Outcome Framework for Health
Services: Case Study of HIV/AIDS
Thailand
Nichawan Nuankaew
Situation Analysis
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Total population
63
million
no. of people living with HIV 610,000
Adults (15+)
600,000
Women (15+)
250,000
Children (0-15)
14,000
Estimated adult HIV prevalence 1.4%
Estimated no. of AIDS deaths 31,000 in 2007
Situation Analysis
120000
100000
80000
60000
AIDS patient
dead
40000
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
0
1984-1997
20000
Age wise Distribution of AIDS patients
30
26.16
25
23.15
20
17.75
15
AGE
10
9.91
8.05
5.13
5
2.53
1.26
1.39
55-59
60
50-54
45-49
40-44
35-39
30-34
15-19
25-29
10-14
5-9
0-4
0
0.36
0.75
20-24
2.45
1.11
Vision
Zero HIV/AIDS in 2015
Goals
To reduce the number of new HIV
infections and the socio-economic
impact of HIV/AIDS in Thailand
HIV/AIDS Strategies
1.
2.
3.
4.
5.
6.
Reform the health management system
Develop the efficiency & ability to access health services
Develop good health behavior practices for HIV/AIDS
prevention control & health promotion
Develop system for customer protection in the areas of
medical services & health-related products for HIV/AIDS
Produce & develop human resources for health
programme in a systemic & continuous manner in all
areas
Promote studies, research & development of healthrelated products & health technologies for HIV/AIDS
HIV/AIDS Control Programme:
Building Outcome Data Base
Plan
Do
Act
Check
HIV/AIDS Control Programme: Building
Outcome Data Base
Steps
Frame the
question
HACP
Research
Time
Activities
Plan Critical areas 3 months -Frame the question
from case study in
target areas
systematically
observe the
HIV/AIDS problem
- Assess causative
factors
-Search for the
available best
practices
HIV/AIDS Control Programme:
Building Outcome Data Base
Steps
HACP
Research
Test the
best
practices
Do
Conduct the
research
Time
Activities
5
-Conduct the best
months practice & assess the
result
-Go to target areas
(vulnerable)
Analyze Check Analysis &
2
-Determine, Analyze,
the result
publish result Months Summarize the result
&
-Publish & Promote
distribute
the result (PoP &
the
organization)
knowledge
HIV/AIDS Control Programme:
Building Outcome Data Base
Steps
HACP
Research
Time
Activities
Implement the
“Proved
Best Practice”
Act
Implement
the
“Proved
Best
Practice”
2
-Implement the
months “Proved Best practice”
-Redo “Plan” as
needed
Output – Outcomes Matrixs
Programme Component: HIV/AIDS
Outcome & Indicators
Outcome:
Improved HIV prevention
through safer sexual practices
among vulnerable groups
Outcome indicators:
In selected areas:
Percentage of young people
demonstrating behavioural
change towards safer sex
practices
Percentage of commercial sex
workers reporting consistent
use of condoms with clients
and non-client partners
Condom use at last high-risk
sex
Output & Indicators
Output 1:
Improved access to information, counselling and
services for HIV prevention among young people,
commercial sex workers, clients of commercial sex
workers and migrants in underserved areas
Output indicators:
Percentage of service delivery points providing
youth-friendly information, counselling and services
for HIV prevention
Percentage of service delivery points providing
high-quality voluntary counselling and testing for
HIV infection
Percentage of young people, commercial sex
workers, clients of commercial sex workers, and
migrants (workers and dependents) having access to
target group-specific information, counselling and
services for HIV prevention
Percentage of young women who are confident
they have the skills to get their partners to use
condoms
partners
Indicative
resources by
programme
component
$3.5 million
Ministry of Public
Health
Ministry of
Education
Provincial public
health offices
NGOs/civil
society
organizations
Output – Outcomes Matrixs
Outcomes & indicators
Outcome:
Increased utilization of disaggregated data
for policy and programme formulation at
national and subnational levels for
addressing maternal and newborn health,
adolescent reproductive health,
HIV/AIDS, gender, migration and
population ageing
Outcome indicators:
Key policies and programmes are
evidence-based
Policymakers support formulation and
implementation of elderly friendly
policies and programmes
Outputs& indicators
Output 2:
Enhanced capacity at national and
subnational levels to collect and analyse
data and to conduct policy research on
issues relating to reproductive health,
HIV/AIDS, gender, migration and
population ageing
Output indicators:
HIV/AIDS and gender issues are
integrated into reproductive health and
population and development policies
Effective policies and programmes to deal
with population ageing formulated and
implemented
Analytical reports on gender-related topics
available and disseminated
partners
National Statistical
Office
Ministry of Public
Health
Ministry of Social
Welfare and Human
Security
Provincial health
offices
Provincial statistical
offices
District
administration offices
NGOs/civil society
organizations
Academic institutions
Indicative
resources by
programme
component
Output – Outcomes Matrixs
Outcomes & indicators
Outcome:
Improved knowledgemanagement and networking
mechanisms for intercountry
communication and action on
population, reproductive health,
HIV/AIDS, gender, migration and
population ageing issues in the
region
Outcome indicators:
Regional-level programmes and
projects addressing populationrelated issues
Increase in South-South
cooperation with other countries
Outputs& indicators
Output 3:
Enhanced capacity and improved
mechanisms for South-South cooperation in
sharing experiences, information, and
professional and technical know-how in
population-related areas
Output indicators:
Statistical information on key populationrelated issues between countries available
Regional-level analyses of populationrelated issues available
Number of initiatives and activities
involving more than one country on
population-related issues
partners
Thailand International
Development
Agency/Ministry of Foreign
Affairs
Civil society organizations
Indicative
resources by
programme
component
Output – Outcomes Matrixs
Outcomes & indicators
Outcome:
Increased utilization of
information & services by
vulnerable groups & underserved
areas
Outcome indicators:
Percentage of in & out of school
youth using information &
services on HIV
Outputs& indicators
Output 4:
Improve access counselling & services,
including HIV prevention for vulnerable
groups and underserved areas
Output indicators:
-Percentage of service delivery points in
vulnerable groups, underserved areas
counselling & services for HIV prevention
-Percentage of vulnerable groups, underserved
population having access to information and
services for HIV prevention
partners
-Ministry of Public Health
-Ministry of Education
-Provincial public health
office
Indicative
resources by
programme
component
Outcome Oriented Budgeting Process
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Annual budget next year: Oct (current year) – Sept
(next year)
MoH (Plan+budget+time) next year
MoF in sept
(current year)
MoF money MoH
Target areas
(vulnerable:5 Provinces)
Roadblocks
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Manpower
Lack of Transportation
Lack of Education
Gov’t change subject activities
Socio-economic factors (Poverty)
Lack of infrastructure
Social crisis (Conflict in target areas)
Lack of information
Lack of knowledge
Outcome Oriented Expenditure Management
1. Audit office Centre (in central level)
2. Internal audit group (in branch offices/local gov’t)
** Particular OOEM: MoH will make sure the local
gov’t in target areas achive intended output
Monitoring & Evaluation
Outcome
Indicators will be check by MoH, SC, MoF, MoP
3 months
Output
Indicators will be check by local gov’t (Provinces)
as well as by MoH
monthly
Input
Data will be maintained by local gov’t
(District + Subdistricts level)