ASSESSING OF THAILAND HIV DATA QUALITY AND ITS IMPACT TO UNAIDS 90-90-90

Abstract

Introduction Despite having an effective Anti-Retroviral therapy regimen that improves the quality of life of HIV patients, HIV is still a major threat to public health and still is growing. To address this threat, UNAIDS has established the policy of the 90-90-90 indicators that needed to be achived. In 2018, Thailand’s indicators have become unreasonably high excessing 100%. Therefore, this study aims to assess the current data quality using the Ministry of Public Health, exploring the causes, and providing recommendations. Methods Using a mix-methods approach this study analyzes and compares across two databases, the Ministry of Public Health (MOPH) and National AIDS Program (NAP) to describe the overall quality and the extent of the two data sources difference. The province with the highest difference was selected for a field visit and the deployment of the Data Quality Improvement Tools (DQI Tools), jointly developed by MOPH and Thai-MOPH-US-CDC Collaborator (TUC) for assessing the HIV data quality. Field interviews were conducted using the MEASURE Data Quality Audit (DQA) as a guide to identifying the drop-off in the workflow. Results Thailand's 90-90-90 indicators were calculated using NAP as a default data source giving 105%,72%, and 83% respectively. For MOPH, the first indicator was 104% and 52% for the second indicator. The third indicator for the MOPH was not available because of a lack of laboratory data. NAP data quality gaps were identified including a legacy data migration problem and a difficult data correction process. MOPH gaps were related to the lacking of a single unified standard for both laboratory and medication, unclear regulation, and lack of incentives for data reporting. Bangkok, while having a similar reporting practices to the non-Bangkok province, it also suffers from having several hospital affiliations, technical problems, and limited data stewardship. Conclusion In this study, NAP suffers from complicated data correction processes, coverage of other health schemes, and disincentive, it was a suitable source for the 90-90-90 indicator calculation. MOPH is not suitable for indicator calculation from lacking national data standards, unclear regulation, and the database structure itself. Bangkok, Thailand's capital city is the area that needs special attention