plueme/wizJson huggingface dataset:
This research has been initiated and emerged from the results of baseline assessment conducted, towards “the trans-border risks with impacts to health and environment” of the mega project carried out, in case of the Hong Sa power plant. The research methodologies comprises two main components, as: (i) the first – the research for development of self-monitoring system through the Community Health Impact Assessment (CHIA) as a tool; (ii) the second – the review of laws and policies of Thailand and of Laos PDR in aspects of supervision and management of trans-border impact (pollution); and (iii) the recommendations made. It could be summarized with finding as follows. The research team also identified that the most serious concern of villagers was the impacts incurred to their cash crops, as the agricultural products might be damaged and declined and causing of the economic loss, since they would be principal incomes gained for their necessities. The second serious concern of villagers was the health impacts incurred from the contamination of poisonous substances and pollutions accumulated in soils, water and air including food crops, e.g. rice and vegetable. These would cause the chronic and emerging sicknesses and diseases with harm induced in the long run. And although the majority of villagers were entitled to the healthcare schemes with social security and with accessibility to sub-district healthcare services centers and hospitals nearby the villages, but these were only for the basic and primary healthcare services provided with first aids or emergency incidents. Thus, the making of risk map of communities, it would be the vital work with further backing-up and supportive needs and such map would cover aspects of environment and health, especially towards the abnormality with agricultural productivity; the vulnerable groups with health problems and those with respiratory system and blood vessels, including those with pregnancy and maternity (mother and infant) whom might be more sensitive than people in general for the design of impact monitoring system toward the community furthermore. And this was relating to multi-sector entities and it deems expedient to cooperate among the government agencies and people. The agencies shall take part with information received and sharing for finding solutions are: those in charge with agriculture, health, irrigation and local administration, as this would be necessary for having more and wide cooperation with all sectors.
Study of the management of metabolic syndrome and its complications among people in Bangkok aimed at disseminating the effective and sustainable management of metabolic syndrome and feasible complications to the communities and key organizations. Moreover, evaluating and monitoring the prevalence of such syndrome in the community levels in Bangkok were also taken into consideration. The voluntary participants resided in Bangkok with no cancer, kidney failure and other types of disability were tested using the interventions from the study. The sample size of 80 participants in total was divided into 55 people as experimental group and 25 people as control group. Paired t-test was applied for statistical analysis to find the significant difference in those two groups. The result highlighted the statistical significance (p-value<0.005) in physical change between before and after the intervention such as fat percentage, basal metabolic rate (BMR) and abdominal fat. Critical changes (p-value<005) in vital sign were also observed such as pulse or heart rate. The physical fitness test including 60 seconds chair stand, sit and reach, and 3 minutes step test were all statistically different (p-value<0.05) between before and after the test. Furthermore, the evaluation and monitoring program were conducted with 530 people following Chi-Square test. The result from such test indicated significant level of 0.00 which is obviously lower than 0.05. The analysis involved body mass index (BMI) and metabolic equivalent (MET) related significantly (p-value<0.05). It could be concluded there was an increasing rate of obese people in Bangkok as well as a decreasing number of body mass index which were mainly a consequence of decrease in physical activities. It is obvious that people in Bangkok were getting more obese. Such situation was risky for non-communicable diseases such as diabetes mellitus, hypertension, and cholesterolemia. Therefore, it is essential to campaign the distribution of knowledge and intervention of metabolic syndrome and its complications as soon as possible in order to increase awareness among youth and people. Importantly, community involvement should be taken into serious account for the sustainability.
This study aimed to assess patients’ experiences on using non-contracted private hospitals and applying for eligibility under the Universal Coverage for Emergency Patients (UCEP). A telephone survey was conducted by using a semi-structured questionnaire. Populations were beneficiaries of three public health insurance schemes, Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS) and Social Security Scheme (SSS) who used non-contracted private hospitals and applying for eligibility through the Emergency Pre-Authorization program (PA) during July–October 2017. A simple random sampling was employed with an equal quota of samples for each scheme in each month for calling. Samples of the study included 212 and 210 cases who were receiving the call and willing to provide information out of 393 and 405 or 54 and 52 percent of calls made for those who met and did not meet the criteria of critical emergency respectively. Data analysis was done by using SPSSpc version 18 and weighted according to actual proportion of each scheme users was applied. Results show that the Universal Coverage for Emergency Patients (UCEP) was quite successful in the implementation. Patients with critical emergency conditions increased in access to financial protection under the program. Convenience in transportation to the hospital and being trust in regular hospital were two main reasons of getting emergency care from the private hospitals. Those with non-critical emergency conditions were more likely to choose their regular hospital than those with critical emergency conditions. The program could protect eligible patients quite well from financial risk during the critical period or the first 72 hours of admission; however, more than half of those with non-critical emergency conditions spent out of their own pocket to cover the cost of care. Furthermore, strengthening of enforcement process of the Sanatorium Act is needed to prevent patients with emergency conditions from being asking for payments prior to provision of services or during the critical period in addition to strengthening of public relations on channel for making complaints.
His Excellency Clinical Professor Emeritus Dr. Piyasakol Sakolsatayadorn, the Minister of Public Health of the Kingdom of Thailand, was invited to deliver his statement at the 70th World Health Assembly on 22 May 2018 with the theme of “Building Better Systems for Health in the Age of Sustainable Development”. This article reviews the content of the statement delivered by the Minister of Public Health in order to get deeper understanding on the key messages. Lessons learnt from the statement lead to deeper understandings on global health context of Sustainable Development Goals and World Health Assembly. In Thailand, an engagement of multiple partners, both government agencies and non-state actors, is needed. This engagement should be based on trust under good governance. In order to combat with noncommunicable diseases (NCDs) challenges, best buy intervention prevention and control of health risks should be implemented, for example, tax and marketing control of tobacco, alcoholic beverage, and sugar sweetened beverage. The next step beyond the statement delivered is to translate the content in the statement into real implementation and monitoring. Another important issue is the strengthening of global health capacity of health staff.
Social determinants of health management is proximal to health promotion of people. The organizational structure of local authorities is conducive for addressing social determinants of health management in communities. This study aims to explore local public policies that managed the social determinants of health and the role of public administration at three different tiers of municipalities. Qualitative study by using direct observations, in depth interviews, and document reviews were conducted in Chiang Rai (Metropolitan) Municipality, Ang Thong (City) Municipality, and Tha Yang (Subdistrict) Municipality. The study revealed that despite different contexts among the three municipalities, a common goal for the well-being of people was set. Those three municipalities provided sustainable public services on health, education, environment and society for their respective communities. For example, they increased the number of healthcare facilities in order to promote accessibility, build health literacy through people engagement, establish student-centered curriculum for children in pre-school to high school along with life-long learning, support and create environment conducive to physical activity (i.e. footpaths, parks and green public spaces). Local authority administration ensured implementation of policies and programs to improve health equity through project planning, building partnerships, budget management, capacity building, and monitoring health outcomes. The study concludes that local authorities should be the main agency for local health promotion. Therefore all related stakeholders should collaborate and synergize their health-promoting effort with local public administrations and regard this approach as key mechanism to address social determinants of health and promote health equity.
Migrant health is an important issue that has caught much political attention for years, particularly at the present where migrant birth rate is rapidly increasing. The objectives of this study are to 1) explore the operational system of the provision of essential vaccines for migrant children in Thailand through views of policy makers and health professionals, 2) analyze the extent to which migrant children have accessed to vaccination services in Thailand, and 3) estimate the budget impact in the provision of essential vaccines to all migrant children in Thailand. Parallel mixed methods design was employed. Data collection techniques comprised in-depth interviews for qualitative part and secondary data analysis for quantitative part. Study sites were public hospitals in four migrant-populated provinces. The results showed that although there was no explicit policy to provide basic vaccination for uninsured migrant children in Thailand but practically, health providers at the hospitals catered vaccination services free of charge for all migrant children regardless of their insured status through the leftover vaccines which were initially provided to Thai children. From migrants’ perspectives, buying health insurance is not the most important reason that influenced migrant parents to pay for health insurance for their children. Some migrant children travelled back to their country of origin when they grew up. The vaccination utilization rates amongst migrant children were quite low relative to standard utilization rate. If the government wished to provide basic vaccinations specifically for migrant children, the additional budget impact would be around 6.9-73.9 million Baht. In terms of policy recommendations, the Thai government should consider imposing essential vaccination as basic rights for all children regardless of their insured status, and such a service should be independent from nationality precondition and financial barriers. The government might consider investing more on vaccination at the cost suggested above. However adequate supporting mechanisms for the health facilities should be in place in order to ensure the country’s health system and financing sustainability.
The antimicrobial resistance (AMR) crisis is rising continuously, which has accelerated by the inappropriate use of antimicrobials either unnecessary or overuse and misuse. To better understand about the appropriate use of antibiotics and monitor as well as evaluate of implementing the National Strategic Plan on Antimicrobial Resistance 2017-2021, the National Statistical Office (NSO) and the International Health Policy Program (IHPP) jointly developed a module to assess the levels of knowledge on antimicrobials and awareness of antimicrobial resistance among the Thai population. The 27,762 adults older than 15 years were asked to self-administer this module. The module was integrated into the decade long National Health and Welfare Survey (HWS) conducted by the National Statistical Office. HWS 2017 was the first time in Thailand that introduced a modified version of the Eurobarometer antimicrobial resistance module into the survey. The module consisted of four sections including antimicrobial use profiles, antimicrobial literacy, public information on proper use of antimicrobial and antimicrobial resistance, and awareness on the use of antimicrobial in farm animals. The key findings showed that 7.9% of Thai adults older than 15 years received antimicrobial drugs in the last month. The majority of Thai people (70.3%) obtained antimicrobial drugs from health facilities (both private and public sectors at all levels), followed by drug stores (26.7%). Respiratory track symptoms were the most commonly reported reasons for taking antimicrobials; 62.7% of the total. In addition, the antimicrobial literacy is probed using five true and false statements. Poor level of knowledge on antimicrobials was alarmingly found in Thai population, only 3.1% gave correct answers to all statements and the most misunderstood statements were “antimicrobials kill viruses” and “antimicrobials are effective against colds and flu”. Moreover, only 17.8% of Thai people received information about proper use of antimicrobials in the last 12 months. Three common sources of the information were doctors (36.1%), other health professionals such as nurses and health workers (24.8%) and pharmacists (17.7%). Almost two-thirds of respondents were not aware of antimicrobial use in food producing animals and about 68.2% of adults did not know that Thailand had banned the use of antimicrobials as growth promoters in food animals. The Ministry of Public Health and the relevant authorities need to steward appropriate use of antimicrobials by health professionals, pharmacists and veterinarians (supply side) as well as create effective public communication and awareness program on antimicrobials use and AMR in general population through new channels such as social media for increasing the potential reach of the information (demand side). The progress of antimicrobials use and literacy should be monitored continuously as part of improving knowledge on antimicrobial resistance and awareness of appropriate use of antimicrobials and monitoring the progress of the National Strategic Plan on Antimicrobial Resistance.
The objective of this study was to examine role and process of care by caregivers to dependent older people in communities after the long term care (LTC) policy of the Universal Coverage Scheme was developed. This study used a purposive sampling method to select 20 caregivers who have looked after dependent older persons in communities for longer than one year. Research tools such as general information questionnaires, semi-structured interviews and voice recorders were used to collect qualitative data. The data were analyzed by content analysis. The findings illustrated that after LTC project was implemented, caregiver role and process of care to dependent elderly in communities have evidently changed. Obviously, the knowledge and practice skills of the caregivers, especially on activity of daily living (ADL) care, health issues, sanitation and environment management in the elderly’s home, have gained considerably through training. Team works, coaching and mentoring, and care buddy matching were explicitly formed, including a clear pattern of work namely a care plan. Details of elderly persons who need care, care goal planning or rehabilitation program and relevant information have been included in the care plan. Interestingly, ADL levels of dependent older persons under the guidance of care managers and multidisciplinary have been gradually improved or there was an appropriate aspect for each individual need. Caregivers have increasing important roles particularly being care assistants to dependent older people who have diseases required specific care. In order to be able to appropriately and sustainably providing care to dependent older people in the community, policies and measures to promote the advancement opportunities of caregivers and the continuous training for development of potential caregivers should be encouraged. Stimulating the proactive services enhancement of caregivers working together with multidisciplinary teams, motivating family members having the potential to provide care to elderly people having specific disease, and finally, the compensation and welfare policy should be appropriately promoted.
Background: Newborn screening for congenital hypothyroidism in Thailand was performed more than 25 years. To prevent mental retardation and delayed development, early diagnosis and treatment should be done within 14 days. Most previous studies reported from some areas or provinces, recent country data is not available. Objective: To determine the incidence of neonates with congenital hypothyroidism from newborn screening in Thailand. Methodology: During August 1, 2014-July 31, 2015, data of neonates who had positive screening for congenital hypothyroidism and confirmatory tests were recorded. Results: Presumptive positive congenital hypothyroidism was found in 1,663 cases (0.24%) from total 699,331 babies screened. Confirmatory test was performed in 1,530 cases (92%) and 348 cases (20.98%) were confirmatory positive. Among these 348 cases, transient hypothyroidism were diagnosed in 23 cases (6.6%). The incidence of congenital hypothyroidism in Thailand was 1:2009. Conclusion: Early diagnosis and treatment of positive cases are necessary for better outcome of congenital hypothyroidism screening in Thailand.
In Thailand, health promotion and disease prevention in children have been operated through school health programs with the collaboration between primary health care units and schools. This study aimed to explore the availability and quality of essential resources at school level of the Elementary School Health Services (ESHS) in Thailand. The methods used in this study were semi-structure interviews and in-depth interviews. Two provinces were purposively selected with specific sampling method, while schools were selected using simple random method. The informants included school directors and school-health teachers from 9 schools and health care workers from 3 health promoting hospitals at the subdistrict level. Although school-health teachers played an important role in this program, this study showed that most of the teachers were newly recruited with little or no experience in providing school health services and that the turn-over rate was high. This was because the unclear career path for such a position also due to inadequate training provided. Moreover, school directors mentioned about shortages of ESHS budget. Devices and equipment for health checks in most study settings were not properly maintained or regularly calibrated. As a result, health information of students was likely not accurate. Also, it was found that a lack of management and linkage between the agencies were the problems in school health services. To sum up, the school health services lacked the necessary resources in all aspects. Therefore, there was a need for knowledge development of human resources, supported budget and materials for health checks, and better management of school health services.
This study aims to determine situation of the prevalence of disabilities and the accessibility to health, education and social services of children with disabilities in the communities of Thailand. Mixed-methods of data collection were used. A community survey by a team of psychiatrists and clinical psychologists was conducted to estimate the prevalence of 7 disabilities in children aged between 2½ and 12 years in nine sub-districts of nine sampled provinces (except Bangkok) during October 2014-July 2015. Altogether, 6,334 children were investigated. Qualitative data were collected from home visit, in-depth interview, non-participant observation, and focus group discussion with parents and teachers of the children identified as having disability, and also with health care providers to explore problems of unmet demands. Results show that 66% of children aged 2½-12 were found normal, yet, 13% had at least one disability of which learning disability was most prevalent, and 21% with physical, psychological or behavioral problems. The availability of health services for children with disabilities in each area varied due to inadequacy or lack of type of health professionals. Community hospital is not allowed to recruit rehabilitation specialists, though policy on disability service provision is assigned to. The study also found that the term “disability” contained stigma connotation and was rejected by well-to-do and educated parents. When compared with the accessibility to service database of the Ministry of Social Development and Human Security, the National Health Security Office, and the Ministry of Education, this study showed much higher number children with disability in communities reflecting that there are still more unregistered children and inaccessible to necessary public services. The un-integrated and difficult-to-access service structure, poverty, cultural beliefs, and social unawareness are among factors that cause unmet demands. Main recommendations for concerned agencies are an urgent policy and program to increase access to care to reduce unmet need in children with disabilities and the integration of disability policy into the strategy to reduce poverty.
This particular research aimed to analyze spatial distribution of infectious disease patients using dasymetric method comparing with areal interpolation technique. This study used infectious disease patient statistical data between 2014 and 2016 provided by subdistrict health promoting hospital (HPH) located in Phlaichumphon, Banklong, Chomthong, Bankrang, and Watchan subdistricts. Land use was classified into 4 categories including residential, agricultural land, forest, and water resource. Furthermore, spatial infectious cases data was utilized together with classified land use data in order to investigate the infectious disease distribution using dasymetric method and areal interpolation method. The results showed that the rate of infectious patients in residential area was 25.75 per 1,000 inhabitants and the rate of non-residential area was 24.92 per 1,000 inhabitants. The highest rate of infectious disease was found in the residential area of Chomtong district. Moreover, the comparison of coefficient of variation (CV) between dasymetric and areal interpolation techniques showed significant difference. The dasymetric method had significantly lower average rate of infectious disease than the areal interpolation.