Thailand National Strategy on STIs Prevention and Control,

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5 ** Key Summary of Thailand is concerned with the increase of sexually transmitted infections that has occurred in the last 4 years, especially syphilis and gonorrhea, particularly among young people aged The Department of Disease Control, Ministry of Public Health therefore developed the National Strategy on STIs Prevention and Control,, in collaboration with the Thai Medical Society for the Study of Sexually Transmitted Diseases, and with technical support from WHO Thailand. In addition, the development and finalization of the Strategy benefitted significantly from the discussion and contribution of multisector partners during the workshops organized in the 4 regions of Thailand. 4.1 Vision To end harmful Sexually Transmitted Infections (STIs) in order to prevent public health threats to the country by 2030 (within 13 years). 4.2 Objectives and Strategic Overall Objectives To prevent and control STIs by strengthening capacity and expanding coverage of STIs prevention and treatment services that are effective and patient-friendly by utilising existing institutional structures, as well as enhancing potentials and collaborating with relevant partners and stakeholders, thus ensuring prompt and sustainable results. Strategic Timeline Within 5 years (by 2021) Incidence of harmful STIs (syphilis and gonorrhea) per 100,000 population Syphilis < 3.5 Gonorrhea < 8.0 Remarks Syphilis incidence in 2014 was 4.89 cases per 100,000 polulation Gonorrheal incidence in 2014 was cases per 100,000 population 1

6 4.3 RRTTRP Process for Comprehensive Prevention and Control of Sexually Transmitted Infections Strategy 1, 2 and 3 play key roles in the RRTTRP process from Reach to Retain. RRTTR-P Process For Comprehensive Prevention and Control of Sexually Transmitted Infections Test Treat Reach Recruit Retain Prevent Department of Disease Control 4.4 Strategy Strategy 1 Expedite prevention and treatment of STIs among specific target populations to ensure effectiveness and sufficient coverage by using new innovations Strategy 2 Strengthen capacity of public health personnel and volunteers to implement comprehensive and patient-friendly treatment and prevention services according to the standards Strategy 3 Expand coverage and ensure continuity in utilising communication innovations to support prevention and treatment as well as promote condom use among different target groups of youth population Strategy 4 Improve data system and information technology to support decision making, policy formulation, planning and evaluation, ensuring linkages at all levels Strategy 5 Improve, promote, recognize and praise innovations, knowledge, pilot models and success from implementation of the national strategy Objectives by Strategies Objective of Strategy 1 Specific target populations adequately receive comprehensive and sustainable prevention and treatment services Objective of Strategy 2 Comprehensive and patient-friendly treatment and prevention services by public health personnel and volunteers according to the standards Objective of Strategy 3 Target youth populations are aware and motivated to reduce risk behaviour in order to prevent infection and seek treatment Objective of Strategy 4 National information system and data is available and used to support decision making, policy formulation, planning and evaluation Objective of Strategy 5 Innovations, new knowledge, pilot models and success are achieved, recognized and praised, as well as transferred and disseminated for scalling up 2

7 Strategies, Tactics and Strategy 1 Expedite prevention and treatment of STIs among specific target populations to ensure effectiveness and sufficient coverage by using new innovations Tactic 1 Expedite comprehensive services for prevention and treatment for military conscripts through collaboration with networks of military hospitals of the 3 forces: Army, Navy and Air Force Tactic 2 Expedite comprehensive services for prevention and treatment for factory workers through collaboration with workplaces and partner hospitals Tactic 3 Develop comprehensive STIs services to expedite comprehensive, proactive and patient-friendly prevention and treatment services for sex workers in high-population (sex workers) border areas 3

8 Tactic 1 Expedite comprehensive services for prevention and treatment for military conscripts through collaboration with networks of military hospitals of the 3 forces: Army, Navy and Air Force 1. Percentage of target military conscripts who undertake self assessment of risk at least once a year, using Department of Disease Control s self assessment of risk form 2. Percentage of target military conscripts who have knowledge, awareness and motivation to support STIs prevention and treatment 3. Percentage of target military conscripts who can easily access condoms when needed while in the camps 4. Percentage of target military conscripts who use condoms the last time they have sex with persons other than their wives 5. Percentage of target military conscripts with syphilis and gonorrhea who are treated according to Department of Disease Control s guidelines and standards 2015 = 35.7% Year Percentage of large military hospitals under Ministry of Defense that are able to provide comprehensive and patient-friendly STIs prevention and treatment services according to Department of Disease Control s guidelines and standards 6.1 Percentage of large military hospitals (in army regions) under Royal Thai Army Medical Department that are able to provide comprehensive and patient-friendly STIs prevention and treatment services according to Department of Disease Control s guidelines and standards 6.2 Percentage of large military hospitals under Department of Naval Medicine that are able to provide comprehensive and patient-friendly STIs prevention and treatment services according to Department of Disease Control s guidelines and standards for

9 6.3 Percentage of large military hospitals under Department of Army Medical Air that are able to provide comprehensive and patient-friendly STIs prevention and treatment services according to Department of Disease Control s guidelines and standards 7. Percentage of small and medium military hospitals participating in implementing the national strategy that are able to provide comprehensive and patient- friendly STIs treatment or referral services according to Department of Disease Control s guidelines and standards 8. Number of the military forces (Army, Navy, Air force) of Ministry of Defense that have collaborative programs/projects on STIs prevention and control with Department of Disease Control, Ministry of Public Health for Year Tactic 2 Expedite comprehensive services for prevention and treatment for factory workers through collaboration with workplaces and partner hospitals 1. Percentage of target factory workers in pilot factories who undertake self assessment of risk at least once a year, using Department of Disease Control s self assessment of risk form 2. Percentage of target factory workers in pilot factories who have knowledge, awareness and motivation to support STIs prevention and treatment Year

10 3. Percentage of pilot factories that have personnel or workers as trainers or target group leaders or volunteers for prevention and treatment campaigns according to Department of Disease Control s guidelines 4. Percentage of pilot factories where workers can access condoms free-of-charge or through sale 5. Percentage of target factory workers in pilot factories who use condoms the last time they have sex with persons other than their wives/husbands 6. Percentage of physicians stationed at pilot factories, where doctors/nursing stations exist, who have knowledge and skills to provide comprehensive and patient-friendly STIs treatment according to Department of Disease Control s guidelines and standards 7. Percentage of pilot factories that have a referral system with partner hospitals/social security hospitals where comprehensive and patient-friendly STIs treament services are provided according to Department of Disease Control s guidelines and standards 8. Number of pilot factories that have collaborative programs/projects on STIs prevention and control with units under Ministry of Public Health, or Bangkok Metropolitan Administration, or Pattaya City Administration for Year

11 Tactic 3 Develop comprehensive STIs services to expedite comprehensive, proactive and patient-friendly prevention and treatment services for sex workers in high-population (sex workers) border areas 1. Percentage of target sex workers in high-population (sex workers) border areas who undertake self assessment of risk at least once a year, using Department of Disease Control s self assessment of risk form 2. Percentage of target sex workers in high-population (sex workers) border areas who have knowledge, awareness and motivation to support STIs prevention and treatment 3. Percentage of target sex workers in high-population (sex workers) border areas who can access condoms easily when needed 4. Percentage of target sex workers in high-population (sex workers) border areas who use condoms the last time they have sex with customers 5. Percentage of target sex workers in high-population (sex workers) border areas who are diagnosed and screened for STIs according to Department of Disease Control s guidelines and standards 6. Percentage of target sex workers in high-population (sex workers) border areas who receive treatment according to Department of Disease Control s guidelines and standards when they are diagnosed with STIs 7. Percentage of districts with high population of sex workers in border areas that have health facilities which provide comprehensive, proactive and patient-friendly STIs prevention and treatment services according to Department of Disease Control s guidelines and standards Year

12 8. Percentage of districts with high population of sex workers in border areas that have trainers and target group leaders on comprehensive, proactive and patient- friendly STIs prevention and treatment services according to Department of Disease Control s guidelines and standards Year

13 Strategy 2 Strengthen capacity of public health personnel and volunteers to implement comprehensive and patient-friendly treatment and prevention services according to the standards Tactic 1 Enhance knowledge and skills of physicians, nurses and other public health personnel in comprehensive and patient-friendly treatment and prevention according to Department of Disease Control s guidelines and standards Tactic 2 Develop capacity of personnel of partner organizations and networks, as well as volunteers, to become trainers and target group leaders for the comprehensive prevention of STIs Tactic 3 Develop and promote use of innovations to enhance effectiveness of comprehensive treatment and prevention Tactic 1 Enhance knowledge and skills of physicians, nurses and other public health personnel in comprehensive and patient-friendly treatment and prevention according to Department of Disease Control s guidelines and standards 1. Percentage of trained physicians, nurses and other public health personnel who have knowledge and skills in comprehensive and patient-friendly treatment and prevention according to Department of Disease Control s guidelines and standards 2. Percentage of trained physicians, nurses and other public health personnel who are confident in providing patient-friendly services without displaying repulse, stigma and discrimination towards certain groups of patients, such as MSM, transgenders and sex workers 3. Percentage of participating hospitals under Ministry of Public Health, Bangkok Metropolitan Administration and Pattaya City Administration that provide comprehensive and patient-friendly treatment services according to Department of Disease Control s guidelines and standards Year

14 Tactic 2 Develop capacity of personnel of partner organizations and networks, as well as volunteers, to become trainers and target group leaders for the comprehensive prevention of STIs 1. Percentage of trained personnel of partner organizations and networks, including volunteers and representatives of target groups who have knowledge and skills in serving as trainers or target group leaders in comprehensive prevention for specific target populations Year Tactic 3 Develop and promote use of innovations to enhance effectiveness of comprehensive treatment and prevention Number of innovations to increase effectiveness of comprehensive STIs treatment and prevention 1.1 Number of STIs treatment and prevention mobile application for public health personnel for Number of treatment flow charts according to Department of Disease Control s guidelines and standards in digital format 1.3 Number of treatment flow charts according to Department of Disease Control s guidelines and standards in print format 1.4 Number of training manuals for training of trainers and target group leaders on comprehensive prevention of STIs Year 10

15 Strategy 3 Expand coverage and ensure continuity in utilising communication innovations to support prevention and treatment as well as promote condom use among different target groups of youth population Tactic 1 Develop innovations to communicate risk, create awareness and build motivation for prevention and treatment, including condom use, that are responsive to risk factors among target youth populations Tactic 2 Communicate to target youth populations widely and continuously using innovations, local media, social media, mobile phones and person-to-person communication while harnessing engagement with target groups Tactic 1 Develop innovations to communicate risk, create awareness and build motivation for prevention and treatment, including condom use, that are responsive to risk factors among target youth populations 1. Number of mobile phone clips/youtube clips /Line clips to communicate risk, create awareness and build motivation for prevention and treatment, including condom use, among target youth populations Year Tactic 2 Communicate to target youth populations widely and continuously using innovations, local media, social media, mobile phones and person-to-person communication while harnessing engagement with target groups 1. Percentage of military conscripts in the 3 military forces ( Army, Navy, Air Force) who receive communications on risk, awareness creation and motivation building regarding STIs prevention and treatment through communication innovations for Year

16 2. Percentage of Thai Reserve Officer Training Corps Students who receive communications on risk, awareness creation and motivation building regarding STIs prevention and treatment through communication innovations 3. Number of target provinces where workers in all factories, in which doctors/nursing stations exist, receive communications on risk, awareness creation and motivation building regarding STIs prevention and treatment through communication innovations 4. Percentage of youths in secondary schools who receive communications on risk, awareness creation and motivation building regarding STIs prevention and treatment through communication innovations (e.g. mobile phone clips and Line clips via Thai student councils nation-wide) for 2018 for 2018 for Year

17 Strategy 4 Improve data system and information technology to support decision making, policy formulation, planning and evaluation, ensuring linkages at all levels Tactic 1 Improve data system and information technology that link all levels, comprising data on epidemiology, screening and treatment, and develop a National Strategic Information Warehouse on STIs that can readily serve policy decision making, evaluation and improvement of implementation Tactic 2 Develop a War Room system at the national, regional and provincial levels in order to use data and information to support timely decision making and STIs responses Tactic 1 Improve data system and information technology that link all levels, comprising data on epidemiology, screening and treatment, and develop a National Strategic Information Warehouse on STIs that can readily serve policy decision making, evaluation and improvement of implementation 1. Percentage of heath facilities under the government and local administration, including Bangkok Metropolitan and Pattaya City, that report STIs into the Ministry of Public Health information system (through form 506) in a complete and timely manner 2. Percentage of success in developing the National Strategic Information Warehouse on STIs that can readily serve policy decision making, evaluation and improvement of implementation for 2018 for Year

18 Tactic 2 Develop a War Room system at the national, regional and provincial levels in order to use data and information to support timely decision making STIs responses 1. Percentage of success in establishing a functioning national War Room (e.g., at Department of Disease Control) that uses data and information to support timely decision making and STIs responses (It may be a virtual War Room without an actual room) 2. Number of War Rooms at provincial or regional level (where the STIs problem is acute) that are established and start operating to uses data and information to support timely decision making and STIs responses (It may be a virtual War Room without an actual room) for 2018 for Year

19 Strategy 5 Improve, promote, recognize and praise innovations, knowledge, pilot models and success from implementation of the national strategy Tactic 1 Improve, promote, transfer and disseminate innovations, knowledge and pilot models for STIs prevention and control to scale up implementation of the national strategy Tactic 2 Develop and implement systems to recognize and praise innovations, knowledge, pilot models and success that belong to projects, institutions and individuals, at the national, regional and provincial levels, to promote learning and boost morale Tactic 1 Improve, promote, transfer and disseminate innovations, knowledge and pilot models for STIs prevention and control to scale up implementation of the national strategy 1. Number of innovations, knowledge and pilot models for STIs prevention and control that are developed from implementation of the national strategy and have been dissseminated 2. Number of provinces that have developed innovations, knowledge and pilot models for STIs prevention and control from implementation of the national strategy 3. Number of multisectoral partner organizations that have developed innovations, knowledge or pilot models for STIs prevention and control from implementation of the national strategy Year

20 Tactic 2 Develop and implement systems to recognize and praise innovations, knowledge, pilot models and success that belong to projects, institutions and individuals, at the national, regional and provincial levels, to promote learning and boost morale 1. Number of national institutions that is implementing a system to recognize and praise innovations, knowledge, pilot models and success of STIs prevention and control in that year (cumulative number) 2. Number of provinces that are implementing a system to recognize and praise innovations, knowledge, pilot models and success of STIs prevention and control in that year (cumulative number) 3. Number of partner organizations that are implementing a system to recognize and praise innovations, knowledge, pilot models and success of STIs prevention and control in that year (cumulative number) for Year