plueme/wizJson huggingface dataset:
The objective of the study on solving anemia in pregnancy living in Sriratana hospital’s catchment area is to decrease iron deficiency anemia in pregnancy through operational research using participatory group process. Data were collected by means of questionnaires, weight and height scales, antenatal care record, record of group process and laboratory investigation including packed cell volume (hematocrit) and screening for thalassemia (DCIP-KKU clear test, Osmotic Fragility test). Various medias were used for disseminating basic knowledge, control and prevention of anemia and related issues in group discussion. All pregnant women living in villages in the catchment area were participated during November 2000 to October 2001. The results showed that using participatory group process to perceive iron deficiency in pregnancy and to formulate solutions has an effect on correcting knowledge, attitude, and behavior to prevent and control iron deficiency anemia statistically significant. In addition, 11 programs had been generated to make other iron food sources available, to disseminate knowledge of iron deficiency anemia and motivate pregnant women attending antenatal care service at first trimester. The outcome of intervening programs indicated that 41.2 % of pregnant women attended first ANC at pregnancy age less than 12 weeks. And, 76.5% took iron tablets regularly according to the prescription. These findings consistent with the increasing of mean packed cell volume from 33.3% (95%CI: 32.3-34.4%) at first attending ANC to 36.8% (95%CI: 35.9-37.6%) at pregnancy age 28-32 weeks. Anemia in pregnancy also decreased from 36.8% to 16.7%. It is concluded that participatory group process in perception of anemia in pregnancy will decrease anemia in pregnancy and results in cooperating between health facility and community.
Need and want analysis for public health information servicesThe purpose of this study is to explore the needs and wants of nine target groups in using health information : the massmedia practitioner, the public health personnel, the teacher, the housewife, the factory worker, the community leader, the teenager, the working adult, and the elder. The study employed the qualitative research method. The data was colleccted by the technique of in-depth interviews and small focus-groups access  745 key informants who were  members of nine target groups and lived in Bangkok and Chiengmai. The results of the study were as follows : 1.All nine target groups felt more the need for health information concerning various types of deseases than for of health information concerning good health. 2.The finding indicated different purposes using health information among the nine groups. The mass media practitioner, public health personnel and the teacher used health information for their professions. The houswife's purpose was to  both take care of herself and others in the household. The teenager and the elder used the information just for themselves. The working adult and the factory worker did not pay much attention to health information. The community leader was the  only group which  wanted to develop their capacity to use health information.3.The importance of needs and wants in using health information depended on the relationship that one has to the care of others  ; for example, nurses have to take are of patients, teachers   have to teach students, housewives have to take care other people in the family. 4.The proper way to respons to the needs for health information is to start first by creating attention/interest in health information. Then, by using the communication strategies which are compatiable with the target group, to associate the information with their previous understanding.  It is important as well to use the medium as which target groups indicated as their preferred source of health information.
การเกิดซ้ำของหินน้ำลายและเหงือกอักเสบในนักเรียนประถมศึกษาที่รับการขูดหินน้ำลายโดยเจ้าหน้าที่สาธารณสุขระดับตำบล  อำเภอโชคชัย  จังหวัดนครราชสีมาRecurrent of calculus depositions and gingivitis in primary school student that scaled by healthworkers at District Health Centers inAmphur Chokechai Nakhonratchasima provinceThe aims of this study were to compare the recurrent rate of calculas deposition and gingivitis in primary school children aged 10-12 years between a group of schools that performthe systematic tooth brushing after lunch program (implementation group; imgroup) and a group of schools without the systematic tooth brushing after lunch program (Comparison group: Cm group)  in Chokechai district. Groups of 4 schools with 141 and 147 schoolchildren were proposively selected from the related criteria. Every subjects received calculus scaling by trained health workers. Data collected by oral examination with Volpe - Manhold Index for calculus, and gingival Index for recording gingival status, 5 and 8 months after scaling by 1 examiner. The results showed that the recurrent rate of calculus deposition between the implementation and comparison groups were significantly different at both 5 months and 8 months after scalling (p=0.1, 0.2). The percentage of subjects in Im group who had no calculus deposited at 5 and 8 months period were 45.4% and 27.0% respectively. While the rate in Cm group were 30.6% and 19.0% respectively. Gingival status between two groups were not significant different at both 5 and 8  month period (p=0.25 and 0.94). It was found that only mild and moderate gingivitis were observed with out any subject with severve gingivitis. The results indicated the low effectiveness of the actual scaling campaign in primary schoolds.
According to the present constitution, the standardized and efficient health information service through information structure is the one required for the public equally.  The information infrastructure that is an alternative for providing public health information consists of three network; telephone, cable TV, and internet.The research team considered four alternatives in providing health information to the public using telecommunication technology and the internet.  The four alternatives were: Information service via Web site (one-way communication via internet), Consultation service via Web board (two-way communication via internet), Information service via audiotex (one-way communication via telephone), and Consultation service via audiotex (two-way communication via telephone).  The target group of the first two alternatives was teenagers, media, working people, doctors and public health officers whereas that of the last two alternatives was major population of the country.The study showed that the unit cost of the four alternatives in the year 2005, ranging from the least to the most, was Information service via Web site, Information service via audiotex, Consultation service via telephone, and Consultation service via Web board.  The difference in cost depended on three factors: frequency of using services, the necessity of using staff to provide information, and the cost of supporting equal information to all target groups.Before providing services to a full scale, it is recommended that the Ministry of Public Health (MoPH) evaluate the outcomes of each service provided at present as to how beneficial it is to the public, whether the service is provided right to the target group, and what the problems/obstacles are.  The MoPH should also play an important role in carrying out or promoting the services using three guidelines: providing direct services by the responsible unit, supporting the community in providing services, collaborating with private sectors and media, as well as developing network similar to Canadian Health Network and apply it to best suit the Thai situation.
The steering committee of health policies and strategies development for health manpower was appointed by the National Health System Reform Committee in May 2003. The committee secretarial tasks done by the Health System Research Institute and researcher team. The mission of the steering committee is to develop and present policies and strategies of health manpower under the changing situations of the Thai health care systems and its context. The secretarial team is carried out process were the documentary reviews and structured interviews, including various sub- committee meetings. The spotlight of the contextual changes in all aspects are described in the introductory chapter which focus on issues that needed carefully consideration. The main report describes results and recommendations with major principles for developing policies and strategies on health manpower. Three main topics have been discussed and concluded, these are:Components to be achieved on policies and strategies for health manpower;Initial plans for further action and;Short- term and long- term mechanisms for system development on health manpower should be based on concert efforts of various organisations. Such mechanisms are to be  functional units that linked with accumulated knowledge and national policy development. By summary, the future proposals for action should be pragmatic and relevant to the governmental policy toward the national policy on universal coverage. Under the contextual changes, health manpower policies and strategies should be grounded on the "demand driven" idea and responsive to basic and specific health needs of the entire population.
The main focus of this qualitative research was to explain folk and popular health care systems concerning promoting health of the middle-aged women residing in Lanna society. Study settings included an urban community, a semi-urban were 55 women, aged between 40 and 59 years old, and nine practitioners working in folk medicine. Data were obtained through the use of focus group discussions, in depth interviews, and participation and non-participation observation. Data were analyzed using content analysis, indicating the main themes, categorization, and mapping the connections. The major results of this study indicated that there were three alternative health care systems for middle-aged women: popular, traditional, and modern health care systems. Regarding the definition of health, the middle-aged women defined ‘health’ as a multi-dimensional aspect including the dimension of physical, mental and physiological function. Therefore, good health, according to these women, was referred to the state of physical fitness, being free from disease, good and happy mind, and being able to function activities. It is also interesting to note that marital status and child bearing was indicated to influence women health. In the period of middle-aged, the women preferably called as “golden age”, a period of various changes had been occurred physically, mentally and emotionally. Some women might call this age as “confusing age” because of uncertainty concerning whether the way they acted was appropriate. Further, the middle-aged women perceived that their age was high risk of developing disease and was irritability. Regarding the management of the physical changes, it was found that the management was depending on the severity of the symptoms. For mild symptoms, there was no special activities performed. Some women used daily activities, traditional herbal sauna, and Thai traditional massage. In case of having severe symptom, the women preferred to seek help from modern health care services, either public or private sector. It the treatment was unsatisfied or ineffectiveness, they would further seek help from traditional practitioners. Concerning the management of mental and emotional changes, almost all middle-aged women stated that they preferred to do mediation, hobbies and listen to Buddha teaching. It worth to note that the concept of health promotion among the middle-aged women was not clearly defined. Nevertheless, they pointed out many activities leading to good health. These were taking good nutrition, exercise, doing leisure activities, and taking tonic medicine or folk medicine. Hence, the results indicate that to promote health of the middle-aged women, it is of great important to modify health care service policy from curation to health promotion and disease prevention. This is anticipated to develop the concept of health responsibility among the middle-aged women. The modern health care services, therefore, should focus on primary or secondary prevention rather tertiary prevention, and such services should be in accordance with culture, beliefs and lifestyle of middle-aged women.
Current Problems of Controlling TB (Tuberculosis) in Thailand	Two major problems of controlling TB in Thailand were lack of new vaccines and drugs development and increasing phenomena of TB drug resistance due to inconsistent drug taking by most patients. Controlling TB by DOTS (Directly Observed Therapy, short course) was a new strategy determined by most international health organizations. One of the DOTS was simply to have the patient’s helper who monitors his or her drug consumption so as to keep continuity of drug taking. The helpers may be the TB official, the health official at a health center, the health volunteer, the community leader, and the family member. Current situations and problems of controlling TB in Thailand by the DOTS were reviewed in this study. The DOTS coverage was found 34.1% of all districts by December 1999 while its operation was lower than the WHO target and likely to decrease. Its effectiveness was found better than the conventional based on the RCT study whereas no significant difference was found under the non-RCT study. Most operations at district level did not have quality monitoring and evaluation process while a number of the patients’ helpers were not trained. 	The problems of DOTS operation in Thailand were regarded into firstly, policy level at which policy makers gave relatively low priority of TB controlling than many communicable diseases, secondly, a number of personnel dealing with TB control neither trained nor interested in getting trained, thirdly, less motivation in health officials to put forward the DOTS operation in their own areas, fourthly, poor reliability in performing the DOTS by family members, and fifthly, lack of based-cohort study to illustrate levels of success or failure in addition to less qualitative study on this topic so far. Establishment of research networking on the DOTS and its policy-based research were recommended. The research topics should be on the DOTS efficiency, the DOTS model development, factors related to its success and failures, and criteria for the DOTS performed by family members.
Health is a dynamic self-regulating process in a living system that is interrelated with its greater ever-changing environment and ecology in which it depends. Physical and mental health of an individual closely correlates with that of its society and ecology. This subtle and complex interconnection has been discovered and articulated in modern science. According to the ecological worldview and deep ecology, to heal ourselves is to heal our relationship with the earth. Our modern human culture is now facing a survival challenge, amidst the postmodern absence of absolute ideology and value system, to come to terms with the realization that we are parts of the whole, and the whole is within us. Without changing in our perception we have towards life and nature, our behaviors will remain unchanged, unhealthy and worsen the condition of this living planet, which in tern will have much greater effects on human health. However, in Thai society as well as in other countries, there have been emerging social and ecological movements that try to cope with this modern sickness from different perspectives and historical backgrounds. This study is to explore the philosophy and practices of deep ecology movement that can contribute to the paradigm change in the way we think about and relate ourselves to the issues of health. We hope that some insights and realizations gained from this research can be of useful and inspiring enough for readers to critically and thoroughly reexamine the way we live our lives as well as and the socio-economical structure and conditions we maintain that shape our present health condition. The local traditional wisdom obtained on a practical basis showed in this study have affirmed that ecological worldview is nothing new but have already been existed and available in its own unique cultural and ecological context. To recognize such endangered local knowledge as invaluable and relevant to our modern needs is the beginning of the healing process towards the restoration of the wholeness and health of this living planet and her members.
Unmet Need for Drug Therapy in Hospital-Visited Patients	This research aimed to analyze the issue of unmet need for drug therapy in hospital-visited patients.  Methods used in the study varied from physician interview, hospital policy survey, analysis of hospital databases, individual patient evaluation, to medical chart review.  Based on opinions of prescribing physicians, the unmet drug need problem tended to focus on expensive or newly marketed drug products, which were considered the target group in this study.  	Results from the hospital survey showed that some of the study drugs were not covered in drug formularies of several hospitals; whereas some were listed in restricted formularies.  In ten therapeutic drug classes, hospital database analysis revealed that out-patients under Low-Income Scheme were less likely to receive and to continue receiving the drugs as compared with those covered by Civil Servant Medical Benefit Scheme.  Disparity in the unmet drug need across patient payment schemes varied widely with respect to the drug classes and study hospitals.  This study confirmed adverse consequences due to inaccessibility to certain therapeutic modalities.  A case study on patients with end stage renal disease found that accessibility to renal replacement therapy by the Low-Income patients was much lower than in the Civil Servant Medical Benefit recipients, thus the former group faced a higher mortality rate.  Inaccessibility to appropriate choice of antibiotics would increase risk of death due to the fatal infectious disease like melioidosis in another case study. 	Four major policy recommendations were generated from this study.  First, standard data sets for drug prescribing and dispensing as well as drug coding harmonization should be developed.  All three health care financing agencies: Civil Servant Medical Benefit Scheme, Social Security Scheme, and Universal Health Care Coverage Scheme should set common structures of electronic files for recording drug utilization data.  Second, prior to use of the stored information, a set of criteria for drug use quality based on up-to-date medical knowledge should be established.  Information on the quality criteria could lead to an agreement among medical communities on variables needed to be specified in the standard data sets and on the way to measure quality of care.  Third, for the issue of health equity monitoring, this study showed high feasibility to assess the extent to which a need for drug therapy was unmet, especially for the drug products that were proven in their effectiveness and efficiency.  Lastly, it is possible to evaluate a policy aiming to increase health care productivity in the future.  The approach used in this study should be disseminated through hospital networks in order that results generated from analyses of drug use databases can be used for quality of care development.
Populations’ Suffering from Health Care Utilisation	The Thais’ suffering as a consequence of health care utilization was studied in order to set up recommendations for improvement. Quantitative and qualitative study was used during August to October 1998. The sampled health care facilities were the university hospitals, both public and private hospitals, and health centers in totality of 1473 facilities. Their suffering and dissatisfaction were grouped in terms of cause natures as following: health providers, patients’ illness, environment of health facilities, medical equipment, facilities’ management and administration, patients’ profiles including their socio-economic status, services features and health insurance schemes. 	With regard to health providers, conflicts among health providers were often found possibly leading to poor quality of care while insufficient providers made long waiting lists. Lack of informing the patients and unavailability of patients’ consensus were also an important issue. Patients’ dissatisfaction led by either crowding or dirty OPD was linked to their uncertainty of how well the facilities did infectious control.  Those insured by the Public Health Assistance Scheme did not feel confident in care quality given. Most of the Thais subjectively related good quality of care to high technology based medical instruments, comfortable OPD space, warm welcome reception, and care provided by specialists. The study viewed that financial resource was not the sole answer to reduce the patients’ suffering.
This report had three objectives. Firstly, it aimed to review the existing knowledge and analyzed about system, structure, and mechanisms of healthy public policy development in 5 case studies: namely, health promotion policy, healthy child development, anti-tobacco policy, AIDS policy, and anti-Amphetamine drug and its derivatives policy. The cases were both from domestic and international experiences. Secondly, it intended to study about community involvement and participation along policy process in each case. Lastly, structure and mechanisms of development were synthesized and proposed as options for Thailand. Case studies shed light lesson learnt at least in 6 areas as follows: 1) re-organization or re-structure is essential to establish with new health promotion approach in the Ottawa Charter. New management, through the concept as health is cross-cutting issue, would give advantage of working together, co-ordination, and collaboration between and among the sectors, as well as strengthening the communities and people participation. 2) appropriateness and relevancy of policy measures depends on health promotion view of the leader / administer and wherter such measure is based on correct knowledge 3) mechanisms for good health information development and transfer, knowledge establishment, research and development, and monitoring and evaluation are required. 4) Law enactment for health promotion, besides justice purpose, need to be enhanced and law enforcement needs to be strengthened. Paradigm to draft such a law for supporting health promotion activities like Thai Health Promotion Fund have to be changed. 5) As key success factor, health promotion activities are central to have partnership involvement and people participation. therefore, effective management and good information exchange are crucial. Appropriate knowledge transfer and awareness of self and community care would alert and call for impact assessment as well as healthy policy measures and transparent decision-making. 6) The government should act as a collaborator to link each partner to assist people and communities to formulate their action plan for health promotion. In summary, development of health public policy needs to change policy process which enhances all stakeholders involvement and participation. To formulate public policy, policy-makers have to think about the impact that might be happened after implement process. Decision-makers should be responsible for mistakes if negative impact occurs. Therefore, it is required to establish new organization with new health promotion approach and good mechanisms for information and knowledge transfer, as well as monitoring and evaluation process.