financial support on conferences to educate HIV prevention Sisaket Provincial Health Office - Participate in publicizing the conferences and the latest status of the AIDS epidemic Public sectors - Provided partial financial support on conferences and campaigns for education of HIV and other sexually transmitted diseases. Educational institution - Carry out a campaign in educational institutions and educate students on HIV/AIDS and other sexually transmitted diseases. Community leaders/ Village Health Volunteers - Take care of their communities and educate people in community on diseases. Private sectors - Participate in a campaign, educate people in HIV/AIDS, take care of and offer a consult to HIV/AIDS patients.

 8. What were the most successful outputs and why was the initiative effective?
1. The cooperation of HIV/AIDs patients, their families, communities, local government, and other organizations. There is a “care team” In community including volunteers such as friend to friend group, Sisaket holistic group, etc. 2. Focusing on not only AIDS, but other HIV/AIDs patients ‘problems 3. Communities realize their own problems and how to solve them. 4. Developing HIV/AIDs patients’ competency 5. The discussion on HIV/AIDs has consistently been held. 6. Developing competency of public health centers 7. the government is supposed to provide financial support and

 9. What were the main obstacles encountered and how were they overcome?
Problems and obstacles - Being disgusted by communities - Migration due to work and being not likely to be allowed to have a day leave - No care givers - Elderly or disabled HIV/AIDs patients has no opportunities to be treated properly

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
The model of service development 1. Patient logbooks were introduced to record medication diaries. 2. Patients are advised by registered nurses. 3. Patients’ information are registered with NAP and HIVQUL, STIQuality, VCT Quality 3 4. Patients are educated in antiretroviral drugs by registered nurses, pharmacists and physicians. They are supposed to remember how the drugs look like and how many drugs they take a day. 5. There is the holistic center, a group of patients with HIV/AIDS in Sisaket Province, working for HIV/AIDS patients in cooperation with Sisaket Hospital. They have been trained by public sectors to be able to work with hospitals. Their job are offering a consult and a home visit before and during the treatment, sending medicine by post, offering a consult in Hot Line, etc. 6. AIDS campaign in 1993, “Mor Lum against AIDS” invited to perform in German in 2004, etc. 7. It won the second prize in the organization of AIDS care at office contest by Department of Disease Control in 2014. 8. It was the Red Ribbon Award Winners for 2006, held by the United Nations in Toronto, Canada. 9. It was held training on AIDS education to students in 2010 10. It was conducted a campaign against AIDS on February 14, 2010 11. We participated in Innovation Award in 2010 and 2015

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
No.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
- To increase life expectancy for HIV/AIDs patient - To educate HIV/AIDs patients to take good care of themselves

Contact Information

Institution Name:   Sisaket Hospital
Institution Type:   Government Department  
Contact Person:   Noopon Buasri
Title:   Doctor  
Telephone/ Fax:   +6645611503
Institution's / Project's Website:  
E-mail:   kultida_sskh@hotmail.com  
Address:   859 Kasikam Road
Postal Code:   33000
City:   Meaung Sisaket District
State/Province:   Sisaket
Country:  

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