National program for preventing mother-child HIV transmission in Thailand: successful implementation and lessons learned.
OBJECTIVE
To describe the development, components, and initial uptake of Thailand's national program for preventing mother-child HIV transmission.


METHODS
Historical review, interpretation of experience, national program monitoring.


METHODS
Public health system, Thailand.


METHODS
Policymakers, clinicians, HIV-infected pregnant women.


METHODS
Voluntary counseling and HIV testing of pregnant women; short-course zidovudine for HIV-infected women and their infants and formula feeding for infants.


METHODS
Program components implemented and program uptake.


RESULTS
Research, monitoring and evaluation of pilot projects, training, and policy-making provided the information, experience, infrastructure, and guidance to develop a program for preventing mother-child HIV transmission that was implemented in all Ministry of Public Health hospitals in Thailand in 2000. A national system was established to monitor program implementation. Monitoring reports were received from 669 hospitals in 65 provinces for the period October 2000 through July 2001. During this period, 93% of 318 721 women who gave birth were tested for HIV; 69% of 3958 HIV-infected women giving birth received zidovudine; and 86% and 80% of the 3865 children born to HIV-infected women received zidovudine and infant formula, respectively, through the program.


CONCLUSIONS
A national program for preventing mother-child HIV transmission was successfully implemented in Thailand. Early monitoring indicates good program uptake. Lessons learned from implementing this program include the importance of paying attention to counseling, communication, and training in the program, and using pilot projects and focused monitoring and evaluation data to guide the program development, expansion, and improvement.
Kanshana
Siripon
S
Department of Health, Ministry of Public Health, Tivanon Road, Nonthaburi 11000, Thailand.
Simonds
R J
RJ
D015492:AIDS Serodiagnosis; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003376:Counseling; D003955:Diagnostic Tests, Routine; D017598:Efficiency, Organizational; D005260:Female; D005544:Forecasting; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006291:Health Policy; D006779:Hospitals, Public; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007391:International Cooperation; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D009313:National Health Programs; D010353:Patient Education as Topic; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D011295:Prenatal Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D013785:Thailand; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine