Public contracting with civil society organizations for HIV/AIDS service provisions: A key strategy to ending AIDS in Thailand

Pudpong, Nareerut; Viriyathorn, Shaheda; Wanwong, Yaowaluk; Witthayapipopsakul, Woranan; Wangbanjongkun, Waritta; Patcharanarumol, Walaiporn; Tangcharoensathien, Viroj

doi:10.1080/15381501.2021.1986188

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…It involves governments contracting CSOs to delivery services to key populations, thus channeling government financing for community-based outreach and care initiatives. 28 A 2021 study analyzing the sustainability of CSO provided services in the Eastern European and Central Asian region found that these services, often provided by peers for those most marginalized, are slow to be financed by local governments, 29 which was also demonstrated in this analysis. Collaborative modelling exercises can support the implementation of social contracting by engaging partners in constructive dialogue and consensus building on target setting and budget allocation.…”

Section: Discussionmentioning

confidence: 58%

Qualitative evaluation of the use of modelling in resource allocation decisions for HIV and TB

Bowring

Brink

Martin-Hughes

et al. 2023

Preprint

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Introduction: Globally, resources for health spending, including HIV and tuberculosis (TB), are constrained, and a substantial gap exists between spending and estimated needs. Optima is an allocative efficiency modelling tool that has been used since 2010 in over 50 settings to generate evidence for country-level HIV and TB resource allocation decisions. This evaluation sought to assess the determinants and outcomes of using modelling to inform financing priorities from the perspective of country stakeholders and their international partners. Methods: In October-December 2021, the World Bank and Burnet Institute led 16 small-group virtual interviews with representatives from national governments and international health and funding organizations. Interviewed stakeholders represented nine countries and 11 different disease program country contexts where Optima modelling work had been undertaken. Interview notes were thematically analyzed to evaluate determinants of research translation into policy and practice. Results: Common factors that facilitated or inhibited the application of Optima findings broadly encompassed the perceived validity of findings, health system financing mechanisms, the extent of stakeholder participation, engagement of funding organization, socio-political context, and whether the analysis was timed to suit data and stakeholder needs. Key reported outcomes of Optima analyses related to improved understanding of data and allocative efficiency, support for strategic planning, financial planning, funding advocacy and grant proposals, and influencing investment shifts between interventions or their delivery modalities. Conclusion: Allocative efficiency modeling has supported evidence-informed decision making in numerous contexts and enhanced the conceptual and practical understanding of allocative efficiency. Most immediately, greater involvement of country stakeholders in modelling studies and tying the timing of such studies to key strategic and financial planning decisions may increase the impact on decision making. To further improve relevance and acceptance of modelling findings, there needs to be greater consideration given to integrated disease modelling, equity goals, and financing constraints.

show abstract

Section: Discussionmentioning

confidence: 58%

Qualitative evaluation of the use of modelling in resource allocation decisions for HIV and TB

Bowring

Brink

Martin-Hughes

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…A 2021 study analysing the sustainability of CSO provided services in the Eastern European and Central Asian region found that these services, often provided by peers for those most marginalised, are slow to be financed by local governments,45 which was also demonstrated in this analysis. The present research demonstrates that collaborative modelling exercises can support the implementation of social contracting by engaging partners in constructive dialogue and consensus building on target setting and budget allocation 46…”

Section: Discussionmentioning

confidence: 83%

“…The present research demonstrates that collaborative modelling exercises can support the implementation of social contracting by engaging partners in constructive dialogue and consensus building on target setting and budget allocation. 46 A number of limitations should be considered when interpreting these findings. The results may not represent the views of institutions and individuals who were non-responsive to multiple interview requests, and thus biased to settings with higher engagement in Optima processes or a more recent Optima analysis.…”

Section: Bmj Global Healthmentioning

confidence: 99%

Evaluation of the use of modelling in resource allocation decisions for HIV and TB

Bowring,

ten Brink,

Martin-Hughes

et al. 2024

BMJ Glob Health

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IntroductionGlobally, resources for health spending, including HIV and tuberculosis (TB), are constrained, and a substantial gap exists between spending and estimated needs. Optima is an allocative efficiency modelling tool that has been used since 2010 in over 50 settings to generate evidence for country-level HIV and TB resource allocation decisions. This evaluation assessed the utilisation of modelling to inform financing priorities from the perspective of country stakeholders and their international partners.MethodsIn October to December 2021, the World Bank and Burnet Institute led 16 semi-structured small-group virtual interviews with 54 representatives from national governments and international health and funding organisations. Interviews probed participants’ roles and satisfaction with Optima analyses and how model findings have had been used and impacted resource allocation. Interviewed stakeholders represented nine countries and 11 different disease programme-country contexts with prior Optima modelling analyses. Interview notes were thematically analysed to assess factors influencing the utilisation of modelling evidence in health policy and outcomes.ResultsCommon influences on utilisation of Optima findings encompassed the perceived validity of findings, health system financing mechanisms, the extent of stakeholder participation in the modelling process–including engagement of funding organisations, sociopolitical context and timeliness of the analysis. Using workshops can facilitate effective stakeholder engagement and collaboration. Model findings were often used conceptually to localise global evidence and facilitate discussion. Secondary outputs included informing strategic and financial planning, funding advocacy, grant proposals and influencing investment shifts.ConclusionAllocative efficiency modelling has supported evidence-informed decision-making in numerous contexts and enhanced the conceptual and practical understanding of allocative efficiency. Most immediately, greater involvement of country stakeholders in modelling studies and timing studies to key strategic and financial planning decisions may increase the impact on decision-making. Better consideration for integrated disease modelling, equity goals and financing constraints may improve relevance and utilisation of modelling findings.

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“…Despite their critical role, only a small proportion of CSOs were accredited and entered into contractual arrangement with health care facilities. Costs such as training of CSO staffs were not covered ( Pudpong et al. , 2019 ).…”

Section: Resultsmentioning

confidence: 99%

Procedural fairness in benefit package design: inclusion of pre-exposure prophylaxis of HIV in Universal Coverage Scheme in Thailand

Viriyathorn,

Sachdev,

Suwanwela

et al. 2023

Health Policy and Planning

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Since 2002, Thailand’s Universal Coverage Scheme (UCS) has adopted a comprehensive benefits package with few exclusions. A positive-list approach has gradually been applied, with pre-exposure prophylaxis (PrEP) of HIV recently being included. Disagreements resulting from competing values and diverging interests necessitate an emphasis on procedural fairness when making any decisions. This qualitative study analyses agenda setting, policy formulation and early implementation of PrEP from a procedural fairness lens. Literature reviews and in-depth interviews with 13 key stakeholders involved in PrEP policy processes were conducted. Civil society organizations (CSOs) and academia piloted PrEP service models and co-produced evidence on programmatic feasibility and outcomes. Through a broad stakeholder representation process, the Department of Disease Control proposed PrEP for inclusion in UCS benefits package in 2017. PrEP was shown to be cost-effective and affordable through rigorous health technology assessment, peer review, use of up-to-date evidence and safe-guards against conflicts of interest. In 2021, Thailand’s National Health Security Board decided to include PrEP as a prevention and promotion package, free of charge, for the populations at risk. Favourable conditions for procedural fairness were created by Thailand’s legislative provisions that enable responsive governance, notably inclusiveness, transparency, safeguarding public interest and accountable budget allocations; longstanding institutional capacity to generate local evidence; and implementation capacity for realisation of procedural fairness criteria. Multiple stakeholders including CSOs, academia and the government deliberated in the policy process through working groups and sub-committees. However, a key lesson from Thailand’s deliberative process concerns a possible ‘over interpretation’ of conflicts of interest, intended to promote impartial decision-making, which inadvertently limited the voices of key populations represented in the decision processes. Finally, this case study underscores the value of examining the full policy cycle when assessing procedural fairness, since some stages of the process may be more amenable to certain procedural criteria than others.

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Public contracting with civil society organizations for HIV/AIDS service provisions: A key strategy to ending AIDS in Thailand

Cited by 3 publications

References 9 publications

Qualitative evaluation of the use of modelling in resource allocation decisions for HIV and TB

Qualitative evaluation of the use of modelling in resource allocation decisions for HIV and TB

Evaluation of the use of modelling in resource allocation decisions for HIV and TB

Procedural fairness in benefit package design: inclusion of pre-exposure prophylaxis of HIV in Universal Coverage Scheme in Thailand

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