Sterling examples of high impact key population or community-led health service deliver models come from Thailand. HIV key populations continue to play a major role in delivering Pre-Exposure Prophylaxis (PrEP for HIV prevention) to those who are at a heightened risk of HIV acquisition. Thailand has the largest PrEP rollout in Asia Pacific region, 80% of people using PrEP in Thailand receive it from a clinic led and staffed by members of the community that it serves.
Key population led health services mean that community thinks, demands and does the work and manages the programmes, for the benefit of their own community members (and the country). This model has proven to help accelerate community-led responses towards ending AIDS with government's support, said Dr Praphan Phanuphak.
"Therefore, it is a collaborative effort with equal responsibility and equal importance [between key populations or communities and the government]. One has to respect the other. It is not that the NGOs are snatching the work or the territory of the government," he said.
"Key population led health services (KPLHS) is a bottom-up approach in providing healthcare. It speaks to the needs and willingness of the community which will increase the value of the effort as compared to some thing being given to them passively (top-down approach). It fills the gaps that government cannot do and it is acceptable by the community they serve," emphasised Dr Praphan Phanuphak.
However, there could be some misunderstanding from the government side in some instances. For example, some may opine that 'government is getting blamed for not doing enough good work because of which NGOs are trying to compete with them'. Truth is that KPLHS or community-led models are only helping complement government's work.
"One has to show the evidence that KPLHS (key population led health services) can actually provide quality services to the populations that conventional healthcare providers cannot. Key population led health services will lead to ending AIDS and other sustainable health goals beyond HIV, such as mental health and NCDs, i.e., KPLHS is in accordance with government policy," said Dr Phanuphak.
He added: "KPLHS or key population or community led health services is one arm of the holistic healthcare approach. They need to collaborate with the main stream public healthcare systems. Once the government accepts these facts, legal and financial supports will follow. However, key population led health services may be more expensive than conventional healthcare since the personnels and office facilities are not provided by the government. Therefore, they need enough financial support to ensure sustainability of the programme."
95-95-95 HIV targets for 2025
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