1.Health Insurance Status and Access to Antiretroviral Treatment Among HIV/AIDS Patients in Northeast Thailand: a Patient-based Analysis
Satoshi TOYOKAWA ; Tsutomu KITAJIMA ; Yasuki KOBAYASHI ; Hajime SATO ; Weerasak CHAIPAH ; Ruengsin THUENNADEE
Journal of International Health 2006;21(2):129-135
The objective of this study is to assess the differences in access to antiretroviral treatment among health insurance recipients, using a patient-based analysis.
METHODS: The subjects were 324 outpatients with the human immunodeficiency virus who were treated at a regional hospital for infectious diseases in Khon Kaen Province. We collected data every visit of the patients during the study period between April1 and September 30 in 2002. We defined access to antiretroviral treatment as having a prescription for antiretroviral drugs on at least one visit during the study period. We examined the relationship between access to antiretroviral treatment and age, sex, stage of acquired immune deficiency syndrome (AIDS), and health insurance. We also compared the results of the patient-based analysis and the record-based analysis that was used in our previous study.
RESULTS: Multiple logistic regression analysis shows that patients insured by the Civil Servant Medical Benefit Scheme have better access to antiretroviral treatment than the others (vs. Universal Coverage; odds ratio=11.38, 95% confidence interval=4.09, 31.65). We have also shown that patients with AIDS-related complex have better access to antiretroviral treatment compared to asymptomatic AIDS patients (odds ratio=3.38, 95% confidence interval=1.31-8.76). Values of these odds ratios were lower in the record-based analysis than in the patient-based analysis.
CONCLUSIONS: Patients insured by the Civil Servant Medical Benefit Scheme had better access to antiretroviral drugs. We reconfirm the differences in access to antiretroviral treatment among health insurance recipients, using the patient-based analysis.
2.Use of HAART and safer sexual behavior among people living with HIV in northeast Thailand
Tsutomu KITAJIMA ; Yasuki KOBAYASHI ; Nonglak PAGAIYA ; Kittisuk NASUGCHON ; Hajime SATO ; Satoshi TOYOKAWA
Journal of International Health 2009;24(4):275-280
Objective
To investigate the relationship between uses of highly active antiretroviral therapy (HAART) and sexual behavior among people living with HIV (PLHIV) in northeast Thailand.
Methods
Data were collected both by interviews using a structured questionnaire and by a self-administered questionnairewith HIV positive patients who made an outpatient visit to a public hospital in northeast Thailand between March2004 and January 2005. Fisher's exact test and multiple logistic regression analysis were conducted to identify thefactors associated with regular condom use when these patients had sex with their spouse/partner.
Results
Among 289 patients (146 with HAART and 143 without HAART) who participated in the study, 122 had sex with their spouse/partner in the three months before the survey. Among them, 70 used a condom every time, 17 used a condom sometimes, 32 never, and 3 unknown. Excluding the 6 patients who did not answer all of the questions, 116 patients remained in the analysis. In the multiple logistic regression analysis, sex, education, employment, years since HIV infection, illness episode in the past one month, and use of HAART were entered as the explanatory factors. Use of HAART (odds ratio=9.8, 95% CI: 2.9 - 32.9) and current employment (odds ratio= 5.2, 95%CI: 1.3 - 20.9) were significantly associated with regular condom use.
Conclusion
Use of HAART was positively associated with use of condoms when PLHIV had sex with their spouse or partner.
3.Reconsideration and definition on the concept “Public Private Partnership” in the field of international health
Motoyuki YUASA ; Yoshihisa SHIRAYAMA ; Ryoko NISHIDA ; Tsutomu KITAJIMA
Journal of International Health 2018;33(1):27-34
Objectives Recently, a Public Private Partnership (PPP) has drawn attention as an efficient strategy to response toward increasing different needs for health in low-income and middle-income countries under tremendously growing private sectors and restricted public finance. Neveretheless, in the society of international health development, there is no commonly acceptable definition of PPP. To make the targets and purpose of the PPP clear, the study attempted to define the PPP, reconsidering the relationship among five concepts, which have been recently used to solve social issues, such as BOP business, social business, Corporate Social Responsibility (CSR), and Creating Shared Values (CSV) as well as PPP.Methods We conducted scrutiny of definitions of PPP in other literatures using bibliographic retrieval and associated PPP with the other four concepts in order to attempt to define PPP.Results and conclusion We analysed the contents and relationship of the five concepts. Thus, the PPP can be defined as a process in which public and private sectors collaborate to aim to solve a social issue, not only to reply to societal expectation but also to achieve company growth.