Performance Evaluation of Eliminate problems of Opisthorchiasis and Cholangiocarcinoma Project in Thailand - Phase 1 (2016-2018)

Abstract

The objective of this study was to evaluate the national program for liver fluke control phase 1 (2016 - 2018) in order to obtain useful information to maximize the efficiency of the operation in the remaining phases. It was conducted by applying the CIPP model evaluation model by analyzing 4 aspects of the model, namely context, inputs, process, and products. The study areas were 19 high prevalence provinces of the country mainly in the north and northeast regions. The methodology included document review, in-depth interviews using a questionnaires, environmental survey, and brainstorming meetings of officials responsible for opisthorchiasis program of the Department of Disease Control and the provincial public health in the risk areas. As for the results, it was found that there had been concrete evidences of prevention and control efforts for the risk population with clear targets of screening and treatment services. The inputs were financial resources and skilled personnel from Ministry of Public Health and other related agencies. However, there was still a lack of experts and budget to meet the need of the some locations. For the process, there was active participation of networks, community leaders, local people, schools, and local administrative organizations. The subjects of opisthorchiasis and cholangiocarcinoma were included in school curriculum in the affected areas. Nevertheless, there was still clear weakness on the participation of local communities. Regarding the products and outcomes, information was obtained from 2,952 samples aged 15 and above of whom 61.8% were female, mostly with primary school education level and were farmers. They were still frequently practiing behaviors of consuming food at risk of liver fluke infestation such as raw fish and fermented fish; and 19.02% of them never thought of discontinuing the consumption. Some of them did not pay attention on the screening as they felt that they could personally be able to buy antiparasitic drugs. Problems of the limited provincial support for program implementation had resulted in some constraints for field operation. Therefore, such information collected from the phase 1 evaluation should be properly utilyzed in order to improve effectiveness and efficiancy of the operation in next phase to ensure the good service availability that could improve the quality of life of the Thai people.