location: nan, 'Thailand 
year: 2007 source: HSRI 
title: Looking at Health Promotion and Disease Prevention Services for Children 0-5 Years Old in the Periods before and after the Introduction of the Universal Health Coverage System 
abstract:Children under five years old normally grow and develop rapidly; during that process they are at
risk of failing to reach the vital goal. Therefore, health promotion and disease prevention comprise potential
means for taking care of such children. This study was aimed at studying a profile of the health promotion
and disease prevention (HP-DP) services for them, regarding the utilization of the Universal Health
Coverage System, and the attendants’ behavior. Descriptive design with in-depth interview was employed
for data collection in the period from April 2003 to March 2004. The materials and the subjects
studied included documents, 1,000 selected children and their parents who attended HP-DP clinics, 12
health-care providers, and experts. Questionnaires and interview guidelines were used for collecting
information. The findings revealed the following:
1. All university hospitals, regional and community hospitals, as well as community primary care
units were providing HP-DP services in those settings both before and after the implementation of the
Universal Health Coverage policy, apparently without establishing institutional policies and practice guidelines,
manpower allocation, staff development or resource planning. Services were also extended to the
community despite the limitations of personnel and time constraints. The majority of health-care providers
did not understand much about the newly introduced benefit package for children under five years
old. In addition, limitations remained on practices in the assessment of childhood development, in
developmental stimulation or promotion, the arrangement of the developmental promotion corner and
counselling on child-rearing. Thalassemia screening for children whose parents showed traits or were
diseased, and thyroid hormone testing for children with indications were seldom practiced.
2. The old and new benefit packages of health promotion and disease prevention in children under
five years old did not differ much. Although the known services in the United Kingdom and the United
States were included, the practices of recording family history, genetic history, vision and hearing tests,
mother-child interaction, parental advice regarding food, oral care, accident prevention, and child development
promotion and empowering parents in child care were covered.
3. General information on children and their parents’ behavior on attending the HP-DP service noted
that the mothers were mostly the persons who brought their children to the well baby clinic. Most of
them were workers, housewives and civil servants. They preferred the hospital’s HP-DP service as it
was the place where their child was delivered and was in the vicinity of their residence. However, the
services included mainly weight and height measurements, and vaccination. Seldom included were child
development assessment and advice on child-rearing and child development promotion. Satisfaction
with the health service was 53.3 percent of the samples before and after the introduction of the Universal
Health Coverage policy, denoting no difference. Satisfaction with the services related to height measurement,
vaccination, developmental promotion, health assessment and advice on child care did not differ
significantly statistically (p <0.001).