Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Knodel, John E., Jiraporn Kespichayawattana, Chanpen Saengtienchai, and Suvinee Wiwatwanich. 2009. "The Role of Parents and Family Members in ART Treatment Adherence: Evidence from Thailand." PSC Research Report No. 09-686. August 2009.
High levels of treatment adherence are crucial for the success of expanding anti-retroviral therapy (ART) treatment programs everywhere. Augmenting adherence through treatment supporters is one promising strategy. Most discussions focus on peers, especially members of persons with HIV/AIDS (PHA) groups, for this purpose. Far less attention is given to family members, and older age parents are almost never specifically mentioned. Yet in many settings, ART recipients often live with or nearby parents and other family members who are highly motivated to ensure the treatment’s success. This report examines the extent that family members, especially parents, are involved in assisting adherence in Thailand based on results from self-administered questionnaires from 912 adult ART recipients in 18 sites throughout the country. Results indicate that most ART patients live with family members and over 60% live with or in the same locality as a parent. Family members, including parents, commonly assist ART patients to remember to take their medications, particularly if they are in the same household. Moreover, parents often remind adult sons and daughters to go for resupplies and sometimes bring or accompany them to their appointments. The results underscore the need to incorporate close family members, including parents, more explicitly into programs intended to augment adherence and to facilitate their effectiveness as long-term adherence partners by providing them with adequate information, training and resources. Peers from community based PHA groups can be a particularly valuable and appropriate asset in this regards. These findings are relevant not only for Thailand but for the many settings where ART recipients are similarly closely linked to other family members through living and caregiving arrangements.
Country of focus: Thailand.