The U.S. Agency for International Development’s Community Partnership project (ENGAGE) aims to assist community-based organizations in Thailand to legally provide high quality HIV prevention, treatment and care to key populations, including men who have sex with men, transgender people, sex workers and people who inject drugs. Supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), this three-year project started in August 2017 and is implemented as the consortium between the Thai Red Cross AIDS Research Centre (TRCARC) and three leading community-based organizations: the MPlus Foundation, the Rainbow Sky Association of Thailand (RSAT) and Service Workers in Group Foundation (SWING).
Ensuring high quality services
To ensure high quality key population-led health services (KPLHS), this project established the ENGAGE technical assistance (TA) platform to train key population (KP) lay providers from community-based organizations working with key populations to deliver efficient and effective HIV-related health services. In addition, ENGAGE TA platform, in collaboration with local authorities, established the training and certification committee to assure development of KPLHS training curricula, training and certification process for KP lay providers under ENGAGE are met with key competencies and services standard for KPLHS. Trainings focused on effective delivery of HIV testing and counseling; sexually transmitted disease screening and treatment; antiretroviral treatment dispensing, and pre-exposure prophylaxis dispensing. Another critical component is to ensure that KP lay providers deliver client-centered prevention and care services without stigma and discrimination. Besides the training, ENGAGE also set up coaching and certification system to trained KP lay providers to assure continuity of quality and effective services delivery.
Advocacy for legalization KP lay providers in Thailand
To assure the trained and certified KP lay providers have been legalized for providing HIV services and accepted among health public system as one of formal health facilities for further allowing the organizations having certified KP lay providers reimburse for health service delivery, the project works with Division of AIDS and STIs (DAS), Department of Disease Control (DDC) and related key stakeholders in advocating for the legalization of KP lay providers in Thailand. Finally, a ministerial regulation sanctioning KP lay providers’ roles was signed by the Minister of Public Health on June 6, 2019 and promulgated in the Ministry’s gazette in September 2019. In addition, with collaboration among key stakeholders, an quality standards for HIV/STIs service delivery for has been developed and launched out nationally. Moreover, national operation plan for KP-lay provider certification has been developed
Impact and Results
As of July 2020, 90 of 208 KP lay providers trained on KPLHS by ENGAGE and are in the process of practicing for certification are certified as KP lay providers for KPLHS. All of these trained and certified KP lay providers are working at community-based organizations in 6 high HIV burden provinces. They are qualified to register as “CBO volunteers” under national certification system according to the announced ministerial regulation.
With the capacity building and certification systems for KP lay providers initiated by ENGAGE and the formal legal endorsement of KP lay providers and KPLHS, domestic financing through the National Health Security Office is being made available to accredited KP-led organizations.
This will lend support to the scale-up and sustainability of KPLHS. As the national certification system becomes operational, ENGAGE will continue to have a key role in KP capacity building and certification as well as provide technical assistance in the scale-up and monitoring of the national system.