Dr. Than Naing Oo

The social impacts of Decentralization of ART on patients in Let-Pa-Dan township, Bago Region, Myanmar Completed in partial fulfilment for the award of MSc ( Public Health) University of Bedfordshire

Abstract

Background: The international community has committed to meet the fast track target of 90-90-90 in 2020 in HIV control. This 2020 target is an indicator to achieve the ambitious goal of eliminating the HIV as a public health threat by 2030. In order to achieve the ambitious target, ART must be scaled up all over the world. To address the shortage of health care service providers due to ART scale up, WHO recommended the Decentralization of HIV services to the peripheral health facilities. The government of Myanmar has committed to achieve the 2020 target. So, the Ministry of Health and Sports, Myanmar adopted the ART decentralization for scaling up of ART. However, very few studies regarding the decentralization of ART in Myanmar are present.

The objectives :To identify the perceived positive and negative social impacts on patients after referring to Let-Pa-Dan township hospital for ARV treatment and to explore patients’ recommendations to address the challenges.

Method: A cross-sectional qualitative study was used to explore the social impacts of ART decentralization to the patients. Face-to-face in-depth interview was used as data collection tool so that the perception and feeling of patients could be identified. Participants were selected among the patients who had been initiated ART at central hospitals and clinics and transferred to Let-Pa-Dan hospital for ART continuation, with inclusion and exclusion criteria.

Results: Among the participants, some were pushed by service providers at the central hospitals or clinics to be transferred to the peripheral centre. Out of 19 patients, almost all are happy with decentralized ART at Let-Pa-Dan hospital. They expressed advantages as less travelling time and cost, lack of physical tiredness, proximity to their homes and warm relationship at the decentralized centre. However, they said negative about lack of laboratory facilities to monitor the HIV status, associated supports and absence of professional health care provider at the decentralized centre.

Conclusion: The study highlights that the decentralization of ART in Myanmar works with several benefits to the patients who were decentralized to peripheral centre. However, there are rooms for improvements such as lack of laboratory services and skilled personnel at the decentralized sites. Moreover, a strong policy that articulates the voluntary transfer of patients should be implemented.

Key words: HIV, HIV/AIDS, ARV, ART, decentralization.

 

Declaration

This study was completely undertaken and written by author, Than Naing Oo. The author used his own words or images, and ideas.  After conducting the study, author has formed the results from his work. This study was not copied from the scripts of other authors or candidates, and no unauthorised materials were used. No false information has been included.