Table 5 Financing and programmatic nature: government and GF

Duration of plan

Usually annual plan and budget cycle

Medium term program (often five years) ensures continuity

Financing profile

84% spent on treatment and care

50% or more on prevention interventions

Financing prevention interventions

Cover operational cost, not on human resources incentives

  ● Cover all expenditures including human resources. More flexible in procurement than government, such as syringe and needle supplies for IDU and ART for non-Thai KAP and migrants

  ● Financial audits are required which can create burden for PR

Accountability framework

  ● Integrated model, where MOPH as principal, and its health service network as agent, results in limited accountability framework.

  ● A proposal-based payment

  ● Clear accountability framework: the Principal Recipients as Agents are accountable to the GF as the Principal, through contractual agreement. Non-performance was sanctioned by termination of grants.

  ● Input focus, regulate use of resources in line with procurement rules and regulation, less accountable to outputs and program performance

  ● Focus on result and performance foster accountability and responsiveness

Monitoring and evaluation

  ● Not clear on timing and requirement

  ● Regular progress report is required

  ● Annual report for monitoring and evaluation

Limitations

  ● Allocation of limited annual budget to too many government sectors (e.g. health, education, defence, social development, labour) results in fragmentation and lack of impact

  ● It ensures continuity of activities in some certain period (depends on the project lifespan). However, there is uncertainty in long term support beyond five year program grants

  ● Doubtful effectiveness of interventions such as public media

  ● Limitation to address preventions among non-Thai population

  ● Poor attitude, rigidity and capacity in outsourcing/contracting services to competent non-state actors