Monitoring and Evaluation Model of Opisthorchiasis & Cholangiocarcinoma Elimination Strategy in Health Region 7th, Phase 2 (2019 - 2025)

Abstract

This action research was conducted to develop a model for monitoring and evaluating the success of the implementation of the Monitoring and evaluation model of the opisthorchiasis and cholangiocarcinoma (OVCCA) elimination strategy in health region 7th, Phase 2 (The years 2019–2025). Participants were 95 health personnel responsible for preventing and controlling liver fluke and bile duct cancer, consisting of 30 people in Khon Kaen, 25 in Roi Et, 22 in Kalasin, and 18 in Maha Sarakham. A record form and Questionnaire were used to collect data. The data were analyzed using descriptive statistics and content analysis.

The research results found that 1) The problems of the implementation of mentoring and evaluation in OVCCA elimination strategies in four areas: personnel’s knowledge and skill in the evaluation method; utilization results of the evaluation are relatively few; Lack of assessment support mechanisms; and networks at the area level. 2) Participant’s expectations and the actual condition related to activities of preventing and controlling OVCCA diseases; the PNI Modified Index, sorted from the most to the least, as environmental management; teaching students to change their risk behavior; Screening for bile duct cancer with Ultrasound in people over 40 years old; Public Communication; developing an individual database system (Isan-cohort) treating cancer patients; academic development; Screening for liver flukes in people 15 years and over; managing strategic plans; and palliative care of end-stage bile duct cancer patients. 3) The average knowledge score was increased significantly (Mean difference 7.21; 95% CI: 4.58- 9.90, p-value<0.001). 4) Performance results according to the strategy to eradicate liver fluke and bile duct cancer plan. (1) The prevalence of liver fluke infection in people aged 15 years and over was 2.32%. (2) The prevalence of liver fluke infection in fish was 9–10%. (3) Death rate from cholangiocarcinoma was 47.34 per 100,000 population. (4) Schools that teach students about liver fluke and bile duct cancer are 66.97%. (5) Environmental Management: standard treatment ponds for waste management was 16.88%. 5) The four standards of this Monitoring and evaluation model of opisthorchiasis and cholangiocarcinoma (OVCCA) elimination strategy found that was ranked at a high level on four dimensions.