plueme/wizJson huggingface dataset:
Civil Society Proceeding for Public Hospitals Reform at District Level	This study was conducted in collaboration  in the search of excellence community hospital for the whole community, strategic partnership was apppraached through all media channels and also direct marketing by sending 7,771 letters to all sectors at all levels for help proposing a delighted community hospital.  Voluntary basis of the hospitals was concerned.	Self-assessment report by executives (60 applied-hospital: 503 non applied) and core personnel (725: 1185), and external evaluation by district health officers (652:1078) and community leaders (225:334) were used in combination including  double teams sites at the end.  Eighty four out of 714 hospitals were proposed a champion, 60 hospitals joined, and 23 were defined as highly effective, 5 entered the third round, and were distinct performance.	The study results revealed that, community hospitals took care of 41 millon people and covered 90.26 percent of all districts with doctor per population 1:19,038; and 32.89% morbidity rate was found with average 2.67 visits per patient.  Increasing trend of inpatient admission and bed used were indentified.  Financial stability was assumed through revenue and expense ratio and current ratio. Most of critical success factors(CSFs) and key performance indicators(KPIs), showed higher mean scored rating by applied group than those non applied with statistical significant differences.  However, community problem-solving and involvement activities had low mean scores for both groups.  Effective coordination and good image were recognized by district health officers and community leaders except rating for participation in health service organization as low.  Those applied hospital were received higher mean scores than non applied significantly.	In conclusion, responses of civil society were fair as the existing circumstance, and high active response from health sector at all levels particularly community hospitals.  At least 23 hospitals showed strong leadership for pursuing development and act as role models.  Stage for sharing their visions, experiences, and success result should be available for continuous learning and deployment.  Community or comprehensive health care accreditation should also be institutional at national level.
This research project has three main objectives. The first objective is to analyze and assess the health insurance problems, resulting from a lack of national health insurance policy. The second objective is to propose a model for health insurance policy coordination and management system in order to achieve universal coverage. The last objective is to provide the appropriate measures, including policies, law, organizations, as well as plans,  to implement a model of health insurance policy coordination and management system. The measures should have sufficient details for the policymakers so that they can make an effective decision.	This  is a policy research that searches for information necessary to set up alternatives of health insurance policy for policymakers. In addition, this research is an action research. That is, it focuses on pragmatic results.	The study employs both  qualitative and quantitative approaches. The research sample consists of four groups : policymakers, top executives, managers of health service providers, and rural community leaders. Two types of sampling techniques are used in combination:   purposive sampling and snowball sampling. 	Various  kinds of data collection are used such as reviewing literature, indepth-interviewing, focus group, brain-storming, public workshop, and self-administered questionaires.  Data compiled is analyzed by both qualitative and quantitative methods.	Research findings are as follow:	First, there are three main problems to the current health insurance system.There is limited stakeholders awareness regarding the policy formulation of universal health Insurance.   	2.) The  coverage   of   health   insurance  in  Thailand  is  to  only  about  eighty percent of Thai     	     citizens,   whereas  about  twenty  percent  of  them  are  not  covered  by  any kind of health   	     insurance  schemes. Besides, there are overlapping   target population  among  the  various 	     kinds  of  health  insurance  schemes. Therefore,  in  reality,  the  figure  of  health  insurance   	     coverage is less than eighty percent.   	3.) Problems  of  equity  and  justice  of  health  care services directly affect the quality of health    care services.	Second, the study proposes a model for health insurance policy coordination and management system in order to achieve universal coverage (Fig. 4.2, page 82). The model recommends the establishment of the Office of the Board of National Health Insurance and the Provincial Health Insurance Offices. The Office of the Board of National Health Insurance is an agency under the administration of central government.
A Study of Collective Opinions Regarding someAspects of Childcare Center  Management in ThailandThe objectives of this study were to find  collective opinions about childcare centers services regarding the following: 1) purposes of childcare centers and goals of child development, 2) the main organization responsible for coordinating childcare centers, 3) roles of community, private organization, and government  in childcare centers services, and 4) activities for quality control and evaluation of  childcare centers services.Sample consisted of  four groups of  people. The first group consisted of academics, politicians,  chief executives of  private  and governmental organizations  providing childcare services.  The  second group consisted of officials coordinating between central  government  and local organizations providing the services in Chiengmai, Khonkan, Songhkla, Chonburi, and Bangkok.  The third group consisted of  workers  at  childcare centers from top level such as heads of schools to bottom level such as care providers.  The last group consisted of  parents of children at the childcare centers.  The total subjects were 1,663.	There was a  collective agreement on the purposes of the childcare centers.  They  were  to promote the correct practices of child development ,and to provide basic social habit training for children.  The results showed also the collective agreement  on goals of  child development for the 0-3, and 3-6 years children.  These  were  good physical health, balance  of psychological, emotional, and social development, and happiness. Moreover  creative thinking  was selected as child development goal for the 3-6 years old children.  As a result, we recommended that the government should  take  actions in  collecting ideas from experts and practitioners on standard of practices for childcare centers in order to achieve the above purposes and goals.  At the same time childcare centers,  related organizations, the general public, and other stakeholders should  be informed.  Their roles and functions should also be identified.
Adverse events can cause huge damages to both patients and hospitals financially and socially. Countries are seeking ways to resolve the problems. To do so, the first step of any institutional actions should be the development of procedures and tools to efficiently detect and monitor adverse events.ObjectivesTo study the reliability and validity of the methods for screening and detecting 	adverse events used by the Harvard Medical Practice Study when applied in ThailandTo estimate incidence, and distributions of adverse events among hospitalized patients in Thailand MethodsThis was a descriptive study. 400 cases were randomly selected from computerized medical records kept in CD-ROM of the Office of Social SecurityA three - step medical record (chart) review by 4 trained nurses and 3 physicians was employed. The procedures were adapted from the methods used by the Harvard Medical Practice Study.ResultsThe agreement of screening process among the nurses and a physician was low  (Kappa = 0.34, 95% C.I. of Kappa = 0.24  to 0.43,  Sensitivity  =  70.23 %,   Specificity  =  66.27 %, Positive predictive value  =  51.69  %, Negative predictive value  =   81.25 %).The agreement of the 2 physicians in detecting the occurrence of adverse events was also low (Kappa = 0.393, 95% C.I. of Kappa = 0.25 - 0.53). The incidence of adverse events was 9.1 per cent (95 % C.I. = 6.19  ถึง  11.94 ). 71.4 % of adverse events occurred were considered preventableConclusions	The reliability of the procedures to screen and detect adverse events in hospitalized patients applied in the study was low. Therefore, studies to improve the reliability of the procedure are needed.
Background Unprotected sex increases adolescent risk of early and unwanted pregnancy and childbirth, unsafe abortion and sexually transmitted diseases such as infection with the human immunodeficiency virus (HIV). Sexuality education serves as one means of helping young people prevent these problems and improve their future reproductive health. Development and utilization of a computer-aided instruction (CAI) on sexuality education may facilitate learning and provide additional education channel to this group of people.Methods	Contents of the CAI were organized into six key concepts including human development, relationships, personal skills, sexual behavior, sexual health and society and culture. Information and illustrations were employed and tailored to fit for Thai society and culture. Tutorial methodology was used and arranged into the following categories: introduction of the tutorial, questions and responses, judgment of responses, feedback about responses, remediation, organization and sequence of program segments and learner control in tutorials. Three phases of planning, design, and development were assigned and followed, The CAI was created in collaboration with a NECTEC staff and had been tried out in an early secondary school classroom within Roi-Et municipality. Macromedia Authorware 5.2 was used as authoring tool and the final material was written into a compact disc.	Results	A six-chapter interactive multimedia tutorial was developed, It occupied about 192 megabytes on a compact disc. While trying out in the classroom, there was some initial perplexity in using the CAI by the students, which made the beginning of the study cumbersome, In the second half of the study, however, the students could easily use the CAI. Each chapter of the tutorial took about 50 minutes to complete. A total of 8 sessions were needed to finish the CAI. In a focus group discussion at the end of the study, the students exhibited their preference to the CAI.Conclusions 	CAI seems to be one of potential methods for comprehensive sexuality education through facilitate learning and provide additional education channel. Problem underlay CAI usage is preparedness of student.
This qualitative study aims to explore a situation of health systems for middle-aged women especially about concepts, treatment modalities, perceptions, and success. The study sites were in both rural and urban areas of Khon Kaen province. Eighty five women age 40-59 and nineteen healers participated in this study. Data was collected by using participatory and nonparticipatory observation, interviewing, and focus group discussions during March-December 1999. Triangulation and content analysis were used for validation and analysis. Major findings were as follows. Humoral theory, religion, health information, and women’s life styles are guidelines for alternative health concepts of practice. There are 30 activities that are regarded as alternative health practices to promote the well-being of the middle-aged women. They were grouped into 4 categories and energetic therapies and exercise. The meaning of health given by women are included in the well-being of physical, mental, spiritual, and social life. The success of alternative health services is related to consumers’ beliefs, providers’ self-reliance, and community participation. It is suggested that highlighting alternative health systems by setting standards of services, and establishing networking between the community and the system is needed. Keywords: alternative health, middle-aged women, folk sector, lay sector, Isaan
Whether MDR-TB (multi-drug resistance TB) had devastated Thailand: 55 articles reviewed between 1968 and 1998Multi-drug resistant tuberculosis have been regarded as the third epidemic and become global emergency since 1993. The multi-drug resistant TB is at least resistant to 2 drugs which are isoniazid and rifampicin. The MDR-TB is uncured despite its rare occurrence. A major cause of MDR-TB is either irregular drug taking or not completing course of drug taking. In 1997, the WHO reported Thailand’s MDR-TB at around 3000 cases considered as high tendency. By December 1998, the rate of drug resistant TB was 26%, 13% to isoniazid, 12% to streptomycin, 7% to rifampicin, 7% to ethambutol and 3% to multi-drugs. Compared between 1968 and 1998, the percentages of drug resistant TB had increased for each drug. Factors related to drug resistant TB were number of lesions in lungs, family history of TB and HIV positive history while factors related to MDR-TB were history of TB treatment, TB family history and HIV positive historyThe paper recommends development of effective and continuous TB program implementation and evaluation, quality of the DOTs, quality of lab testing and its network and effective information system. In terms of research and development, factors related to treatment success for MDR-TB should be studied and treatment evaluation should be performed according to national TB control by Ministry of Public Health.
Health Impact Assessment (HIA) of Contract Farming in Thailand : A Scoping Process Objectives: 1) To define the scope of health impact assessment of contract farming policy. 2) To provide a venue for stakeholders’ participation in the health impact assessment Methods: The assessor used varieties of methods to identify the scopes of the health impact assessment. The processes were consisting of two meetings with stakeholders, in-depth interviews with farmers and seed companies’ personnel as well as government officials, direct observation at the farms and literature reviews. The definition of health used in the study was based on bio-psycho-social model. Results: The Thai government has been promoting Contract Farming practice since the 6th National Economic and Social Development Plan in 1987. Farmers will produce agricultural materials for agricultural industry companies and receive payment for the products if they comply with the standards defined in the contracts. Tomato seeds, chili seeds, tobacco leaves, vegetable seeds, chicken raising are examples of the agricultural products that are commonly defined in the contracts. Contract farming policy brings numbers of potential impacts, particularly on one that uses a lot of pesticides, on the health of farmers and villagers. Potential positive impacts are short-term financial benefits, choices of employment during dry season. Potential negative impacts are on physical health especially impacts on neurological illnesses, illnesses of endocrine systems, illnesses of reproductive systems. It has been shown that stakeholders were concerned about health impact of the contract farming practice in terms of physical health, mental health, social health, spiritual health, social impacts and environmental impacts. Literature reviews found that farmers and farm employees were affected by the heavy use of pesticides. Neurological illnesses were the most common problems. Stakeholders have identified scopes for health impact assessment including impacts on physical health, mental health, social health, spiritual health, social impact, economic impact, environmental impact. The stakeholders also proposed that assessment of impacts on illnesses of endocrine system, reproductive system and cancers were needed. Qualitative and quantitative methods of data collections with stakeholders’ involvement have been identified for the assessment. Conclusion It has been shown that early involvement of stakeholders in the scoping processes of health impact assessment is feasible and beneficial to all involved and it is more likely that the results of health impact assessment will be used.
This research on development of developmental promotion activities package for children from birth to five years old at the primary care level was aimed to analyze the policy, concepts and the current situation on developmental promotion activities for children from birth to five years old in the child daycare centers, kindergartens, well babies clinics and the primary care units; to study the developmental screening and assessment tools, and propose a package for promoting child development at the primary care level.  Data were collected from document review, the interview with the 63 administrators, teachers and the child care providers in kindergarten or in the child daycare centers and nurses in well baby clinics or in the primary care units from the Northern, Southern, Eastern and Northeastern regions of Thailand. Data from the meeting with eight experts in child developmental field.          The results is the following :Most nurses, kindergarten teachers and child care providers knew and shared the same an understanding of child developmental activities promotion. Some of health care centers or kindergarten had the written policy concerning  child development. In health care centers or kindergarten where there was no written policy. In well baby clinic, the emphasis was on vaccination, weight & height measurement and providing advice. In some places simple child developmental assessment and stimulation were conducted by involving parental participation. At well baby clinics, the maternal and child health guidebook was commonly used to assess development progress. The role of the nurse at primary level of promoting development of children from birth to five years old, comprises of the following activities:-Maintenance of a child’s developmental history record. -Screening and assessment children at scheduled times suitable for their age.-Organizing child developmental promotion activities and the corner for  child developmental promotion.-Giving advice/ consultation to parents on anticipated development and guidelines for developmental promotion.-Referring the child for proper diagnosis and help.           6. A package of developmental promotion activities was designed for the following persons:  For child care providers, For Kindergarten Teachers, Nurses at the primary care level
This research examines the contents of human rights in liberal and communitarian theories. While liberalism emphasizes liberty and equality of individuals, communitarianism claims the very rights of peoples and community. The question is whether rights holders can be both individuals and/ or a community.  The research discusses the various on-going debates between liberal and communitarian theorists relating to the issues of human rights and puts this in context with the right to health, in particular, how liberal and communitarian concepts have been used in the process of health reform in Thailand.It is evident that the present concepts and systems of human rights have been significantly influenced by Western political philosophies. In classical liberal theory, in order for the rights of individuals to be protected, the State must refrain from intervention. Negative rights – political and civil rights - must be respected. This concept has been argued against by other liberal theorists who consider that liberty brings about inequality and injustice. For the individuals to realize their very basic rights, the State must fulfill its obligations by guaranteeing some rights which enable individuals to maintain dignity and well-being. Positive rights - economic, social and cultural rights, or welfare rights – require positive action by the State. Rights are therefore indivisible and interdependent.Liberalists consider only individuals are rights holders; however, the communitarians argue that communities, groups and society can be also holder of rights; and those rights demand obligations by the State. Communities and societies, by virtue of their being a “person” by themselves, can act and have relationships to rights. In their view, insisting on individual rights is acceptable under the condition that the rights of community are recognized.The right to health, a very basic human right, is morally and legally recognized in all societies. The right to health is in general an individual’s right, arising from the sovereign right one has over one’s life and mind in particular. Well being and living standard of individuals can be realized only if both positive and negative rights are respected and fulfilled. In general, the right to health is closely related to liberal concept of rights. There is, however, an increasing trend to consider that necessary conditions for an individual’s well-being and right to health can be materialized only if community rights are respected and protected. In Thailand, the introduction of modern medicine allows the State to control the rights and life of both individuals and communities. The rights to health have been, for decades, determined by the State. The health reform process initiated some years ago is based mainly on liberal concepts, but while attempting to integrate communitarian concepts. For the success of health reform, the power relationships between the State, individuals, and community must be revisited. Rights to meaningful participation of both individuals and community should be the key to health reform. In order to achieve this a paradigm shift must occur in the health system of Thailand.
A study determining health performance indicator of ThailandThe research study is to determine the indicators of the performances of health system in Thailand thorough the two processes, searching input from various sources in Thailand and other countries and brain storming technique, to create the process of learning together among resource persons and academics that leads to the vital information for conducting further researches and programs. All the derived data were processed, analyzed and synthesized to determine the definition and the composition of health system, the objectives of the evaluation of the health system performance, the scope of the evaluation, the domains of indicators used in the evaluation, and the indicators appropriated to make use of in the evaluation. Besides, the suggestion of sources and the methods of which we derived the valuation of the indicators, the readiness of the implementation in investigating and collecting each indicator, and some special issues in a group of these indicators that needed to be developed and studied, were also presented in the study.The results of the study could not be used immediately and still need the process of broad considerations from academics and practitioners especially policy planners and executives which could be made by distributing all the information and receiving more opinions of all resource persons for the improvement of the outcome. However, this research has provided the scope and important guidelines, which are necessary for developing the evaluation of the health system in Thailand.Even though the suggested indicators of this study are used for health system performance evaluation; but through the way of using these indicators in the future, the development for further improvement will be needed continuously.