location: , 'Thailand year: 2023 source: HSRI

title: Extended Use of Negative Pressure Chamber for Home and Community Isolation Preventing the Spread of Respiratory Infection in the Situation of the Covid-19 Epidemic

abstract: During the COVID-19 pandemic, MTEC researchers developed “HI PETE”, patient isolation chamber for Home & Community Isolation, a device for isolating patients with respiratory tract problems, which is crucial as it helps reduce the infection, numbers of medical personnel while transferring patients, and time, as well as protect their safety while taking good care of the COVID-19 patients. Most of negative pressure isolation chambers or tents are currently expensive and have various limitations, like, most designs are heavy and it takes time to install. Therefore, they are not practical due to high costs for maintenance, and lack of quality testing and certification of equipment in safety and performance. The HI PETE consists of 2 main parts; a clear plastic patient isolation room and a negative pressure unit designed to control the air circulation inside the chamber. This HI PETE innovation is developed in consideration of local manufacture, reduction of shortage necessary medical equipment, and future improvement on the medical devices in accordance with global safety standards. The HI PETE is designed efficiently and approved after being reviewed along with literature and solution ideas gathered from concerned parties. The outcomes attached with this innovation are an air circulation system, a high-efficiency particulate air filter (HEPA filter), and a UV-C light sterilization system. From a study of current problems and reviews by actual users from 3 sampling institutions: Mongkutwattana hospital (Bangkok), Saint Mary hospital (Nakhon Ratchasima) and Sai-ngam hospital (Kampangpetch). Different types of HI PETE chambers are used both in emergency department to treat COVID-19 patients using spray medicine, and in COVID-19 pre-screening station. Especially in Sai-ngam hospital (Kampangpetch), the HI PETE is applied in obstetrics gynecology department. Based on the user feedbacks, the MTEC research team had digested and concluded for specification of the equipment which its main characteristics or essential features of a product are as lightweight, quick and easy to install, compatible with existing medical equipment such as respirator, infusion pump. Foldable chamber requires small space to keep and be easy to transport. Pre-inlet filter prevents redundant disease. Chamber gloves ensure safe patient manipulation and additional ports for connection external medical devices Complies with ISO 14644 standard (Clean room and associated controlled environments), IEC 60601-1 standard (electrical safety testing standard for medical devices) and IEC 60601-1-2 (electromagnetic compatibility).


location: , 'Thailand year: 2005 source: HSRI

title: The situation of health communication in Thai Daily Newspapers

abstract: The objectives of this research were to examine the quantity and to identify format of health-related contents in Thai daily Newspapers, to identify distinctive parties involving in process of health message delivery, and to study the concerning parties in terms of their preferences in delivering different health-related messages, their work limitations, their awareness of roles and functions as pressmen, as well as to study the newspaper’s readers concerning types of health information they wanted, their means in searching these information, and their responses towards  all health information acquired from the newspaper.  This research employed three methods including content analysis, in-depth interview, and focus group.  Six Thai newspapers were purposively selected as the sample for content analysis.  The total of 84 issues publicized during September 2004 were analyzed.  Thirty-three health-related personals working for the six Thai newspapers were interviewed. Furthermore, six focus groups representing newspaper readers, who were different in term of their reading behavior concerning health-related contents, ages, and genders, were conducted. In conclusion, the results from content analysis showed that the most frequent health-related topic and health-related theme found among the sample was topic concerning various deceases, and theme concerning health prevention. Moreover, the most frequent presentation format of health message was the column format. Health-related content could be found in various sections such as women, technology, health, and foreign news sections, as well as the front page.Concerning parties in delivering health-related message consisted of editors in chief, news editors responsible for health-related desks, reporters, columnists and health-related informants.  The research found that some specific parties partly shared their roles and functions.  Editors in chief, news editors, and columnists mainly acted as message screeners based on their own judgment towards the impact of each topic or content upon readers.  Reporters and columnists obviously perform their roles in rewriting and adjusting health-related contents and formats. Health-related informants including the health specialists and the information coordinators played their roles in delivering health-related information. Besides health-related informants, other information sources of the press were government and non-government organizations, documents, and various media channels, locally and internationally. Definitely, each concerning party realized the importance of their role-playing in health-related message delivery. Contents they had paid attention were contents that had tremendous effect upon the public, in term of its benefit and interest.  Obstacles in producing health-related messages obviously mentioned in the interviews were difficulties in understanding specific terminologies and particular health-related contents, the thin line between public and private interest over some health-related issues, and the press-owned company’s policy towards health-related content.From the focus group interviews, it was obvious that newspaper was still the accessible medium for different types of readers. Interestingly, attendants mentioned that to read health-related content was not their main purpose in reading newspapers. Therefore, their expectation of exposing health-related content in newspapers was relatively low.  Moreover, health-related contents or messages which the readers sought for were different among age groups, gender-based concerns, individual’s health consciousness, and individual’s and or family members’ illness.         Further, the findings demonstrated that heavy readers of health-related content were habitually exposed to health-related columns in newspapers and most of them were very active in seeking for other information they would like to know by the use of other media.  Light readers of health-related content in newspapers were passive in seeking health information unless they or their family members were ill. Some of them were identified themselves as heavy users of health-related content of other mass medium.Three patterns of responses were found among readers due to their exposure to health-related message. First, due to their own confrontation with health-related problems or concerns, the readers would immediately implement the information they just exposed. The second pattern was to advice surrounding people after considering the involvement of the content upon each person’s situation. Thirdly, the reader would gather all concerned information to build up and to maintain their personal health-related database, and would use this information later whenever needed in the future.


location: , 'Thailand year: 2008 source: HSRI

title: Retinal examination of type 2 diabetes patients at Thaluang hospital, Lop Buri province

abstract: Serious complications of the eyes often occur in diabetic patients. This research was
aimed at studying diabetes retinopathy (DR) in type 2 diabetes patients who were registered
with the diabetic clinic of Thaluang Hospital, Lop Buri Province, using pictures
from a fundus camera. All pictures from this camera were interpreted by an ophthalmologist.
In addition, if some cases could not be diagnosed by the pictures taken, these
cases were examined by the ophthalmologist directly. Out of 763 type 2 diabetic patients
(86.31% of all the diabetic patients), 87 patients (11.40%) had to be examined by the ophthalmologist.
The results of this examination revealed that there were 121 cases of non-proliferative
diabetic retinopathy (15.89%); seven cases of proliferative diabetic retinophathy (0.92%); 15 cases of glaucoma (1.97%); 44 cases of presenile cataract (5.77%); and 156 cases
of senile cataract (20.45%).
The results of this study showed that DR could be found in the early years of diagnosis
as type 2 diabetic patients. The percentage of DR increased in relation to the number
of years after the patients were diagnosed as diabetic. Screening DR by examining pictures
from a fundus camera is appropriate for community hospitals and hospitals that
have no ophthalmologist because it could be performed in these hospitals and sent to the
ophthalmologist for diagnosing later. Therefore, using pictures from the fundus camera
to search for DR in diabetic patients would decrease a large number of patients who
should be examined directly by ophthalmologists.


location: , 'Thailand year: 2011 source: HSRI

title: Standardization of Speech and Language Test for Thai Children Aged 0 - 4 Years

abstract: Background: Children with congenital hearing loss without treatment and rehabilitation of hearing,
language and speech have difficulty in daily communication, learning, and life living. It is necessary to
find tools for assessment and screening early language and speech problems to use for early diagnosis,
treatment and rehabilitation. That would help these children to have nearly normal language and
speech development. Objective of this study was to investigate reliability of tools for screening and
assessment language and speech development
Method: Assessments of language and speech development from caregiving’s report and test for 54
children with or without risk for delayed language and speech development in each age interval [6, 9,
12, 15, 18, 24 months (± 1 ½ months), and 30, 36, 48 months (± 3 months)] were done with Denver
Development Screening Test, Denver Development Screening Test in part of language (Denver II
Language), Thai Early Language Mile Stone for Children Aged 0-4 years: ELM) , Thai Speech and
Language Test for children Aged 0-4 Years Old (TSLT)
Report: Denver II and Denver II in part of language (Denver II Language) , ELM and TSLT had
Cohen’s Kappa coefficients range:κ rang from fair to good agreement (κ = 0.27 – 0.75 ) Denver II
language and TSLT both from caregiver’s report and test at moderate agreement (κ = 0.52 – 0.60 )
Denver II Language and ELM lead a good agreement (κ = 0.61 – 0.75 ) Investigators inter-rater
reliability in using these tools were very good agreement (κ = 0.86 – 1.00 ). TSLT from caregivers’s
report and test have moderate agreement (κ = 0.52 – 0.60 ).
Conclusion: For screening of language and speech development, investigaters can use Denver II
Language or ELM. Investigaters have reliability and standard in assessment language and speech in
children.


location: , 'Thailand year: 2008 source: HSRI

title: Effectiveness of Cardiovascular Risk Reduction Model of Nongkhoon Primary Care Unit, Amphur Watsing, Chai Nat Province

abstract: Cardiovascular diseases are among the three most important causes of death worldwide, including in Thailand and in Chai Nat Province. This one-group prepost test design of quasi-experimental research was conducted in order to study the effectiveness of the cardiovascular risk reduction model of Nongkhoon Primary Care Unit, Amphur Watsing, Chai Nat Province. The study sample included 129 residents aged 35 to 60 years, living in the vicinity under the responsibility of the Nongkhoon Primary Care Unit; they were selected by simple random sampling. Data were collected using questionnaires, i.e., the pre-test data were collected in the month of March 2006 and post-data in September 2006. The statistical analyses were descriptive, such as percentage, arithmetic mean and standard deviation, and analytic statistics by paired t-test and multiple regression. The results revealed that pre- and post-data disclosed that all samples had normal blood pressure and body mass index. Men had a low health risk, while women had a high health risk. Pre-test data denoted a low level of self-care practice for prevention of cardiovascular risks and post-test data had a medium level. All parameters, i.e., blood pressure, body mass index, health risks and the practice of self-care for reducing cardiovascular risks both pre- and post-data, yielded significant correlations at a p-value of


location: , 'Thailand year: 2008 source: HSRI

title: Potential of caretakers in the development of intelligene quotient(IQ) and emotional quotient(EQ) of children in day care centers in Phen district, Udon Thani province

abstract: This cross-sectional study was aimed at (1) assessing the knowledge, attitude and
practices of caretakers regarding the development of IQ and EQ of children in day care
centers, (2) identifying problems related to this issue, and (3) proposing suggestions to
improve the development of IQ and EQ of those children in day care centers in Phen
district, Udon Thani Province. Questionnaire interviews were conducted with 80 caretakers,
randomly selected from all 54 day care centers in Phen district from January 15 to February 28, 2008.
The results indicated that these caretakers had low levels of knowledge about childhood
IQ and EQ development, with a mean score of 7.65 (SD= 1.34) out of 15. However,
they had higher levels of attitude and practices concerning childhood IQ and EQ
development, with an average score of 3.79 (SD = 0.33) out of 5 and 3.10 out of 4 (SD =
0.37) respectively. The caretakers identified several obstacles related to childhood IQ and
EQ development, including lack of knowledge of the caretakers, inadequacy of materials,
equipment and budgets, poor building structures and management problems of the centers.
These caretakers suggested various measures to solve the problems: providing training
for caretakers, and supporting more equipment, materials and budgets for the centers.
Participation of the local governments in terms of supporting more budgets and
working cooperatively with parents, communities and hospitals would be a successful
strategy for the development of IQ and EQ of children in day care centers.


location: , 'Thailand year: 2004 source: HSRI

title: National health accounts in Thailand 1994-2001

abstract: The results from conducting the third phase of National Health Accounts (NHA III) shown the estimation of a Total health expenditure (THE) of Thailand in 2001 of 170,203 million baht at current price including capital formation. The total health expenditure of Thailand had gradually increased during 1994-2001 with average of 1.2 percent of annual growth rate at constant price, though, there was a recession due to the economic crisis during 1997-1999. Whereas the average of annual growth rate of Gross Domestic Product (GDP) during the same period was 0.9 percent at constant price. Ratio of THE to GDP at constant price was 3.2 percent in 1994 and reached to 3.9 percent in 1997, the year which Thailand faced the economic crisis, after that period the ratios of THE to GDP had decreased continuously to 3.2 percent in the year 2001. The THE per capita accounted for 2,560 baht at constant price in 2001 which increased from 2,477 baht in 1994. The share of public sector was 45 percent of THE in 1994. However, it dominated the greater part  which was equivalent to 56 percent of THE in 2001. It was due to high average annual growth rate of 7.7 percent which was greater than that of non public sector which expanded only 0.7 percent per year. The major sources of healthcare finance in 1997 came from central government and household sector which accounted for 30.5 and 44.5 percent of THE respectively. Nevertheless, the share of these two main sources had become nearly one third of the whole health expenditure each in 2001. It was due to the high average growth rate of central government expenditure which was 5.5 percent per annum while that of the household was 0.1 percent per annum. During 1994-2001, three third of THE of the Thai health system was personal healthcare consumption. Prevention and public health services had its rather stable share of 7-8 percent, though the country had encountered the difficulty during this period. While the ratio of expense on health administration and health insurance was 4 percent during 1994-1996 and sharply increased to 7-8 percent in the year 1997 on ward. The investment on health sector reflected the impact of the economic crisis apparently, its ratios were about 14-18 percent of THE before the crisis and had declined to be 15.9 percent in 1998 and rapidly decreased to 5-6 percent during 1999-2001. The average growth rate of recurrent healthcare expenditure was 5.6 percent per annum during 1994-2001. Public hospitals earned the highest share of growth of recurrent healthcare expenditure which  was 64.8 percent of total amount or average 7.5 percent per year. Private hospitals, though occupied the second large of share, their average growth rate was only 0.3 percent per annum during this period. Private clinics and retail sale of medical goods distributors  which shared some extent of important role in the Thai health system showed the average growth 2.5 and 3.4 percent respectively. Pattern of personal health care expenditure in 2001 had been changed when compared to that of 1994. In 1994, non-government sector occupied the highest ratio of personal health care expenditures, which was 63.7 percent. Of which 51.7 percent contributed by private households mainly for ambulatory care (32.9 percent), in public hospitals 12.3 percent, in private hospitals10.3 percent, in private clinics 8.8 percent; for in patient care in private hospitals 5.8 percent, in public hospitals 4.5 percent. In addition, private households paid for over the counter medicines 8.5 percent. The government sector earned the rest of share, 36.3 percent. Of which 19.1 percent paid by central government for ambulatory care in public hospitals (10 percent), and public in-patient care (7.8 percent), the rest 1.2 percent was for provision in health centers. In 2001, non-government ratio declined to 51 percent due to the decrease of private households whose expense decreased to 40.8 percent from 51.7 percent in 1994. However, the main service consumed by private households was for ambulatory care (23.2 percent) in public hospitals 8.9 percent, in private hospitals 6.1 percent, in private clinics 7.4 percent. On the other hand, the private household utilization for in-patient care in private hospitals was increased to 6.1 percent whereas that in public hospitals decreased to 3.7 percent. The share of self prescribed medicine declined to 7.6 percent, though its portion was still high. For the government side, its share increased to be 49.1 percent, of which 24.1 percent was contributed by central government for public in-patient and ambulatory care which equivalent to 12 and 10.8 percent respectively, the rest 1.3 percent was for provision in health centers. Compared with NESDB’s SNA, the amount of the1994 NHA’s recurrent expenditures, which accounted for 110,167 million baht and increased to 161,752 million baht in 2001, less than that of NESDB which estimated for 168,244 and 277,051 million baht in the year 1994 and 2001 respectively. The discrepancy rates were 38-71 percent during that period, the discrepancy rates increased sharply especially in the last two years. It was the main reflection of the increase in non-government sector. The ratios of the NHA’s recurrent expenditures to GDP were approximately 3 percent during 1994-2001, while those of the SNA’s health care consumption to GDP were approximately 4-5 percent during the same period.


location: , 'Thailand year: 1999 source: HSRI

title: Health systems reform in Malaysia

abstract: Health Systems Reform in MalaysiaMalaysia had been recognised as one with the best economy and healthcare system in the region.  The health services were subsidised by the governmental budget as social welfare.  The poor or needy received the services free-of-charge.  Without a national health insurance scheme, the consequence is economic burden of the country.  This forced the government to set up a healthcare reform policy during the 4th Malaysian Plan (1981-1985).  It started from non-medical services, such as laundry, catering, and hospital maintenance at selected hospitals were contracted out.  A hospital was leased to a private company.  A following policy was that the government support the setting up of private medical facilities, such as hospitals and clinics, to cater for those who can afford such services.  As the private sector expanded, it has drawn upon the staff resources of the public sector where wages were less attractive.  In 1992, the National Health Institute was established as a corporatised organisation.  The aim was to create a good working environment with attractive payment when comparing to those of private sector.  Two year after this corporatisation, the goverment medical store was privatised.  In 1997, non-medical services at 71 hospitals were privatised.  The rest was the target of the year 2000 (the end of the 7th Malaysian Plan).  In spite, a national health insurance scheme is a part of the national plans but it is not placed yet.  To gather with no clear evaluation and control programs of those organisations reformed,  the consequent negative effect is higher medical fee.  Some of patients are enable to pay.  People and relating organisations have complained via mass media.  Ad hoc advocated body was formed up against the government  reform plan and request people participation.  Finally, in the end of 1999, the health minister declared to stop the planned privatisation and to revise the reform particularly the national health insurance scheme.	Experiences of Malaysia could be raised as a concern of the healthcare reform in Thailand.  Participation of both providers and consumers, and evaluation of the program have to be priorities  These would be guaranteed that the proposed healthcare reforms would adhere to the fundamental principles of equitable, accessible, effective, and sustainable healthcare.


location: , 'Thailand year: 2008 source: HSRI

title: Maternal Risk Factors for Having Low Birth Weight Infants in Panomsarakham Hospital, Chachoengsao Province

abstract: Low birth weight newborns are more vulnerable to higher mortality and morbidity
rates than normal weight infants. Research to determine the maternal risk factors would
be valuable in planning a way to solve the problem. This retrospective study was aimed
at finding out those risk factors in women of more than 28 weeks pregnancy from the
delivery records during the period from September 1, 2005 to October 31, 2007. There
were 3,622 deliveries, of which 174 delivery incidents of low birth weight infants were
taken as the study group and 177 deliveries of normal birth weight infants as the control
group by systematic randomized sampling. The prevalence of low birth weight in this
study was 4.8 percent. Results from the univariate analysis showed that a maternal age
of less than 18 years, a gestational age of less than 37 weeks, attending ANC less than four
times, and maternal height less than 145 centimeters were risk factors. Multiple logistic
regression analysis revealed the risk factors to be maternal age being less than 18 years
old, gestational age less than 37 weeks, twin pregnancies, ANC less than four times, premature
membrane rupture, and pregnancy-induced hypertension.


location: , 'Thailand year: 2003 source: HSRI

title: The primary health care system in Amphur Bangsai, Phra Nakhon Si Ayutthaya : Phase II

abstract: Health care reform in Thailand is still in the process of development and planning.  This study emphasized primary health care in Amphur Bangsai, Phra Nakhon Si Ayuthaya.  The participatory action research was utilized and aims to analyze and synthesize the primary health care system in Amphur Bangsai, Phra Nakhon Si Ayuthaya including planning, organizing, staffing, directing, controlling, tools, and what should be the minimum health care service package for people in all age groups. Since the participatory action research was utilized; some traditional research methods were still needed such as documentary review, in-depth interviews, focus group interviews, brain storming, and reflection. The quantitative and qualitative analyses were included within this study as well.  The Bangsai’s situation analysis was done during January 2002 until December 2002.  The action plan was developed and some critical points of primary health care systems including instruction for action, and was implemented during January 2003 until March 2003.The results were as followas:Since health insurance policy for all Thais and the “All For Health and Health For All” policy were utilized, Amphur Bangsai, Phra Nakhon Si Ayuthaya built up the transitional primary health care system by organizing and registering the previous structures into two primary care units (PCU).    PCU 1 includes three northern primary health care centers, and PCU 2 includes three southern primary health care centers.  Bangsai Hospital is the only public hospital (10 bed-admissions) in this area that functions as a contraction unit for primary care (CUP).The study has shown that staffing in Bangsai health care organization still has some positions available especially in the six primary health care centers as stated.  As a result, in both quality and quantity of health care service for these people in this area remains unsatisfactory.Based on the long-term effects of not having enough quantity and qualified workers in each position, causes the services to deteriorate.  Bangsai Hospital (CUP) designed to provide mobile clinics consisting of doctors, nurses, pharmacists from the hospital and the workers from the health care centers.  At the beginning, there was a need to provide services that would emphasize a cure for chronic illnesses.  The health care center workers need to come together with their customer service ability, including teamwork as a whole. Whether they are a secretary, health care worker, nurse, or doctor in the clinic, they need to learn to perform some common procedures to take care of the people.  Even though they may not be a qualified doctor or nurse, they need to be willing to work as a team and get the job done. All workers in the primary health care unit need to be able to get suggestions from other colleagues if their people are sick.  Since the mobile units have been constructed, each care worker in the PCU clinics has improved their ability and has become more efficient in terms of investigation, diagnosis, and treatments.   In this study, we found that most workers lack health promotion and prevention foundation in service quality.  For example, health care workers would provide the person and family preventive service (such as home visit as their schedule posted) when they had enough time, which never was the case.  As a result, the equity and continuous service was not achieved.  We found that in some severe illnesses, there was a need to refer to another hospital but the referral system was not appropriate.  In most cases, it did not serve the quality of care. In terms of community participation, most people in Amphur Bangsai participated to create good health practices such as seeking good nutrition habits, self-care, and building a good environment.  In addition, alternative medicine was also  being used in Bangsai, which has proven not to be risky in medical science point of view, and in some cases, it saved money and improved the quality of health.  However, some villages still have little awareness to solve their own health problems.  The community institute in Amphur Bangsai has a lack of concern in health care if we compare to other communities due to the budget being arranged for visible stuff instead of health promotion and prevention.  	In terms of directing, the executive team in Amphur Bangsai had the most experience, since they had worked and solved many community problems in the past.  Some good strategies have been used which emphasized making a serious situation into a positive learning atmosphere. Some things were ignored from the executive team if they felt they could not change the situation at this time.  The Bangsai’s workers preferred not to point fingers at each other, instead wanting us to move on in a positive attitude.  This attitude made Amphur Bangsai progressed in a positive way by having good teamwork with good intention to develop Bangsai community. In terms of using tools in primary health care system in Amphur Bangsai, the Komart’s 7-tool was modified based on the concepts of anthropology being used.  The workers stated that the tool was effective to study the community.  The tool also helped to understand the people at Amphur Bangsai.  They continue to use this tool to work with the community.Within the short term of this study, the minimum health care service package for people in all age groups resulted in showing most people lack the knowledge to know what they need for health care services.  They trust health care workers as their representative to direct their health care.  However, the minimum health care service package for people in all age groups including promotion, prevention, curing and rehabilitation still need to be researched in each health care problem, especially dealing with chronic illnesses such as diabetes or hypertension. In Bangsai’s view, most people in Amphur Bangsai were not satisfied in the transitional primary health care system because of the following reasons: Not enough health care workers in both quantity and quality.No trust from the people since the health care center has no technology in both technical service and instruments.No effective referral system for severe cases.Since the Bangsai’ situation analysis has been completed, the solution of the action plan was, “We want to develop the referral system to the one which is effective so we can earn trust and credibility from the people in Amphur Bangsai.”  The action plan had been done during January 2003 to March 2003.  The team decided to increase the potential of writing the health project to develop the community in Amphur Bangsai.  Therefore, those health care workers can learn to write the project to develop their community.  Two research proposals were as follows:1.   Hypertension and Diabetes screening and health education in people with the age 40 or higher in Amphur Bangsai.2.  Health promotion of exercise related to need of the people in Amphur Bangsai.After the implementation of the referral system in Amphur Bangsai, all objectives have been met in both quality and quantity.  We received instruction for the referral system so that they could refer patients between the health care centers in Amphur Bangsai, Phra Nakhon Si Ayuthaya with more effective and high quality.  During the implementation, we met the most important challenge, which was to increase the potential of the health care workers in Amphur Bangsai.  All health care workers in the projects said that their ability improved in terms of working as a team, learning how to turn problems into challenges. Every worker had a chance to take turns in the leadership role within each team.  We all learned how to complete the process of monitoring and evaluating with positive thoughts.  We learned how to utilize resources in the most effective way.  We all agree that it is useful for further development of primary health care reform research to meet the health community and governments goal “All For Health and Health For All.”	There are some suggestions in terms of plan and policy to make it better next time and they are as follows:                  1.  Continuing development of health care workers in terms of role and       functional fit in their positions with the highest potential. Utilize especially in terms of       transitional primary care unit system.   We need to make job descriptions for each        position.2.  Retrospective study of man-power and job from both ministries (Publichealth Ministry and Interior Ministry, and “All For Health and Health For All” policy), man- power is all right for all requirements.  Workload needs to be done for the PCU.Encourage health care workers to further their studies by supporting community’s scholarships and having them utilize their existing potential. Sign contract in joint programs with academic institutes such as Ramathibodi School of  Nursing to produce graduate nursing students to work in the community.  For the open positions, they need to recruit people for the position that are vacant such as a dentist. Executive team should continue strategies to encourage health care workers to have unconditional love for their community and be proud to work with their community to make them meet the over all goal “All For Health and Health For All”Due to earning very little money working with the government, we should support health care workers whenever we can by rewards or presents to create more happiness.Planning and management should be continuous such as workload or budgets.Personnel training in specific courses have to be appropriate in timing frequency, so that they would be able to utilize what they have learned in their community. Emphasize work quality more than quantity including service and educatingpeople in the community.Coordinating planning and development between Ministry of public healthand Ministry of the interior in terms of underlying what kind of jobs need to be done by health care workers in the community.In terms of development in researchers, we discovered and applied improved primary health care mechanisms and strategies into Bangsai Primary health care system research.  We mobilized actions and initiated collaboration to continue, articulate and promote new health care teams to promote a future vision for all in Bangsai community.  We had a chance to take a positive role in policy development.  Finally, we maintain that the researchers’ team and Bangsai have developed a healthy relationship with strong communication that leads to future projects working together.


location: , 'Thailand year: 2022 source: HSRI

title: Exploring Nursing Workforce Management and Competencies during the COVID-19 Crisis at the 10th Public Health Region Focusing on the Secondary and Tertiary Care Level

abstract: The increasing number of COVID-19 patients during the pandemic posed a great challenge for health care services. Nurses play a vital role in in providing care to these patients and managing other health care services, which created a significant challenge in regard to work force management and competency varied with a hospital’s resources. This qualitative research aimed to discover the lessons we can learn from the COVID-19 crisis experience which can lead to policy suggestions regarding workforce management and nurse competency at the secondary and tertiary care levels in the 10th Public Health Region of Thailand. Document analysis, in-depth interviews, and focus group discussions were used to collect data from October 2021 to April 2022. The 293 key informants included the Ministry of Public Health (MoPH) inspector for the 10th Public Health Region, representatives of the Thailand Nursing and Midwifery Council and the Nursing Division of the Ministry of Public Health, the Provincial Chief Medical Officer, a group from the Emergency Operations Center (EOC) Committee, hospital directors, heads of nursing departments, physicians, infection control (IC) nurses, and nurses engaged in COVID-19 patient care. The data were analyzed using content analysis. The study revealed two major findings as follow: First, workforce management in responses to the Covid-19 crisis in both the secondary and tertiary care setting included several similar strategies, namely: 1) implementation of pooled staffing using personnel from different units including nurses who volunteered when asked or were given direct ordereds, 2) using mixed-skill nursing staffing, and 3) assigning the head nurses of the units with lower workloads as supervisors in the COVID-19 cohort wards. However, some different strategies were implemented at the secondary care setting, including modifying working hours from 8-hour shifts to 12-hour shifts Last, having different nursing competency development models for COVID-19 care, which varied from setting to setting. The majority of competency development was on-the-job training, followed by pair-mentoring and self-directed learning strategies where staff searched the internet for available COVID-19 related resources to improve their knowledge about how to provide care for their patients. The IC nurses played a major role in increasing the hospital staff’s infection control competency, as well as updating and distributing the COVID-19 practice guidelines. Moreover, in the tertiary care settings, nurse competency development was focused on the essential skills required to care for critically ill and complicated patients and the technical skills related to using advanced technology medical equipment, negative pressure rooms, and other equipment related to COVID-19 patient care. The most common education and training conducted in the hospitals were related to the donning (putting on) and doffing (removing) of personal protection equipment (PPE) or powered air purifying respirators (PAPR), intubation of COVID-19 patients, Auto CPR, prone positioning of COVID-19 patients experiencing Adult Respiratory Distress Syndrome (ARDS), and mechanical ventilator care. The key to the success of the response to the crisis was the collaboration from all of the partners and stakeholders. The policy suggestions focus on designing and planning a comprehensive nursing workforce management and competency policy to handle crisis situations, developing the nursing workforce system and mechanisms in order to retain nurses in the system, implementing education and training programs to promote the continuous maintenance and improvement of nurses’ competencies, and creating a working environment which allows nurses to maintain their roles in providing direct patient care.


location: , 'Thailand year: 2014 source: HSRI

title: Alcohol‘s Harm to Others in Thailand: Concept, Situation and Gap in Knowledge

abstract: Study on Alcohol’s Harm to Others (HTO) is an innovative paradigm for revisiting the whole range
of alcohol-related problems. It comprehensively focuses on the negative consequences of alcohol drinking
to non-drinkers. Patterns of relationship between drinker and non-drinkers play a major role for this
harm. Problems emerged from drinking by family member, relative, friend, colleague or stranger in
society can be vastly different in terms of magnitude and pattern. The range of HTO covers from the less
severe such as mere annoyance to the most severe such as assault and death. HTO-related national data
were only available from social cost study, population survey and data of service system such as the
hospital, the police and court cases. But due to methodological or conceptual constraints, the data might
not best reflect the real situation. While Thai society may recognize alcohol-related traffic accident and
domestic violence as HTO, other problems have been largely ignored. Other HTO issues have not been
covered such as quality of life, impact on physical, mental health and belonging of people surrounding
drinker, impact to children and youth from parents and caretakers as well as impact on co-workers in
workplace. Comprehensive HTO data could demonstrate panoramic magnitude and severity of negative
impacts to the public, support alcohol policy development, and raise public awareness.


location: , 'Thailand year: 2008 source: HSRI

title: Evaluation of the labor unit system development of Srithat hospital, Udon Thani province

abstract: This evaluation research was aimed at assessing the results of service system development of the Labor Unit of Srithat Hospital, Udon Thani, and its problems and providing a basis for making recommendations for the further development of the Labor Unit.
The qualitative data were obtained from relevant document reviews, in-depth interviews,
participatory and non-participatory observations, from October 1, 2007 to February 29, 2008. It was revealed that the Labor Unit had improved its service system in both process
and outcome as follows: (1) Capacity-building. The administrators assigned multidisciplinary staff members to the Labor Unit.  A staff member visited Kumpawapee Hospital, the model hospital, to gain insight into the Labor Unit’s service system development.
The Unit organized training for staff to improve the quality of care for pre-labor, labor,
post partum, newborn, discharge plan and special equipment applications; (2) Facility
improvement. There was also structural development in that the pre-labor attending room
was separated from the Inpatient and Emergency Units. Essential equipment was procured and allocated to the unit; (3) Process improvement. Three service practice guidelines were developed by the multidisciplinary team to ensure good quality of care for
both normal and high-risk labor. The three practice guidelines were (a) care map for intra-partum and immediate post-partum care: low risk, (b) pregnancy-induced hypertension (PIH) care practices guidelines and (c) birth-before-admission practices guidelines.
A post-partum and newborn care handbook was also developed and distributed to mothers
before they were discharged from the unit in order to educate them on how to look after
themselves and their children. The results of improving the system were satisfactory.  Client
satisfaction with the services of the Labor Unit increased from 75.2 percent to 88.4 percent. There was no infant and maternal death. Maternal complications also decreased.
Problems encountered in developing the Labor Unit service system were unfamiliarity
with the practice guidelines of staff for both normal and high-risk labor. Reporting on the
care given to patients was still incomplete.  Recommendations for further development
included training on applications of the service practice guidelines, simplifying the practice guidelines, monitoring the reporting and establishment of continuous and systematic evaluation of the performance of the Labor Unit.


location: , 'Thailand year: 2021 source: HSRI

title: Situations and Factors Associated with Pre-Diabetes Mellitus and Pre-Hypertension Among Myanmar Migrant Workers in Suratthani Province

abstract: This research was a cross-sectional analytic study of both quantitative and qualitative methods. The objectives of the study were 1) to describe the level of Pre-Diabetes Mellitus among Myanmar migrant workers in Suratthani Province 2) to describe the level of Pre-Hypertension among Myanmar migrant workers in Suratthani Province 3) to evaluate the factors associated with Pre-Diabetes Mellitus among Myanmar migrant workers in Suratthani Province 4) to evaluate the factors associated with Pre-Hypertension among Myanmar migrant workers in Suratthani Province and 5) how to solve the problem through policy development support of those having Pre-Diabetes and Pre-Hypertension situation. Five hundred and eight samples of Myanmar migrant workers in Suratthani Province. In the first phase study (Quantitative study) data was collected data by interviews questionnaires; questionnaire structures were constructed based on literature reviews and were used for data collection. Cronbach’s alpha coefficient of stress, attitude, and practice were 0.78, 0.87, and 0.82, and the Kuder-Richardson coefficient of knowledge was 0.77. Multi-stage random sampling was used for sampling selection and data analysis was perfumed using Multiple logistic regression. The second phase (Qualitative study) collected data by focus group discussions and multi-disciplinary meetings. The results revealed that those workers who had a normal blood glucose level of 81.30% (95% CI: 77.66-84.46), had a blood glucose value at risk of 12.60% (95% CI: 9.97-15.78), and had a blood glucose level in the group requires of the clinical confirmation of a diagnosis by a physician of 6.10% (95% CI: 4.32-8.55). Those workers had blood pressure values in the normal group of 31.70% (95% CI: 27.78-35.88) and had blood pressure values at the risk group of 43.70% (95% CI: 39.43-48.06), had blood pressure values had to submit a doctor's diagnosis of 22.24% (95% CI: 18.83-26.07) and had to see a doctor within the same day 2.36% (95% CI: 1.34-15.78). Factors associated with Pre-Diabetes Mellitus consisted of graduating below junior high school students (Adj.OR=2.12; 95% CI: 1.09-4.10; p-value=0.026) married (Adj.OR=1.96; 95% CI: 1.04-3.70; p-value=0.037), unsupported media or materials in Myanmar language (Adj.OR=1.78; 95% CI: 1.11-2.85; p-value=0.016), and the problem of housing environment was moderate/high (Adj.OR=1.71; 95% CI: 1.05-2.77; p-value= 0.028). Factors associated with Pre-Hypertension including age >30 years (Adj.OR=2.77; 95% CI: 1.77-4.33; p-value<0.001), BMI on the overweight /obese scale. (Adj.OR=2.30; 95% CI: 1.50-3.53; p-value<0.001), average family payment per month ≥5,000 baht (Adj.OR=2.28; 95% CI: 1.17-4.44; p-value=0.015), not received health information (Adj.OR=2.28; 95% CI: 1.44-3.61; p-value<0.001), male (Adj.OR=1.97; 95% CI: 1.27-3.07; p-value=0.002), had duration stay in Thailand ≥48 months (Adj.OR=1.69; 95% CI: 1.06-2.71; p-value=0.027), and had work our per day ≤8 hours (Adj.OR=1.60; 95% CI: 1.03-2.49; p-value=0.036), respectively.
In conclusion, the results of this study were found that almost a fifth of Myanmar migrant workers are at risk of Pre-Diabetes and two-thirds are at high blood pressure risk. Factors associated with Pre-diabetes Mellitus and Pre-Hypertension include personal and socioeconomic characteristics, Environment factors, and the health service system. These factors are thought to have a profound effect on Pre-diabetes Mellitus and Pre-Hypertension. The recommendations policies; 1) The development system of spatial management in the public health system should be developed for the special area to operate area-based public health for Myanmar migrant workers. 2) Integrating all health network partners in Suratthani Province and establishing a Provincial Health Promotion Committee for migrant workers is a very useful process for integrating resources for the development of the labor health care system.


location: , 'Thailand year: 2010 source: HSRI

title: Economic evaluation of Prime-Boost HIV vaccine ALVAC-HIV ® and AIDSVAX B/E® for the Thai population

abstract: Objectives: This study aims to determine the maximum cost of HIV vaccination at which the vaccine is still cost-effective under the Thai healthcare setting and to identify the possible relative importance of several vaccine characteristics and subsequent impact of risk behavior changes among vaccine recipients. on its value for money.
Methods: A semi-Markov model was developed to estimate the relevant costs and quality-adjusted life year (QALY) over the patients’ lifetime based on the government perspective of providing prime-boost combination HIV vaccines (ALVAC-HIV® and AIDSVAX B/E®) in conjunction with the existing HIV prevention programs compared to existing HIV prevention programs. The analysis focused on the general population aged 18 to 30 years as well as high-risk populations (i.e. female sex workers, injecting drug users, men who have sex with men, and military male conscripts). Threshold analysis was carried out to determine the maximum cost of cost-effective HIV vaccination at a Thai ceiling threshold of 100,000 Thai baht per QALY gained. One-way and probabilistic sensitivity analyses were performed to examine the uncertainty of all input parameters. The study also employed an analysis of expected value of perfect information (EVPI) to determine the relative importance of input parameters and prioritize future HIV vaccines studies.
Results: The highest cost of HIV vaccination given to the general population was identified at 12,000 Thai baht with 70% efficacy, lifetime protection, and unchanged in terms of risk behaviour post-vaccination. The vaccine would be cost-ineffective at any price if it demonstrated relatively low efficacy (30%) and increased risk behaviours by 10% or more of the population. This is especially true among those high risk populations. This study also found that incremental cost-effectiveness ratios were the most sensitive to the change in risk behavior post-vaccination, followed by vaccine efficacy, duration of vaccine protection, and vaccine acceptance rate. The analysis of EVPI indicated the need to quantify several parameters, namely risk behavior changed post-vaccination, vaccine efficacy, and costs of community engagement and vaccine delivery.
Conclusions: The results are useful and important for both researchers conducting future HIV vaccine research, as well as policy decision makers who, in the future, will consider the vaccines adoption in Thailand.


location: , 'Thailand year: 2017 source: HSRI

title: Effectiveness of Nutrition Information Provision on Food Consumption Behavior among Undergraduate Students in Urban Areas

abstract: The objective of this study is to evaluate the effectiveness of the provision of nutrition informa¬tion on food consumption behavior. Field experiments were conducted on undergraduate students from three universities. The total number of research participants was 375 undergraduate students. Each participant was randomly selected to answer one of 12 possible questionnaires, each with a different set of nutrition information. They were subsequently provided with a meal of their choice. At each university, the experiment was conducted twice, within a one-week interval. Mean differences and regression analyses based on an ordinary least squares (OLS) technique were used. The results show that the provision of calorie information for each item on the menu and the provision of information on daily recommended caloric intake did not have an impact on food consumption behavior. Nevertheless, the selection of dishes into a recommended menu had an effect. Participants who answered questionnaires with healthy recommended dishes were more likely to choose a meal that contained lower calories by 73.97-105.4 Kcal, compared to those who were assigned with a menu highlighting unhealthy recommended dishes. However, the effect was found only in the first week and dissipated by the second week. The implication is that featuring a healthy recommended menu may have only a contemporaneous effect on food consumption.


location: , 'Thailand year: 2023 source: HSRI

title: Thailand’s Global Movement on Mental Health

abstract: In the situation of the COVID-19 pandemic, people were stressful due to the impact on social, economic and health situation from the pandemic. As a result, the number of people with mental health problems and the burden of mental health problems has been increasing. Recognizing the importance of mental health issues during the COVID-19 pandemic, Thailand proposed a mental health preparedness and response for the COVID-19 pandemic as the agenda of the 148th session of the World Health Organization Executive Board and played a leading role in developing a decision on this issue with supports by many countries. Thailand’s movement on mental health was the result of close collaboration between different organizations, continuous investment on capacity building of potential global health personnel and a strong network with countries and the WHO. Therefore, what Thailand has gained from driving mental health issue on the global platform is building a positive role and image of Thailand, incorporating Thailand’s interest into a decision and adapting lessons from other countries on mental health into Thai context.


location: , 'Thailand year: 2004 source: HSRI

title: Songkhla drug system

abstract: The objective of this project was to search for problems of drug system in Songkhla hospitals, which is major portion of drug system in terms of both expenditure and quantity.   Questionnaire mailed survey was used to collect data from pharmacists who were in charge of drug system in 21 hospitals.  These included both public and private owned hospitals.  Also, focus group technique was used to search for the problems in the drug system.  A total of ten hospital pharmacists sent the survey back and pharmacists from 19 hospitals participated in the focus group.  From all data, the conclusions were as followed	1. Drug Selection	An important problem in drug selection process was the problematic performance of the hospital patient and therapeutic committee (PTC).  It started from the beginning process when the data was gathered for submitting to the committee and continued to the committee meeting.  They had an impact on the performance of hospital drug selection.  Another potential problem was the problem of non-officially listed drugs in the hospitals, which were drug products that were not selected through the PTC but they were available in the hospitals.  It affected the drug system in various perspectives such as equity problems among different patient types of payment or problems of avoiding regular drug selection process.	2. Drug Procurement	Various problems related to the procurement process were identified.  First, the hospitals were forced to buy drug products manufactured by the Government Pharmaceutical Organization (GPO).  Some of the GPO’s products were more expensive.  The GPO also provided poor services such as they did not notify in advance when some products were out of stock.   Second, the human and information resources were scarce for decision making in drug purchasing groups, which was a government policy.  Another problem was the quality of drug products.  Under resource constraint, less expensive products were procured.  They were required the quality assurance at the hospital end.  However, limited resources were available for the hospitals themselves and the number of analyzing agencies were also inadequate.  	3. Drug Distribution	An important problem regarding the drug distribution was the distribution toward the primary care units (PCU).  The pharmacists’ roles at the PCU were ambiguous.  Also, data of drug storage appropriation at the PCU did not exist.Drug UseOther than general drug use problems such as clinical outcomes of irrational drug use, economic efficiency and equity among the different patient types of payment were the problems in the drug system.  For instance, non-essential drugs, which were usually more expensive, were likely prescribed for patients who paid out-of-pocket or were covered by the government.  They eventually created unnecessary high national drug expenditures.In conclusion, this study reflected various problems in Songkhla hospital drug system.  Some of them were long time problems such as the problem of PTC in drug selection process.  However, there were also contemporary problems which occurred from either technological change or government policy change, such as the scarcity of information, the impact from the universal health insurance coverage (UC) and the drug purchasing group policies.


location: , 'Thailand year: 2007 source: HSRI

title: Dapsone Hypersensitivity Syndrome: Report of a Patient, Resident in Banfang District, Khon Kaen

abstract: Dapsone hypersensitivity syndrome (DHS) is a condition rarely reported in Thailand.  Recently, during the period from January 1 to August 8, 2007, a 40-year-old male
patient, among the five cases on multidrug therapy (containing dapsone) for treatment of
leprosy, developed DHS (fever, maculopapular rash, hepatitis, lymphadenopathy and
pneumonitis) eight weeks from the start of the treatment.  Prompt drug withdrawal, administration of corticosteroid and supportive treatment led to his rapid are recovery; he
was discharged on the 11th day of hospitalization.  The patient is likely to have represented the second reported case of its kind in Thailand.  The author is publicizing this
case as a  warning to physicians who chance the use of dapsone; they must be aware that
the severe and potentially fatal side-effects of such a hypersensitivity syndrome is not so
rare


location: , 'Thailand year: 2003 source: HSRI

title: Study of financial report for hospital efficiency

abstract: Financial report plays an important role in organization management. Nowadays, each hospital, however,  has its own format of financial report and provides inadequate financial information. Therefore, it is difficult to compare the managing performance of each hospital. The objective of this research is to set up the standard form of financial report, which could be used for evaluation of hospital efficiency.In this study, we developed the new financial report format and the service cost data had been filled in (accrual basis), which could be categorized into 2 groups: outpatients and inpatients. Furthermore, we calculated service cost for each group based on three types of health insurance policy, i.e. 30 baht, social welfare, government officer, using data from Bhuddhachinnarat Hospital during January-May 2003. The result showed that the average outpatient’s unit cost/visit =1, 039.20 and the average inpatient’s unit cost/head = 14,967.68. Moreover, we found that outpatient’s unit cost/visit for 30 baht and social welfare is similar, whereas unit cost/visit for government officer is relatively high. In case of inpatient, the lowest unit cost/head is social welfare, 30 baht and government officers, respectively. In addition, comparison of service cost of each health insurance policy showed that only the difference in medicine cost affected the difference in outpatient’s unit cost/visit. In case of inpatient, not only the difference in medicine cost but also other service cost affected the difference in inpatient’s unit cost/visit.The result from this study is useful for the health authority and other involved users to obtain the proper financial report in the same format. Evaluation of hospital efficiency can be readily performed and comparison between each hospital can be assessed.


location: , 'Thailand year: 2003 source: HSRI

title: Capacity of Civil Society to Intervene on Violence Against Women

abstract: This study aims to examine the capacity of civic groups that work on issues related with violence against women and children from the macro and micro levels. The scope of the study covers the situational analysis on civic groups that work on issue related with violence against women and children covering their origin, concepts, principles, development, roles, and patterns. The study also focuses on factors that promote or inhibit their potential to be effective.  The analysis of the civic group’s capacity is done according to three components of civic groups including civic consciousness, civic organization, and civic network which considering socio-cultural, economic and political context at the global, regional, country and community levels. This study has utilized qualitative, documentary and case study research designs. The research methods used are mapping, documentary review, internet search, telephone interview, in-depth interviews, focus group discussion, key-informant interviews, and observation. Data analysis is based on concepts of civil society, feminism and critical theory.We found that there are 89 civic groups that work on the issue related with violence against women. They are Non Governmental Organizations (NGOs), community-based organizations, media, radio stations, and business enterprises. The concepts used for their motivation are human rights, women’s rights, child’s rights, and gender mainstreaming. The strategies they use are based on community-based, integrative and interdisciplinary approaches.  Their work covers policy formulation, advocacy, legal reform, societal campaigns for attitude change, prevention and providing support systems that are women-centered and gender-sensitive as well as helping battered women to return to live in society with dignity.Factors that influence the capacity of NGO civic groups that are working experience, development approach, the women’s movement at the global level, policy and support from the government.  Factors that influence the capacity of community-based programs are social structure and cultural system of the community, which includes patriarchy system, kinship system, seniority system, patron-client relations, social class, political system at different level and the bias toward the respect for the formal political structure. An important factor is the community belief of the myth that violence against women is a private issue, not a societal issue. These factors promote or obstruct civic groups in working on issues related with violence against women and children. Moreover, the processes by which various NGOs support communities to work on this issue influence the capacity of civic group at the grass root level, especially the processes of raising community awareness and mobilizing various groups of community members to work on the issue.Recommendations at the Policy LevelWorking on issues related with violence against women and children requires working together on issues related  to structural violence Campaigning against  violence against women and children  at the societal level requires an emphasis on the concept that: 1) violence against women and children is gender-based violence;  2) violence against women and children is not a private, but a public matter;   3) battered women and children have a right to life and to live without violence as well as to seek  helpIn order to work on the issue of violence against women and children, we should integrate our work on this issue with other social problems that occur in the communities. This is because most  social problems share the same root causes and they are connected to each other. For example, the campaign on the issue of violence against women and children should be done together with campaigns on HIV/AIDS, drug abuse, and unwanted pregnancy among the youth. The campaign should based on a gender perspective, which will help us to be able to successfully solve the root causes of these problems To determine principles regarding rights, welfare or safety of community members in order to support civic groups that work at the community levelTo promote other civil societies to work on issues of violence against women and children such as the  taxi network, business women’s groups in various provinces, media, press, advertisement enterprise, creative companies and  radio stations.Recommendations at the Community Level Principles: To mobilize community members to work on the issue of violence against women and children is to work with every sector in the community including village leaders, volunteers, and all other community members, both men and women. An effort must be made to close the gap of knowledge among community members and raise the potential of both males and females, leaders and non-leadersTo form a civil society on the issue of violence against women, we should start with getting the community to analyze their own views regarding gender-based violence including situation, magnitude, forms, types, myths etc. This should include an attempt to raise consciousness on the relationship between patriarchy and violence against womenTo work on  community-based programs require the networking of other organizations  in both  the private and government sectors. These sectors require  clear and specific tasks and roles that complement each otherTo form civil society on violence against women, we should utilize the social and cultural capital that exists in the community, i.e. various forms  social relations existing in the community.Strategies:To form a civil society on violence against women, we should start work with persons who have a clear understanding of gender issues and persons who are most concerned with   working for societal benefit. We can organize community-based programs on violence against women with both types of people, which is considered social capital for us. However, we should try to change the consciousness from the non-gender one to gender perspectiveTo create a strong awareness of the gender-based violence problem, the stage of problem analysis by the community members and the mobilization of broad-based participation from different groups of community members are important community awareness-raising. We should thoroughly consider the community’s views on violence, socio-cultural context that promotes or inhibits community participation and the formation of civil society to address violence against womenTo create an awareness needed to form civil society for violence against women is to deconstruct and reconstruct the consciousness and myths related with gender-based violence. The process of deconstruction and reconstruction can utilize both formal and informal methods including formal training by volunteers and chatting in everyday life conversation. Gender issues must be embedded in content of the messageTo do awareness raising on gender-based violence problem, to deconstruct the production and reproduction of patriarchy and myths related with violence against women that exist in Thai society is important.  The deconstruction process should also involve the production of new set of knowledge on women and gender system, including roles of women in the family and society, human right and gender equalityTo expand the network among various civic groups by sharing and exchanging the working experiences regularly is the key mechanism to strengthen the potential of civil groups to work for violence issue.


location: , 'Thailand year: 2022 source: HSRI

title: The Synthesis of Policy Recommendation for Thailand’s Health Systems Resilience by Applying System Dynamics Modeling of COVID-19 Epidemic

abstract: The pandemic of Coronavirus Disease 2019 (Covid-19) comprises complex health and socio-economic issues. The limited knowledge of this emerging disease has led to uncertainties in solving the problem. Policymakers need comprehensive data to support policy decisions and reduce the constraints of compartmentalized thinking. The literature review suggests that controlling the pandemic depends on developing policy decision processes that effectively deal with public health emergencies at the national policy level. The governance structure of the "Information and Strategy Department" is required to collect data and present it to the "Incidence Commander", who makes the decisions, develops guidelines, and communicates risks to the public. Systems thinking can be applied to the policy process by better understanding the relationships between all connected system components from the perspective of all relevant stakeholders and by testing the effectiveness of policy scenarios by simulation modeling. Thus, the process enables policymakers to make well-informed decisions supported by sound scientific evidence, likely to create optimal disease control with negative impacts and manage the risks that may arise from those decisions. A vital tool to synthesize evidence is the mathematical models that can predict epidemiological scenarios by considering the natural transmission capacity of the 2019 coronavirus. Yet they are still too limited for supporting more comprehensive policy decision-making, as the COVID-19 pandemic comprises complex health and socio-economic issues. The Susceptible-Exposed-Infectious-Recovered (SEIR) model customarily used for epidemiological forecasting can be modified to build a structure of system dynamics (SD) models that include all components of health systems resilience. So the SD model can function as an analytical tool that considers health systems' short-term absorptive, immediate-term adaptative, and long-term transformative capacities. We applied the group model buildings (GMB) process to work more closely with stakeholders to integrate all aspects of problems and solutions. Disease control measures, enhancing healthcare capacity measures, and remedial measures for economic and social consequences were considered in our modeling. Then we can use the simulation model to test policy options and effectively support the policy decision-making process in this public health emergency. Both qualitative and quantitative data were collected from participants in our workshop on health systems design in the COVID-19 era to synthesize a causal loop diagram that demonstrates the relationships of all factors within the health system affecting the control of the COVID-19 pandemic in Thailand. Additional quantitative data were collected continuously between 2020 and 2021 to construct the model for testing policy options and support the policy decision making process in several key policy options, including 1) lifting the intensive disease control measures for remedying socio-economic consequences, including reducing the quarantine duration of inbound international travelers, after the 1st wave of the COVID-19 pandemic in Thailand (the January 2020 outbreak), 2) implementing "lockdown" measures in hyperepidemic areas in the 3rd wave of the COVID-19 pandemic in Thailand (the April 2021 outbreak) at both the national level and in the Greater Bangkok Area, 3) raising the capacity of testing, contact tracing, and isolation and quarantine systems after the enforcement of lockdown measures in July 2021, and 4) enhancing the healthcare capacity to sufficiently care for COVID-19 patients during the April 2021 and the January 2022 outbreaks. The findings from our simulation model show that new waves of outbreaks can reemerge after being well controlled in early 2020. The so-called "lockdown policies," including the closure of government offices and public services and banning cross-provincial and international travel, had been implemented since March 2020. The need for easing intensive disease control measures arises due to the far-reaching socio-economic negative consequences of the government authorizing intensive disease control measures to cope with the first wave of the COVID-19 epidemic in Thailand. Therefore, policymakers should consider adopting integrated policies aimed at disease control and remedying its socio-economic impacts. For instance, subsidizing businesses affected by the lockdown policies to maintain local employment can reduce workers' traveling across territories and lower the risk of spreading the COVID-19 nationwide. Our model also suggested that at both the national level and in the Greater Bangkok Areas during the April 2021 wave, a more severe outbreak than that of January 2020 may happen due to the rapid transmissions capability of Alpha and Delta strains. The number of COVID-19 infections likely exceeded the capacity of the health service systems in some areas, especially in the Greater Bangkok Areas. Yet the effectiveness of disease control can improve if intensive lockdown policies can reduce at least 40% of community transmissions in approximately month of lockdown. Hence, policymakers should ensure that the lockdown policies are effectively enforced intensively enough in the short term. Moreover, the previous policy of isolating all infected people in hospitals should be adjusted by providing additional community isolation services, especially for those with no or minor symptoms, to cope with the limited existing healthcare capacity. The simulation also shows the outcomes of enhancing the performance of testing, contract tracing, and quarantine and isolation systems during the April 2021 outbreak. Proactive screenings in the communities could increase the reported cases in the short run but reduce the number of patients in the long run. Therefore, policymakers should consider implementing a more proactive community screening during the enforcement of lockdown measures in July 2021 to provide more access to testing and take advantage of the opportunity that vulnerable populations still have limited travel during the lockdown. The rapid lateral flow tests, or antigen test kit (ATK), should also be incorporated for screenings, even though it may lead to some false-negative results. As many people still have limited access to real-time polymerase chain reaction (RT-PCR) testing, ATK can help control the disease than using RT-PCR alone for testing. Lastly, the models show the outcomes of optimizing health care systems to provide adequate care for COVID-19 patients during the April 2021 and the January 2022 outbreaks. The number of available hospitals beds may not be sufficient to support the April 2021 outbreak, especially after the outbreak of the Delta strain in June 2021. Hence, it was necessary to build a surge capacity of health care delivery systems, such as creating additional quarantine and isolation services in hotels or the communities. The capacity of healthcare delivery systems for the January 2022 outbreak was likely insufficient to be used as the isolation facilities for an even larger number of people infected with the Omicron strain, which is even more contagious than the Delta. The simulation also shows the most critical policy that could prevent an overrun of healthcare delivery systems is accelerating the vaccination coverage of vulnerable groups to reduce the morbidity and case-fatality mortality rate. The preliminary results of our research have been presented to policymakers at different levels to support their decision-making process. They included the scientific advisory committees of The Centre For COVID-19 Situation Administration (CCSA) of the Royal Thai Government, The Emergency Operation Center (EOC) of The Ministry of Public Health, The Macroeconomics Department of the Central Bank of Thailand, and The Board of Directors of the Health Systems Research Institute. The study findings were also communicated to the public through the researchers' website and the mass media periodically. Nonetheless, using system dynamics modeling as a policy decision support tool (DST) considering health systems resilience still has limitations. The public policy process to cope with Thailand's public health emergencies tends to focus more on reactive measures than on planning and addressing the structural issues of the health systems that created persisting problems during the COIVD-19 pandemic. Without policies that address the high-leverage point of the systems, many problems have persisted more than two years after the pandemic began. Therefore, it is crucial to create a learning platform among policymakers and stakeholders to synthesize lessons learned on integrating research in the public policy process and what governance process can be further improved in public health emergencies. By focusing on the evidence-informed policy-making process under the country's emergency management systems, Thailand's health system can be more fully developed as a "learning health system," an important concepts suggested by the World Health Organization. It can be challenging for policymakers to use evidence from simulation modeling in the decision-making process amid uncertain information and pressure from the public. Nonetheless, it is vital to work on this complex problem-solving process to prepare for any soon emerging health, economic, and social problems.


location: , 'Thailand year: 2016 source: HSRI

title: Trimming Method for Outlier Trim Point of Casemix

abstract: This paper aims to review and describe method to determine outlier trim point for outlier cases in
diagnosis related group. This review demonstrates concept and experiences in each country. The outliers
cases divided into 2 categories: length of stay (LOS) outlier and cost outlier. Outlier trim point methods for
LOS were 4 methods: inter-quartile range (IQR) method, 10th - 95th percentile method, L3H3 method and
geometric mean method. The literature review will be information for decision in formula of outlier trim
point in Thailand. Since the trimming of outlier cases will effect for relative weights that used for payment
to hospitals.


location: , 'Thailand year: 2009 source: HSRI

title: Health and Quality of Life of Residents Around A Petrochemical Industry

abstract: This health status and quality of life study was a cross-sectional descriptive one. It was aimed at
exploring the health status and quality of life and their related factors in the study population: 943 people
living near one of the petrochemical plants in Rayong Province. Data were collected during July and
October 2008, using an interview questionnaire and WHOQOL-BREF-THAI. Data were analyzed by
descriptive statistics (frequency, percent, mean) and inferential statistics (chi-square).
Results revealed that the majority of the study population were females (76.8%) with a mean age of
46 years, and having had a primary school education (57.8%). Of the total, 27.9 percent were traders, 16.5
percent consumed alcohol, 8.7 percent smoked, and 48.9 percent did exercise. The distance between their
house and the petrochemical plant was less than 5 kilometers (59.4%). In the past three months, 6.8
percent of them got ill and sought care at hospitals. In the past month, 61.8 percent of them had respiratory
symptoms, 57.2 percent had neurological symptoms, and 53.7 percent had dermatological symptoms.
Regarding their family members, 26.9 percent were allergic to dust or had hay fever. In the past
month, 59.8 percent of them experienced chemical odors: 52.3 percent a gas-like odor, 21.5 percent a
pungent odor, and 15.6 percent an odor similar to a ripe guava. A third of them experienced these odors
in the evening (33.3%); 23.2 percent smelled the odor during the day and 17.2 percent did so at dawn.
The majority of them (68.6%) had a moderate level of quality of life, 31.3 percent had a good level of
quality of life, and 0.1 percent had a poor level of quality of life. Factors related to quality of life were
personal factors (gender, education, job, exercise), health status (getting ill and family illness), and distance
from the petrochemical plant. In addition, respiratory, neurological, and dermatological symptoms
in the previous year and the previous month were significantly related to experiencing the chemical
odors.
This study emphasizes the concern that experiencing chemical odors in ambient air relates to health
and may affect people’s quality of life. Health authorities should develop and enhance measures, especially
short-term and long-term surveillance, and monitor the health status and quality of life of the
people living around industrial zones.


location: , 'Thailand year: 2019 source: HSRI

title: Mental health gap and related economic burden (year 2)

abstract: Objectives: 1). To compare the economic and social impact of mental illness between those who receive early and delayed treatment, between those with early and late onset of disease, and between those with short and long durations of illness. 2) To examine the effectiveness of home visits made by community health workers in improving patients’ outcomes (by conducting a before-and-after home visit evaluation among those who receive visits). Methods: The mixed method study design was employed. First a cross-sectional community survey was conducted by sampling: 1) psychotic patients aged 18 or above residing in the catchment areas of Thammasat University Hospital and its primary care unit (PCU), namely the areas administered by Kukot and Lamsamkaew Municipalities, who had had histories of receiving psychiatric treatment at the hospital and its PCU, 2) individuals living in the areas who had been screened positive for psychiatric conditions in the earlier community survey (year 1) and 3) psychiatric individuals who were so called “hard to reach” and recruited by using a technique called chain referral method (i.e. by asking community residents to introduce patients they had seen or known in the area). Face-to-face interviews were conducted by trained interviewers with the World Mental Health - Composite International Diagnostic Interview version 3.0 (WMH-CIDI 3.0)-Thai version, eliciting sociodemographic information, education, employment, finances, DSM-IV diagnoses (including psychosis, depressive disorders and alcohol use disorders), chronic physical conditions, history of service use, health care coverage and family burden. The second study design employed was before-and-after treatment without control group. The intervention was home visit delivered by community health workers to those who had had histories of medication non-adherence or losses to follow up, and were therefore at increased risk of relapse and rehospitalization. Results: The sample comprised a total of 623 participants (respondent rate 89.1%). The majority of the sample were recruited using the chain referral method. The proportion of those with a lifetime history of psychotic symptoms was 88.9%, depressive disorders 81.4% and alcohol use disorders 19.6%. Multivariable analyses revealed that early onset of illness was significantly associated with increased risk for low educational attainment, unemployment, reduced annual earnings and metabolic syndrome. History of delayed treatment was significantly associated with increased risk for low educational attainment. Long duration of illness was significantly associated with unemployment and reduced annual earnings, whereas relatively short duration of illness was significantly associated with greater risk of metabolic syndrome. In terms of family burden, the majority of carers reported substantial or great burden related to illness such as keeping (him/her) company, giving emotional support, and helping with medication. More than half reported time spent on caregiving at 8-9 hours/week. The majority of carers also reported substantial or much embarrassment due to having a mentally ill relative. More than a third reported financial burden caused by caregiving. The majority of respondents had had received psychiatric treatment (86.4%), most of whom were in regular follow-up (57.1%), followed by those who had lost to follow-up for less than a year (20.5%) and for a year or more (14.2%). Of those who had never sought treatment (N=301), 38.2% were able to get treatment after the interview assessment. A total of 61 respondents received home visits. After a period of visits, the majority of these respondents showed improvements in almost all areas under evaluation, except employment, quality of caregiver and home environment. Conclusions: A substantial number of psychiatric patients in the community has dropped out from treatment, or never even received treatment. These patients would never have had access to regular and adequate treatment if psychiatric care was only facility-based without community involvement. Proving early treatment without delay, especially to those with early onset of disease, and continuous care, by effective interventions such as home visits, is essential. This will help reduce the long term serious impact of illness such as school dropout, unemployment, family burden, chronic physical diseases. Development and evaluation of innovative early identification and continuous care methods in the community, with the help of modern technology, is essential in reducing the accessibility and treatment gap experienced by mentally ill patients.


location: , 'Thailand year: 2023 source: HSRI

title: A Model for Community Empowerment to Prevent New Outbreaks of COVID-19 in the Western Border Areas of Thailand

abstract: This research aims to develop a community empowerment model to prevent new outbreaks of COVID-19 in the western border areas of Thailand using action research, combining both research methods. qualitative and quantitative Research results: Development of a community empowerment model to prevent new outbreaks of COVID-19 in the western border area of Thailand. There are 10 activities in the implementation phase as follows: 1) Group meeting to determine work roles. together of agencies and determine the punishment of community measures. 2) Support equipment to prevent and monitor the re-epidemic of COVID disease. And support the growing of related herbs. 3) Distribute a manual for using media applications. Along with a video teaching how to use the new COVID-19 outbreak surveillance system for relevant agencies. 4) Community leaders monitor the use of protective equipment. and the use of media applications 5) Community leaders, researchers, the Director of the Health Promotion Hospital, along with the Phraya Suea Special Military Unit that coordinates patient case reports. or risk group and exchanging information through applications 6) Training to provide knowledge on preventing new outbreaks of COVID-19 in the western border area. by the surveillance network in the area 7) Use media application manuals Surveillance system and follow up and evaluate. 8) Turn on the audio through the communications broadcasting tower. Local dialect in the area (Karen) 9) Public health volunteers monitor and monitor behavior, and 10) Researcher, Director of Subdistrict Health Promoting Hospital, evaluates the results of monitoring and monitoring of the new outbreak of COVID-19 through the operations of the network. household level network


location: , 'Thailand year: 2021 source: HSRI

title: Determination of optimal timing for discharge of Covid-19 patients to the community

abstract: Background and Objectives Thailand has experienced the COVID-19 pandemic since mid-January 2020. Symptomatic COVID-19 patients are admitted for hospital inpatient treatment. At present, there is limited information on the association between treatment time and dynamics of viral load, as well as incidence of sero-conversion of household close contacts of COVID-19 patients after the patients are discharged and return home. Such information may have implications for stakeholders in COVID-19 prevention and control. The objectives of this study were: 1) to describe the association between treatment period and presence of viable virus in respiratory fluids of COVID=19 patients, and; 2) to describe the incidence of sero-conversion among household contacts of discharged COVID-19 patients. Methods For Objective 1, we conducted a retrospective cohort study among COVID-19 patients at Songklanagarind Hospital and an affiliated field hospital who were admitted in early 2020 and received at least two nasopharyngeal swab tests. We extracted data regarding patient characteristics and rRT-PCR results in the hospital information system, and sent leftover swab samples to the Department of Medical Sciences' central laboratory for viral culture with anonymized unique ID designated for each sample. We then merged culture results data with the rest of the data set and performed data analyses using descriptive statistics and regression analyses. For Objective 2, we conducted a prospective cohort study among household close contacts of COVID-19 patients who were discharged from the study hospital. Investigators contacted the patients and asked for the contact details of their adult household members, then contacted the mentioned household members and invited them to participate in the study. After giving informed consent, investigators briefly interviewed the household contacts (study participants) and collected blood samples on the day of the discharge or day after the discharge (Day 0), at 7 days after discharge (Day 7), and at 28 days after discharge (Day 28). Data were analyzed using descriptive statistics. Results For objective 1, there were 20 patients in the data set, 16 of whom met the study inclusion criteria with adequate data available (n=16 patients). The median length of stay was approximately 28 days, and more than half of the patients did not have positive viral culture in any sample. Among patients with at least one sample with positive culture, while the median length of time from admission to the date when viral culture became consistently negative was 10 days. There were large fluctuations in the patients' rRT-PCR cycle time during the course of treatment, but the rRT-PCR cycle time gradually increased and became plateaued after the first 15 days. Pattern of changes in cycle time differed between patients with viable virus in swab samples and patients without viable virus in swab samples. Discussions and Conclusion For objective 1, we found indications that patients might have unnecessarily overstayed at the hospital during their treatment. However, the study findings should be used selectively and cautiously, with due considerations for the study limitations including limited generalizability and lack of statistical power. For Objective 2, the absence of evidence on infection based on RT-PCR test results (which cannot be published) suggested that there was no new COVID-19 infection among the study participants, and thus there was no evidence that the 10-days stay guidelines for treatment of COVID-19 patients had become inadequate for prevention of intra-household COVID-19 transmission. Caveats regarding the lack of generalizability and potential effect of vaccination should be considered in the interpretation of the study findings.


location: , 'Thailand year: 2000 source: HSRI

title: Development process of pesticide-free vegetable production systems in Chiang Mai Province

abstract: Development process of pesticides-free vegetable production systemsin Chiang Mai Province	The research has the objectives to provide better understanding on pesticide-free vegetable production systems, on process of group formation, organization and management of farmer groups and their sustainability, and to determine the roles of external institutions on the development of farmer groups.  The sites selected for case studies were the pesticide-free vegetable production in Saraphi, Mae Rim and Phrao districts of Chiang Mai province.  The research methods included semi-structured interview, where the target interviewees were farmer members, and key informants such as chairperson and committee members, farmer leaders, kaset Tambons (Subdistrict extension agents), NGOs, and retail markets of pesticide-free vegetables in Chiang Mai.	The results showed that the farmer groups in Saraphi, Ban Muang Khum of Pong Yang subdistrict were organized and assisted by the District Agriculture office.  The Doi Khum group of Pong Yang subdistrict were organized by the Doi Khum Royal Project, and the NGO was helping the farmer group at Phrao district to produce organic vegetables.	The Saraphi group intercropped vegetables in young longan orchard.  There was a tendency to cease growing pesticide-free vegetables when the fruit tree matured.  The Mung Khum and Doi Khum groups grew their vegetables in rotation with flower production.  Both open-field and closed net production practices were found.  The Saraphi group grew more vegetables.  Which the Pong Yang area (Mung Khum and Doi Khum) mainly produced vegetables on open field, consisting of both common type and sub-temperate vegetables.  All three groups practised safe-use of pesticides.  The Phrao group produce organic vegetables without using any chemicals or pesticides.  The vegetables which were mainly local, were planted on open-fields around or not too distant from the house.  The common vegetables were also grown during cool season.	The groups marketed their produce differently.  The Saraphi group, depending on one member as local trader, delivered their produce daily to various markets.  The Doi Khum was contracted to the Royal Project, but was allowed to sell their discarded products to other markets.  The Mung Khum group was further divided into six sub-groups, each handling its own marketing outlets independently.  The Phrao group sold their surplus in the Saturday market organized by NGO in Chiang Mai at Im-Boon place.	It is anticipated that the Saraphi group was not sustained due to less motivation to grow vegetables among most farmer members.  The Doi Khum group depended solely on the Royal Project for marketing arrangement and production plan without the Royal Project, the group would disintegrated.  The Mung Khum group, consisting of six subgroups working independently, could become strong if those sub groups could form alliance or network for production and marketing.  The Phrao group, developed slowly but steady, would become self-reliance when the production is more stable.


location: , 'Thailand year: 2013 source: HSRI

title: Research health care systems in the nation‘s hospital, Thai within ten years ago.(2002 – 2012)

abstract: This study is a descriptive study to develop the information systems research
health care systems in the nation's hospitals, Thai standards by storing data in research agencies / organizations and educational institutions since the year 2002-2012. Total 4371 researches. The data was collected during March to August 2013. The enterprise has a number of 194 story was 12.82 percent and from educational institutions of 4177 story was 3.34 percent. Researches have passed the criteria the most on 2007 was 12.06 percent. Mahidol University research through the qualifying criteria was 10.71 percent. Trends in health care systems research in the hospital. Recognize the anniversary of the studies found that the dimensions of health care are the most in a year since 2007 was 12.06 percent dimensions of health are the most in a year since 2006 was 11.28 percent dimensions the location with the most in a year since 2007 was 14.62 percent dimensions according to the level of management systems with the most in a year since 2004 was 11.69 percent dimensions dimensions based on the value chain of the health system are the most in a year since 2004 was 12.83 percent and the dimensions of health care are the most in a year since 2007 was 15.56 percent. Research overviews of each dimension by organization and institutions. The research was found to be compatible with the dimensions. There is a lot of research, as each organization and Council of education that have been carefully selected according to the criteria. In this study, the researchers conducted health care systems in the country's overall Thai hospital. On the basis of all education data is recorded in a computer program that can be added to the trace. So that is gathered. There are to be useful.
There should be a study of health service systems research collection in the community of the country, Thai within 10 years, and the study of storage systems research on public health service system. Basis both in the hospital and the community as a database for educational and research use to advantage.


location: , 'Thailand year: 2009 source: HSRI

title: The Assessment of Health Surveillance System for Haze in Chiang Mai

abstract: The objective of this study was to review and analyze the problems and obstacles of health surveillance system for haze in Chiang Mai including to propose policy recommendations for the development of health surveillance system for haze. The study methods were literature reviews of health surveillance systems in overseas countries, in Ministries of Public Health and Natural Resources and Environment, and in Chiang Mai province. For domestic reviews, the related governmental officials were in-depth interviewed. In addition, the experts in the field had been convened for brainstorming.
The results showed that the surveillance system that might be suitable to Thailand is the World Health Organization’s STEPwise approach to Surveillance or STEPS, by using model so-called DPSEEA Model developed by the World Health Organization to construct the health indicators. In regard to data dissemination derived from surveillance system, the Internet-based Health & Air Pollution Surveillance System (iHAPSS) developed by the John Hopkins University is recommended. The recommendations for the policy makers are that the Ministry of Public Health should play a major role in setting the health surveillance system including database system, health indicators and steps of surveillance in full details. Furthermore, it should develop a manual of health surveillance system for haze for the health personnel to use as a guildline. There should be also training courses for the health personnel to upgrade their capacity in diagnosing haze-related health problems and in statictical analysis to link the health problems and air pollutants. For Chiang Mai province level, the role model of health surveillance system for haze should be developed by focusing on reporting system, frequency of reports, linkage analysis of air pollutants and health problems, including on the utilization of data analyses to seriously warn or manage the haze problems. Additionally, the health surveillance system for haze in general population version should be promoted.


location: , 'Thailand year: 2008 source: HSRI

title: Benefits of Performing Vaginal Papanicolaou Smear in Visual Inspection, Using Acetic Acid-positive Subjects

abstract: Carcinoma of the cervix is the most common cancer in Thai women. Over 40 years,
Pap smears have been used as the standard technique for cervical cancer screening, but
the coverage is quite low among the population and the incidence of advanced stage
cancer is still high. Acetic acid (VIA) testing had been introduced as an alternative method
in order to improve the effectiveness of cervical cancer screening in Thailand. When the
VIA result was positive, the client is referred for further management, but most doctors
do a repeat Pap smear to start rescreening as usual. This study was conducted to evaluate
the effectiveness of VIA and determine how necessary it is to practice in VIA-positive women.
This retrospective descriptive study was conducted in VIA-positive women who
were sent for colposcopic examination between February 17, 2004 and February 16, 2007,
a total of 109 cases. Pap smear and colposcopic cervical biopsy, with or without LEEP
conization, were performed. A Pap smear result of “normal” meant normal; inflammation
was found in 102 cases. “Abnornal” meant SIL or CIN to carcinomas, which was
found in seven cases. The histopathological result was classified as “normal”, meaning
negative and cervicitis, and “abnormal” meaning CIN I to carcinomas, which were found
in 90 and 19 cases respectively. Pap smear sensitivity was 36.84 percent, specificity was
100 percent, positive predictive value was 100 percent, and negative predictive value was
88.24 percent. This study suggested that repeated screening by Pap smear in VIA-positive
women should not be recommended due to its low sensitivity.