location: , 'Thailand year: 2023 source: HSRI

title: Digital Health Governance Model: Recommendation for Thailand Health Systems

abstract: Background: Digital health governance was identified as an essential foundation for establishing e-health in Thailand by the Ministry of Public Health (MOPH) and World Health Organization (WHO) Thailand since 2010. Despite many health information systems and digital health developments, there is still no consensus amongst stakeholders on national digital health governance mechanism. Objective: This study aimed to identify appropriate digital health governance mechanism for Thailand health systems. Methodology: There were two parts to the study. First, we reviewed literature including digital health governance and health systems from international reports and various digital health governance documents from Malaysia, the Philippines, Australia, England, the USA, and Canada. Second, a qualitative study design was used involving a semi-structured in-depth interview method. Eleven health information technology scholars, executives, and startup entrepreneurs were interviewed face to face or online. Result: The review on digital health governance in the six countries showed the influences of political systems, culture, and health systems leading to diverse implementation models. In-depth interviews employed the governance models of the Broadband Commission 1) the health ministry mechanism, 2) a government-wide digital agency mechanism, and 3) a dedicated digital health agency mechanism. Majority of key informants agreed with the dedicated digital health agency mechanism. More than two-thirds made pertinent suggestions: 1) leaders should be decisive in their decision-making with continuity of leadership, 2) strong collaborations to reduce working in silos, and 3) proper health information standards. Conclusion: In the context of Thailand, the MOPH alone cannot govern digital health. However, the MOPH can lead governance mechanism through collaborating with other ministries and stakeholders. Good collaborative governance is the key to an effective digital health governance system, with decisive leaders and continuity of leadership. The preferred model is the dedicated digital health agency mechanism and health information standards are crucial.


location: , 'Thailand year: 2012 source: HSRI

title: Attitude and rural job of choices of newly graduated doctors

abstract: Doctor shortage has long hindered the development of Thai health service system. It is thus crucial
to understand attitudes towards working and living in rural areas and factors driving job of choices of
doctors. The cross-sectional study conducted with 1,219 newly gradated doctors in 2011 was conducted.
Self-administered questionnaire comprising individual characteristic information, questions on attitude
towards working and living in rural areas, factors affecting their jobs of choice was used. Statistics used
were percentage, and Logistic regression.
The results showed that of the population 1,219 (527 from normal track and 313 from rural doctor
track), the majority of doctors were female. Half of the rural track doctors were from regional areas, and
the majority graduated from regional universities. Whereas, the majority of normal track doctors were from Bangkok and vicinity, and graduated from universities located in Bangkok and vicinity. Factors were
likely to affect their job of choices were workplace that : close to their hometown, enhance their learning
experience, provide case consultancy. With regards to their intention to work, few of them intended to
work at rural areas after 3 year and factors associated with their intention to work in rural areas were:
rural background and regional training.


location: , 'Thailand year: 2021 source: HSRI

title: The Review of International Cooperation Frameworks on Health Management for Migrants and Cross-national Population

abstract: This study is a documentary research and aimed to study and review the contents of international cooperation frameworks at global, regional and national levels concerning issues on migration management and health care provision for migrant workers and cross-national populations and health collaboration frameworks between Thailand and Mekong sub-region countries, especially Cambodia, Lao PDR and Myanmar as well as mechanisms for implementation, coordination, monitoring and evaluation of the international cooperation frameworks. Results of the study revealed that global and regional international cooperation frameworks, with selected criteria mentioned above, have provided concepts and guiding principles for migration management and promotion of migrant and refugee health, which are harmoniously interlinked and aimed to realize the sustainable development goals (SDGs) that facilitate orderly, safe, regular and responsible migration and mobility of people (SDG target 10.7) and ensure healthy lives and promote well-being for all at all ages (SDG goal 3) including achieve universal health coverage (SDG target 3.8). The concepts and guiding principles can be applied by member countries as guidelines for dealing with problems and issues related to migrant workers and cross-national populations or can be used as conceptual frameworks for developing additional agreements to address the issues with countries of mutual interests. Since health management for migrant workers cannot be carried out alone by one country, collaboration and cooperation among the countries of origin or the sending countries and countries of destination or receiving countries are required. As movement of migrant workers can provide both positive and negative impacts on the economic development of countries and the region, integration of migrant health management as a public health issue of international cooperation in existing regional economic cooperation frameworks, such as ACMECS and GMS will help mobilize resources and efforts from member countries to address this issue in more effective and concrete ways, thus, makes the migration to be a positive impact for the overall economic development of the member countries and the region. Recommendations for better dealing with the challenges on provision of health services for migrants and cross-border population have been emphasized on the development of health and health-related policies to solve the obstacles at national level, such as to integrate primary care services or community-based health care provided at migrant community health centers with support and assistance of migrant health workers and migrant health volunteers to be a part of existing universal health insurance system for migrant workers and cross-border population, and the development of bilateral and multilateral international cooperation to mobilize efforts and collaboration in order to reduce negative impacts to the overall economic and social development of the region.


location: , 'Thailand year: 2012 source: HSRI

title: Blindness, Low Vision and Eye Diseases in Thai Children 2006-2007

abstract: The objective of this paper was to study the epidemiology of blindness, low vision and eye diseases
in Thai children population by analysis the secondary data of surveyed sample aged 1-14 years totally
2,743 cases in the First Thai Visual Impairment Project 2006-2007. The surveyed data weighted on the
basis of stratified cluster random sampling represent the whole country was collected in 22 provinces.
The study found that the prevalence of blindness and low vision were 0.11% and 0.21% respectively.
The estimated number of blindness and low vision in Thai children population were 13,101 cases and
26,670 cases respectively. The causes of blindness were retinopathy of prematurity (ROP) 66.67% and amblyopia from uncorrected high myopia (-9.00 diopter both eye) 33.33%. The causes of low vision were
amblyopia from uncorrected high myopia (-6.00 and -11.00 diopter both eye) 28.55%, cortical blindness,
congenital cataract, optic atrophy, corneal disorders and congenital nystagmus 14.29% each. Top five of
eye diseases with visual impairment were refractive error 19.36%, strabismus 1.24%, amblyopia 0.36%,
cataract 0.25% and eyelid disorders 0.22%. Top five of eye diseases without visual impairment were glaucoma
suspect 0.73%, allergic conjunctivitis 0.22% and nasolacrimal duct obstruction, epiretinal membrane,
pterygium, retinitis pigmentosa 0.12% each.
Thus the Ministry of Public Health and the Department of Medical Services who have the responsibility
to take care the health of the population, should have the effective policy and strategy to reduce the
prevalence of childhood blindness and low vision. The comprehensive projects cover early detection,
proper intervention and referral system for complicated cases with participation of the community were
the key of success factors.


location: , 'Thailand year: 2021 source: HSRI

title: Model Development to Prevent the Hazards of Natural Latex Pillow Process among Workers, Nakhon Si Thammarat

abstract: This research aim to 1) investigate risk perceptions and preventive behaviors as well as the control of work-related risks among latex pillow processing workers, 2) study the factors affecting risk perceptions and preventive behaviors as well as control of work-related risks among latex pillow processing workers, and  3) establish the guidelines or measures and prepare manuals on the development of hazard prevention to address the occupational health and safety problems among latex pillow processing workers in Nakhon Si Thammarat. The sample size for the survey on risk perception and hazard prevention from working with latex pillow processing were a total of 10 community enterprises and SME groups for latex pillow processing in Nakhon Si Thammarat, with a number of 74 workers. The research adopted the Participatory Action Research (PAR) through the qualitative study and participatory learning technique during November 2019 to December 2020. The research was conducted by studying the baseline data of occupational health hazards, survey the working condition, and monitoring the physical working environment.  Researchers apply work improvement in small enterprises (WISE) and job safety analysis (JSA) techniques that points out hazards in every working process. It is also required for their participation in determining the procedures and methods in each procedure to ensure collaborations between researchers and latex pillow processing workers. Data analysis were analyzed using descriptive statistics and Inferential statistics by multiple regression analysis to analyze the correlation of factors influencing risk perceptions and preventive behaviors as well as work-related risk control among latex pillow processing workers in Nakhon Si Thammarat. The study found that top five rankings of risk factors exposed to latex pillow processing workers were working positions with lowering/raising their heads, positions with body bending, repetitive working positions for a long time, chemical exposure, and moisture exposure, accounted for 3.29, 3.10, 2.94, 2.78 and 2.70 mean, respectively. The correlation between personal factors and risk perceptions among latex pillow processing workers through an analysis of correlation between variables found that females had statistical significance (p-value = 0.006; 95%CI: 3.75 – 21.55), working periods of latex pillow processing with statistical significance (p-value = 0.001; 95%CI: (-1.05) – 7.36), and receiving the trainings of safe and proper latex pillow processing with statistical significance (p-value = 0.0001; 95%CI: (-29.72) – (-12.96)). An adjustment of possible influences from other covariate variables found that females (p-value = 0.006; 95%CI: 3.75 – 21.55) with working periods for latex pillow processing approximately 8 hours/day (p-value = 0.014; 95%CI: (-19.35) – (-2.31)), having the records of allergies (p-value = 0.003; 95%CI: (-38.61) – (-8.47)), and receiving the training of safe and proper latex pillow processing (p-value = 0.0001; 95%CI: (-33.91) – (-2.31)) showed statistical significance. The results of the development from the application of Work Improvement in Small Enterprises (WISE) and Job Safety Analysis (JSA) techniques to improve the working environment were found that after the implementation, community enterprises had a better working environment in several areas based on the WISE Technique elements, such as improving work posture, chemical safety, and personal safety equipment, etc. The steps for successful work improvements among workers used by the researchers include 1) understanding the problems, 2) providing knowledge of safe working conditions, 3) collaboratively finding the guidelines for improving the work environment, 4) jointly improving the work environment, and 5) doing follow-up and supporting the operations. The hazard-prevention models are regarded as the primary prevention strategies developed by collaborations of latex pillow processing workers and relevant agencies in the local area, which will result in the prevention for health impacts and improve the quality of working life in a concrete and sustainable way.


location: , 'Thailand year: 2009 source: HSRI

title: Assessing the implications of the compulsory licensing policy in Thailand between 2006-2008

abstract: nan


location: , 'Thailand year: 2016 source: HSRI

title: Concepts and Practices of Community-Based Health Interventions for Vulnerable Populations in Thailand: a Qualitative Study

abstract: Objective: To synthesize lessons learned from the existing community-based health interventions
for vulnerable populations in Thai contexts in order to create policy recommendations for further health
systems development and response to health needs of vulnerable populations. Methods: This study utilized
qualitative study design to investigate and compare community-based health interventions for vulnerable
populations in eight district health systems (DHS) of Thailand, including Umphang, Ubolratana,
Dan Sai, Khon Buri, Kuchinarai, Lam Sonthi, Kong Rha, and Khlong Khlung. Qualitative data were collected
from the local practitioners by semi-structured interviews, focus-group interviews, and non-participant
observations, and were synthesized by thematic content analysis. Results: Content analysis reveals
four emerging themes. First, sense-making of the vulnerable population concept was challenging
for practitioners in Thai contexts. Second, effective community interventions for vulnerable populations
were initiated by local practitioners, not from policy and planning at the national level. Third, effectiveness
of community interventions for vulnerable populations depends on services design being customized
to the nature of vulnerability. Lastly, traits of local leadership, not authority, are necessary for creating
and implementing sustainable community-based health interventions for vulnerable populations.
Discussions: Despite no mutual understanding of the vulnerable population concept in Thai contexts,
we found strong evidence of innovative community-based health interventions in Thailand. To
scale up such programs, policymakers should create criteria to help practitioners identify vulnerable populations
in their contexts, allow for contextualizing health needs of different vulnerable populations, and
put more emphasis on developing information systems at both the national and the local level, so there
will be more systematic monitoring and evaluation of community-based health interventions for vulnerable
populations in Thailand.


location: , 'Thailand year: 2013 source: HSRI

title: Problems in the pediatric brain and spinal cord tumor treatment system from Thailand CNS Tumor Network

abstract: The purpose of the study was to explore the problems in the caring system of the pediatric CNS
tumor in Thailand. CNS tumors in children need sophisticated diagnosis and treatment, which include
large multidisciplinary care teams. At present, there are many problems in the caring system in Thailand,
including the inadequate number of physicians involved in many aspects of the diseases, equipments for
diagnosis and treatment, and inappropriate referral and payment system, all of which can result in the
delayed diagnosis and treatment leading to an increased rate of morbidity and mortality. Suggestions
derived from the study were made to solve the problems systematically and serve as the basic data for the
improvement of the CNS tumor care in Thailand.


location: , 'Thailand year: 2007 source: HSRI

title: Randomized Assessment of the Health-care Quality by Public Health Standard Year 2007

abstract: This descriptive study was aimed at assessing the results from the monitoring process
in following the quality standards of the Ministry of Public Health in Sungmen District
Hospital. The survey, which was conducted on June 27, 2007 by the Ministry of Public
Health Standards Committee, was done by random sampling of people visiting 10
health-care service interfaces: ER, OPD, IPD, LR, Dental Clinic, OR, Laboratory, X-ray,
Pharmacy and community medicine. The Ministry of Public Health standard 2007 questionnaire
was used in collecting data. Data were statistically analyzed in terms of the
quality of services received compared with the service specifications subjects’ understanding
and satisfaction.
It was found that (1) 85.75 percent of the respondents received services as stated in
the service specification (covering four aspects of the Ministry of Public Health standard),
and all respondents understood the process of services, with 92.78 percent of them being
satisfied with the services, (2) the result of the award audit monitoring among the 10
health-care service interfaces was 91.96 percent.


location: , 'Thailand year: 2022 source: HSRI

title: Health at a Glance Thailand 2020 - 2021

abstract: The development of economy and society significantly affect to many factors involving national health system including the demographic and population behavior change, the increasing of senior citizen while workforce age is decreasing significantly, the expanding of industry and urbanization, the Inefficient natural resource management causing environment pollution, and the emerging infectious diseases and non-communicable disease causing the increasing of direct and indirect health cost. Consequently, Health system competency evaluation is necessary in formulating effective health policy for Thailand. However, Thailand still does not have an overall health system competency evaluation, while there are only specific aspects health evaluation report such as health systems financing research, health promotion in different age populations and health impact assessment This research is to evaluate overall health system competency by using international organization health impact assessment concept as well as comparing Thailand's health result to other ASEAN countries and the average value of Organisation for Economic Co-operation and Development (OECD) country in health dimensions consist of health status, health risk factor, service access, healthcare quality and health resource. We are hoping that this research would be useful in health policy making level. Health executive boards at every level can manage their health resource and compare results at provincial, regional, national and international levels.


location: , 'Thailand year: 2008 source: HSRI

title: Umbilical cord care using alcohol vs. dry cotton wool

abstract: A randomized controlled trial for determining the incidence of omphalitis and observing cord separation time in two groups of newborn infants used two different methods of umbilical cord care, namely, cleaning with alcohol or with dry cotton wool.  Of 384
full-term newborns, 169 were assigned randomly to receive dry cord care and 188 infants
alcohol cleaning.  Both groups were followed up for examination at one week and one
month after delivery.  There was only one infant in each group showing signs of omphalitis.  Cord separation time in the alcohol group was significantly longer than in the dry
cord care group (8.03 days vs 6.74 days; p-value < 0.05).
It was concluded that dry cord care should be recommended for umbilical cord care
in newborn infants based on the results of the study that it did not increase the incidence
of omphalitis and took a comparatively shorter time to achieve cord separation.


location: , 'Thailand year: 2022 source: HSRI

title: A Study of Field Hospital Administrative System in COVID-19 Situation: A Case Study of Budsarakhum Hospital

abstract: Budsarakhum Hospital was a large field hospital specialized in providing temporary care for COVID-19 patients, where modern technology was used in providing comprehensive patient care according to referral and treatment standards addressing both physical and mental health. However, there are still few studies in the management system of field hospitals in Thailand. Therefore, it is necessary to study the body of knowledge that leads to the development of a field hospital management system in the face of a crisis other than COVID-19. This is qualitative research. The research objectives were 1) to study the current situation of the field hospital management system in the situation of COVID-19: A Case Study of Budsarakhum Hospital, 2) to study the problems, obstacles, and recommendations for hospital management systems in the Covid-19 Situation: A Case Study of Budsarakhum Hospital, and 3) to synthesize policy recommendations for the development of field hospital management systems. The researcher collected data by in-depth interview during December 2021 - January 2022. The purposive sample composed of 43 participants who were executives in policy level as well as executives from various departments, Budsarakhum Hospital as follows: Director of the Field Hospital under the Department of Medical Services; Director of University Field Hospital; Director of Private Field Hospital; Emergency Medical Specialist; Deputy Director of Budsarakhum Hospital; Secretary of Emergency Medical Department; Executive of Administrative Staff including nurses; Team Leaders of Referral, Loading, Caring, Treatment, Medical Emergency Response Team (MERT); Information Technology staffs; medical practitioners including doctors, nurses, pharmacists, and patients who have been already admitted to Budsarakhum Hospital. Data was collected through a semi-structured interview form developed by the researchers from the literature review and it has been consistent with the objectives. Content validity was checked by experts and to determine the reliability of the tool. The research team collected data from 1) Documents related to the operation of Budsarakhum Hospital, including: documents on the operating policy of Budsarakhum Hospital; hospital structure; processes of those involved, including executives, key and supplemental practitioners in all field hospital zones; as well as documentation related to performance outcomes in the field of COVID-19 patient care; 2) Information systems related to the operation of Budsarakhum Hospital such as news in various media, various announcements, websites, and Facebook related to Budsarakhum Hospital; 3) Sample groups were then analyzed using the content from all the data, in order to categorize and interpret the data according to research objectives as follows: 1. Field hospital management model in the situation of COVID-19 from the review literature and interviews with experts consisted of input factors, including structure, (i.e. location/objectives/hospital structure, setting up working group, team and responsibilities). The process aspect, including commanding/coordinating/control, inside and outside organization communication, emergency mobilization, information technology management, risk management, infection control, and medical record systems. Staff, including recruiting manpower, roles/responsibilities, orientation/training, staffing/scheduling, morale building, compensation and benefits. Supply, including financial management, handling of medical materials/devices. Process factors, including admission/diagnosis, screening clinical care, medical record/document system, continuing care/referral system, and psychological care. Outcome factors, consisting of outcome follow up. The management of Budsarakhum Hospital was consistent when compared to literature review and experts in the management model of field hospitals in the situation of COVID-19, except for emergency mobilization and the outcome follow up. 2. Problems, obstacles, and strategies of the hospital management system in Budsarakhum Hospital were found in various aspects, including hospital structure, communication outside the organization, risk management, infection control, recruitment, medical records system, personnel stress management, handling of medical materials/devices, admission, clinical care, patient referral system, and outcome following up. 3. Policy recommendations for the development of field hospital management systems consisting of staff, system, supply, and structure. Recommendations for Staff include: develop workforce plan of field hospitals in both the central and regional areas; train health care personnel to work in emergency situations; develop a system of volunteering from both the public, private, and public sectors; develop a system to increase health literacy for people to have basic self-care in emergency situations; study and research knowledge gained from field hospital services and develop innovations that support the management system of personnel and patient care in field hospitals; add disasters course to curriculum and practicum of health care students. Recommendations for System include: develop a field hospital practice manual which include inputs, processes, and  outcomes; establish the Public Information Officer; develop a system for monitoring health outcomes and voice of customers (VOCs); develop information technology system in field hospitals; develop cooperative human resource plan among government sectors and between the government and the private sectors. Recommendations for Supply include: establish cooperation policy in sharing medical devices between public and private hospitals in emergency situation; build networks with agencies and communities to participate and support the establishment of field hospitals. Recommendations for Structure include: develop a manual for the field hospital structure which consists of place of establishment, layout of the space, zoning, and command line.


location: , 'Thailand year: 2011 source: HSRI

title: Impact of Overweight and Obesity on Health-care Costs in Thailand

abstract: Overweight and obesity are associated with several chronic diseases. Economic costs attributable
to overweight and obesity are substantial. In Thailand, the prevalence of overweight and obesity is increasing
rapidly. It was also found that overweight and obesity were the 6th leading risk factor attributable
to Disability-Adjusted Life Year (DALY) loss in Thailand in 2004. However, there had never before
been a study which examined health-care costs due to overweight and obesity in Thailand.
This study is aimed at estimating the health-care costs attributable to overweight and obesity in
Thailand in the year 2009, employing the overweight and obesity-attributable fractions (OAFs), which are
generally defined as the proportion of a disease in a population that is attributable to overweight and
obesity. OAFs were calculated for each disease associated with overweight and obesity. OAFs can be
calculated from the prevalence of overweight and obesity and relative risk of each disease. The number of
patients in each disease category attributable to overweight and obesity was then calculated as the product
of OAFs and the total number of patients with that disease in 2009. The health-care costs of overweight
and obesity were further estimated by multiplying the number of patients in each disease category
attributable to overweight and obesity by the unit cost of treatment.
Health-care costs attributable to overweight and obesity in this study were estimated at 5,580.8 million
baht (i.e. out-patient department = 847.4 million baht and in-patient department = 4,733.4 million
baht). The top three leading causes of health-care costs were diabetes mellitus (3,386.6 million baht),
ischemic heart disease (1,070.5 million baht) and colon and rectal cancer (377.2 million baht), respectively.
The findings clearly confirmed that the economic impacts of overweight and obesity on health-care
costs in Thailand were substantial. More effective policies/interventions aimed at reducing the prevalence
of obesity should be implemented.


location: , 'Thailand year: 1999 source: HSRI

title: The Reform of drug management system in the MOPH Hospitals, FY1998

abstract: The economic crisis, that occurred nearly two year ago, has affected on campaigning all sectors to cut back their spendings and buying local made products in order to reduce national currency reserve. Drugs or pharma ceutical products are considered as manufactured goods that are relied on imported raw materials that represented 35-50%of the local manufactured pharmaceutical product cost. For import finished products, it represents 80-100% of the cost. With this import dependency, there is no doubt that the impact of economic crisis on pharmaceutical business would be unavoidable.
This study was aimed at describing and analyzing the situation and problems of drug management system and utilization in the Ministry of Public Health hospitals, recommending measures for drug management reform.


location: , 'Thailand year: 2019 source: HSRI

title: Equity in Health in Thai Elderly under Universal Coverage Scheme: A Systematic Review

abstract: Background: Health equity is systematic deprivation gaps in resource allocation, accessibility and utilization of health services. The elderly people with high prevalence of chronic, and non-communicable diseases (NCDs) usually face problems with respect to high treatment cost, and if health inequity exists, they disproportionately suffer a decrease in their quality of life. Objective: The study was aimed at exploring the factors affecting health equity in Thai elderly, as well as activities that improve health equity. We focused on horizontal equity dimensions of cost, use, and accessibility to health services. Methodology: This was a systematic review, searching 5 Thai and 2 international databases. The inclusion criteria covered equity in health in elderly and related meanings (in Thai and English). Content analysis, and descriptive presentation were used in this review. Result: The affecting factors to inequity in health included external factors (e.g. socioeconomic factors) and internal factors (personal/behavioral factors on use of service). The external factors that improved equity in health in elderly included health insurance coverage and living in urban area. The external factors that decreased equity in health in elderly included education lower than high school level, low income, no occupation, no insurance and living in rural or remote area. The internal factors that decreased equity in health in elderly included 1) having disability or chronic illness, 2) stress, and 3) behavior for not using health service. All of these factors affected on 1) health status, 2) health financing, and 3) health needs (accessibility and utilization). The interventions that decreased inequity in health and improved equity in health were as follows: 1) treatment and rehabilitation activities at secondary and tertiary hospitals, 2) health promotion and disease prevention activities at the community or primary care units, and 3) public services or social welfare activities aimed at reducing inequity by decreasing health service expenditure to elderly. Recommendation: Appropriate approaches amending factors and activities affecting inequity should be implemented to achieve health equity in elderly.


location: , 'Thailand year: 2007 source: HSRI

title: Factors Affecting Blood Pressure in Patients with Hypertension in Tha Chang District, Sing Buri Province

abstract: The purpose of this study was to identify factors influencing the control of blood
pressure levels encompassing four aspects, i.e. personal, pre-disposing, enabling and reinforcing factors.  A sample of study subjects included 381 hypertensive patients living in
Tha Chang district and seeking health care at Tha Chang Hospital, Thon Samo Subdistrict Health Center, Wihan Khao Subdistrict Health Center, and Phikun Thong Subdistrict
Health Center for Commemoration of Her Majesty the Queen’s 60th Birthday Anniversary.  Data were collected by using a questionnaire and analyzed by using percentage
values and the binary logistic regression method for testing the statistical significance of
the factors influencing blood pressure control. The study revealed that the factors influencing blood pressure control among hypertensive patients in Tha Chang district include, in order of high-to-low levels of significance, enough income (OR=2.345), perception of health worthiness (OR=0.478), co-morbidity with hypertension and other diseases (OR=0.414), and supportive care from relatives or someone else with a close relationship (OR=0.316).  Other factors that were found
to be unassociated with blood pressure control are sex, age, educational attainment, knowledge about the illness, perception about being ill, perception about continuous care, attitude toward hypertension, accessibility to health-care facility, satisfaction with healthcare facility, satisfaction with the effects of medication, assistance from health personnel,
and doctor-patient relationships.


location: , 'Thailand year: 2008 source: HSRI

title: Development and outcome of an integrated participatory model for maternal and child health, Kahpo district, Pattani province, 1999-2007

abstract: Maternal and child health is a major health concern in the lower reaches of southern
Thailand. This action research was aimed at developing an integrated, participatory model
for solving problems related to maternal and child health in Kapho district, Pattani Province.
The model incorporated several activities, namely promoting community participation
through, for example, participatory community development for solving problems
related to maternal and child health; increasing access to maternal care through, for
example, promoting the delivery of newborns in the hospital by providing incentives for the pregnant women and traditional birth attendants (TBAs); and improving the quality
of maternal care through, for example, developing antenatal care clinic (ANC) and laborroom
services to meet with the safe motherhood project standard, the arrangement of a
place for Muslim ceremonies for the newborn in the hospital, training TBAs about postpartum
care, including ancient Thai massage and hot herbal compression.
The outcomes were assessed by ANC visits at least four times and delivery in the
hospital in comparison to the Department of Health standard of 90 percent of such visits
and deliveries. During the period from 1999 to 2007, the results clearly demonstrated
continuous improvement. In that period, the percentages of pregnant women attending
ANC at least four times were 78.9, 89.0, 93.4, 94, 97.5, 97.5, 98.4, 95.4 and 98.1, respectively.
The percentages of pregnant women delivering in the hospital were 52.1, 54.6, 63.7, 72.4,
81.5, 91.8, 97.1, 97.5 and 97.6, respectively. This study has shown a successful model of
maternal and child health problem-solving using the Plan-Do-Check-Act process,
multidisciplinary integration and community participation.


location: , 'Thailand year: 2012 source: HSRI

title: Evaluation of Using Practical Guideline Manuals for Health Promoting Hospital

abstract: This study was conducted to evaluate practical guideline manuals for health promoting
hospital in aspects of the level of use, appropriate use and delivery process. Data collection were
collected by self administered questionnaire with directors or staffs of health promoting hospital,
and focus-group discussion with directors or staffs of health promoting hospital and focus-group
discussion with administrative staffs of health provincial office, health district office and
contracting unit for primary care.
Results showed that most of health promoting hospitals received the set of practical
guideline manuals from Bureau of Policy and Strategy, Ministry of Health. The levels of using
each practical guideline manuals were moderate to high, and most of respondents revealed that the
contents in manuals guided them to complete work easily. However, not all contents in these
manuals could be applied in practical. The barriers of using these manuals were the lack of
communication and public relations, and the lack of staffs to work at health promoting hospital.
The finding of this study suggested that the policy of using manuals should be established
and informed to all organizations: health promoting hospital, provincial health office, district
health office and contracting unit for primary care. The monitoring and evaluation should be done
continuously and the knowledge management should be conducted in each area to gain specific
guidelines for area.


location: , 'Thailand year: 2011 source: HSRI

title: A Survey of Supplementary Vitamins and Minerals Prescribed for Pregnant Thai Women

abstract: Iodine supplementation is an additional intervention of the Ministry of Public Health that is used to
alleviate iodine deficiency disorder among the Thai population. This survey was aimed at examining the
opinion of obstetricians nationwide regarding vitamin and mineral supplements for pregnant women. It
can be used as input data for formulating national policy on iodine supplementation.
Over 90 percent of obstetricians prescribed folate and iron compared with 25 per cent of those prescribing
iodine. The number of participants who considered that iron deficiency, thalassemia and folate
deficiency comprised a severe or the most severe health problem in their areas of responsibility was 2-4
times greater than those who concerned iodine deficiency to be such a problem. This finding contrasts
with epidemiological data showing that iodine deficiency could be found in most of the places. Potassium
iodide plus folate and iron tablets were the preference of 90 per cent of obstetricians. Thus, we suggest
that the combination of the three minerals should be provided for pregnancies. Iodine only tablet should
be prescribed for thalassemic pregnant women. To effectively implement the administration of iodine
supplement tablets, guidelides are essential for vitamin and mineral supplementation for pregnancies
and good monitoring and evaluation systems are essential.


location: , 'Thailand year: 2003 source: HSRI

title: The development of violence research database and the synthesis of research on violence issues in Thai society

abstract: This study aims to analyze and synthesize research on violence issues conducted in the last twenty years (1981-2001) and to place the information into the violence research database initiated on the World Wide Web, http://www.violence.au.edu The 190 research papers were reviewed and classified according to WHO violence classification and subsequently analyzed using qualitative data analysis methods. The content analysis was done and the essence of the research was synthesized by applying the concepts of violence research and women’s health research as the frameworks. The results reveal that most of the existing researches are quantitative and repetitive studies on the causes and factors contributing to the violence occurrences. The survey of incidence and prevalence of the issues, and the attitudes toward violence perpetrators and survivors as well as the characteristics of available services or resources are substantial. Self directed violence research was mainly focused on suicide and attempted suicide cases. Stress from unsolved family problems is the major factor contributing to the rising of suicide among teenagers and adult women. These research findings also reveal that the Thai people lack effective coping skills and seek no assistance when facing with crisis. The limitation of available resources is also problematic. The studies on child abuse and neglect found that children who are witness violence or were raised by abusive parents are likely to be abusers. Thai society lack knowledge and awareness toward this issue and have no effective legal system to isolate children from abusive family and concretely protect children’s rights. The research on violence against women in intimate relationships and/or domestic violence especially those were conducted in 1997 to date reveal that researchers have more insight about gender based violence. Nevertheless, the studies affirming the impact of sex role stereotype and gender double standard that is rampant in Thai patriarchal society are very rare although the concepts were mentioned in certain domestic violence studies. The study to develop problem solving solutions, the improvement of resources and legal systems must be sponsored as priority. Sexual violence research is the most prevalent especially on the issues of stranger rapes. The sensitive nature of this issue kept the researcher from studying about acquaintance rape and misled the extent and characteristics of the problems. Although the empirical research reveals that acquaintance rapes are more common in Thai society, the numbers of scientific research in this area are limited. The results of existing research on sexual violence reflect researcher’s rape myth acceptances and bias attitudes toward rape survivors because of the influence of sex role stereotype and gender double standard socialized in Thai patriarchal society. Gender based violence research and the study of empowerment the women to flight against violence must be continuously supported. The research on adolescent violence, social violence and other forms of violence reveal the common root of problems regarding the limitation of appropriate social and legal system in preventing, diminishing and/or eliminating of the violence issues. Beside the research findings, ethical consideration and principle of human subjects protection in violence research should be seriously enforced among research scientists and constantly pronounced by Thai scientific research community.


location: , 'Thailand year: 2001 source: HSRI

title: Potential of women society for AIDs management

abstract: Potential of Women Society for Aids Management	AIDS patients tended to be stigmatised by society resulting their broken families. AIDS crisis reflected inability of public organisations and people’s understanding to cope with AIDS. Social movement for AIDS was an interesting activity to handle such a crisis. A number of AIDS / HIV female patients associated together with objectives to manage AIDS problems for AIDS women in northern region. This study was to explore women ability of doing social movement in two issues. The first issue was grouping and developing its task groups for managing AIDS problems for northern AIDS women. The second issue was developing its potential and ability for AIDS management. 	Qualitative technique was used in this study. 3 studied groups were AIDS / HIV female patients, women society for community development and female members of local administrative organisations. The study found that awareness of problems and their impact was a driving force for women to gather into society and possess civic consciousness. Management potential and ability were largely developed and promoted by NGOS instead of public organisations. However, the infected group’s flexibility to manage their own issues was limited due to little confidence received for their management ability which were perceived by the NGOS while the second group, the community development society was given more flexibility for AIDS management. The second group then became the consultant for the first group. 	A lack of civic consciousness in members of local administrative organisations was a significant inhibitor for AIDS management in local areas. Their concern was more on development of community infrastructure which led to less budget for AIDS management. It is recommended that developing more concrete working partnership in these three groups should be put into practice.


location: , 'Thailand year: 2023 source: HSRI

title: Proposal of House Dust Mite Sublingual Immunotherapy Compared with Subcutaneous Immunotherapy for Treating Allergic Rhinitis with and without Asthma in the COVID-19 Pandemic

abstract: The COVID-19 outbreak greatly disrupted healthcare systems and made it more difficult for patients to access treatment, ultimately affecting the quality of life of patients and society. This paper highlighted the issues and importance of policy management and examined the financial cost and social benefits of treating allergic rhinitis and allergic asthma caused by house dust mites (HDM) amid an outbreak of COVID-19. A comparative analysis was executed between HDM sublingual immunotherapy (SLIT) as an intervention and subcutaneous immunotherapy (SCIT) as a comparator. It was found that HDM SLIT provided a better return on investment from the perspective of society during the COVID-19 pandemic in 2021 than HDM SCIT. The benefit to cost (B/C) ratio of the HDM SLIT to HDM SCIT was 1.72 and likely to be less than 1.00, respectively, which were statistically different. Policymakers could use these results to establish strategies for treating allergic rhinitis with and without asthma by choosing between HDM SLIT and SCIT, particularly during the pandemic.


location: , 'Thailand year: 2018 source: HSRI

title: Theories and Concepts of Public Health Policy Implementation Research: Call for Systematic Action to Achieve Efficient Implementation Strategies

abstract: Implementation of a policy needs different knowledge from that for formulating or adjusting one. Implementation Research (IR) aims to develop strategies to bring policy into effects and achieve  successful results as stated in policy. This study used scoping review method to gather knowledge regarding theories and concepts of implementation research. Although IR has been conducted for some times, the attempts still are unsystematic, scattered and unstandardized. The report addressed 6 theories and conceptual frameworks from which a research can utilize more than one. IR can be conducted at pre-, during- or post-implementation using quantitative, qualitative or mixed methods. Context plays an important role in implementation. Therefore a successful implementation in one context cannot guarantee another success in others. To implement a policy, an implementer or a policy maker needs to consider a variety of implementation strategies and balance between policy adaptability and policy fidelity. Health care workers should be allowed to be involved in designing implementation strategies to enhance effective policy implementation process. Policy maker should pay more attention to establish standardized and longitudinal study of implementation research to achieve information regarding implementation of a policy as inputs to contribute with a policy process especially a policy formulation or a policy adaptation.


location: , 'Thailand year: 2020 source: HSRI

title: Physical Activity, Carbon Dioxide Emission and Cost of Transport: A Case Study of Three Communities in Thailand

abstract: Walking and cycling are common physical activities if performed regularly in daily life will return health, environmental and economic benefits. This study aimed to 1) assess built environments that encourage walking and cycling in communities, 2) assess levels of physical activity and energy consumption, and 3) investigate the amount of carbon dioxide emission and cost of transport. Quantitative method was employed. Data collection techniques comprised direct observation and questionnaire survey in three communities: 1) King Taksin community in Bang Khla district, Chachoengsao province, 2) Suksabaijai community in Mueang Kalasin district, Kalasin province, and 3) Ban Thatsopwaen community in Chiang Kham district, Phayao province. The results showed that King Taksin community had the highest scores on walking, cycling and use of public transport as the community center was close to the district shopping center with a well-managed public transport system. Samples from King Taksin and Ban Thatsopwaen communities had the highest levels of physical activity due to frequent walking and cycling in their daily life. Suksabaijai community had the highest level of carbon dioxide emission from motorcycles and cars, and the highest transport cost as the community center was far from the shopping center with its built environments of having a high-speed road passing through the community center hence discouraged walking and cycling. This study recommends that all agencies promoting physical activity should work with local community in designing built environments and evaluating effectiveness of walking and cycling promotion programs that fit with each community.


location: , 'Thailand year: 2004 source: HSRI

title: Multi-centered study of anesthesia related adverse events in Thailand: The Thai anesthesia incident study (TAIS)

abstract: Objectives: To develop and institute a methodology for the study of anesthesia related adverse outcome in 20 hospitals in Thailand: 7 university hospitals, 5 tertiary hospitals, 4 general hospitals and 4 district hospitals.Methods: The Thai Anesthesia Incident Study (TAIS) was prospectively conducted by collecting data of all consecutive anesthetics in preplanned structured data entry form (form 1). The database including patients demographics, anesthetic, surgical factors and anesthesia related adverse anesthetic records and hospital charts and interview attending anesthesia personnel. Data were collected and entered by double entry technique and analysis of outcomes determined for preoperative intraoperative and 24 hours postoperative periods.Results: The 86265 patients were take care by anesthesia personnel. The mean (S.D.)age, weight and height of the patients were 38.5 (21.4) years, 53.2 (18.4) kg. And 146.6 (38.5) cm. In this study 87.5 % of patients were classified as ASA physical status 1 or 2 and 31.2 % were in emergency setting. The six most common choices of anesthesia were general anesthesia (61%), spinal anesthesia (23.3%), total intravenous anesthesia (5.5%), monitor anesthesia care (3.4%), brachial plexus block (2.9%) and epidural anesthesia (1.2%) respectively etc. There were 53 cases (0.1%) of cardiac arrest and 17 cases (0.02%) death within 24 hours due to all etiologies. The common respiratory adverse events were desaturation 123 cases (0.1%), difficult intubation 83 cases (0.1%), reintubation 26 cases (0.03%) and esophageal intubation 19 cases (0.02%). Other important adverse events were coma/CVA/convulsion 9 cases, myocardial ischemia or infarction 8 cases, anaphylactoid or anaphylaxis 9 cases. The systemic events were 10 cases of drug error, 18 cases of equipment malfunction or failure, 5 cases of anesthesia personnel hazard, 6 cases of unplanned hospital admission and 27 cases of unplanned ICU admission.Conclusion: This was first large anesthesia epidemiological data which can be implied to anesthesia practice in Thailand. The rates of cardiac arrest and death within 24 hours due to allKey words: anesthesia, complication, adverse events. Cardiac arrest, death


location: , 'Thailand year: 2003 source: HSRI

title: Thai drug system and woman health : a case study of contraceptives

abstract: Thai Drug System and Women Health: A Case Study of Contraceptives	This study is aimed to be integrative research. Its objectives are to study on Thaicontraceptives policy and their situation under the drug system framework namely selection, procurement, distribution, and use. In doing this the project looks at thestructure and process of drugs system by analyzing roles and collaborations of relevantsectors to gather critical information for women health development. The result is thusproposed in order to protect health of Thai women using contraceptives.	Methods include multi-disciplinary techniques such as documentary study, interview, simulated case survey, observation, and questionnaires. Data collections are conducted at various levels from policy maker, professionals, practitioners, and consumers.	Various studies show that Thai health status has changed dramatically, with longer lifespan (life expectancy = 75 years) but still face complex health problems. These came from multipart social phenomena and over utilization of technology. Sources of illness and death  are changed from complicated delivery and infectious diseases to accident, committed  suicide, killed, and cancers of breast and vagina. Sexually transmitted diseases (STD),  AIDS, rapes as well as unwanted pregnancy and abortion are the rising problems. These situations occur in younger girls as low as 14 years old. However, numbers of abortion practices in married women are also prevalent from failed contraception together with social norms and economic constraints.	Thailand is recognized as success in population control shown by the decline in growth rate as being less than one. Nonetheless, women have the most responsibility in this job (more than 90% of all contraception used). Oral contraceptives are gradually less preferred than injectables. The potent and the longer hormones used the more harmful women received.  But there is less policy to motivate men involvement for family planning program showing  by very few and decreased rate of men sterilization and condoms used.	Thai policy on family planning focused merely on birth control hence ignored safety of hormone use for women. Lots of irrational contraceptives with unclear evidence were approved while the post marketing surveillance, re-evaluation, and improvement of package insert were worked at slow pace.	Data were gathered from 14 public health facilities – one university hospital, one public provincial hospital near Bangkok, 10 health centres from Bangkok MetropolitanAdministration (BMA), and 2 health centres from Ministry of Public Health (MoPH) byinterviewing health providers and their clients together with the observation. It was foundthat services of these facilities are delivered to response more on birth control policy than on  women health needs, reproductive rights, and women integrity. This reflexes by the simple services that are convenient to personnel such as contraceptives both orally and injectably. However the quality of services is questionable on the understanding, and knowledge of providers result in various forms of practices. Thai women of poverty are thus face less  choice and have to accept the circumstances.  	Simulated cases in 23 pharmacies in Bangkok and vicinity are intended to study family  planning provision, standard of practices, and dispensing behaviours. Interestingly, there  was no difference between practices of pharmacist and non-pharmacist in this setting. Not  enough information was given to clients asking for contraceptives in 3 various scenarios. The only useful information is probably derived from labelling and package insert. By comparing this information with legal requirement, WHO criteria, and recent academic information, we found that information from labelling and package insert were not conformed to the law and not enough for safety consumption. There was no information mentioning that contraceptives can not about STD and AIDS. The most important thing it unclear whether the package insert is intended for health professionals or consumer and lead to inadequate utilization.	Post-coital contraception is currently popular among adolescent. The study done in one public university in Bangkok showed that they know this product quite well and sometimes  introduces to their friends.	The result from this study provides some policy implications toward reproductive health in  Thailand. First, the MoPH needs to adjust their direction on reproductive health by  acknowledging women rights and providing enough information for women to decide, as we  as recruiting women in the policy process.


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: Supply Chain Management of the COVID-19 Vaccines

abstract: The coronavirus disease 2019 (COVID-19) pandemic is a complex, highly dynamic problem with negative impacts on health and socio-economics aspects, both nationally and internationally. In addition to the direct impacts on the health of COVID-19 patients, the pandemic also affected the provision of healthcare services for patients with many other diseases and conditions. Policymakers in Thailand and around the world are trying to take measures to deal with the outbreak to reduce its consequences with two major groups of disease control policies: by general measures (non-pharmaceutical interventions: NPI) and by using drugs or vaccines (on-pharmaceutical interventions: PI). At the beginning of the pandemic there were no drugs or vaccines to control COVID-19. Many countries around the world therefore focus on an enforcement of non-pharmaceutical interventions, such as a ban on travels in and out of the country, limited people going out of residence for certain periods (curfew), the closure of government buildings and the suspension of social and business activities, physical distancing and personal hygiene campaign. Yet, these non-pharmaceutical interventions measures are of limited effectiveness when applied over the long term, and also have serious economic and social impacts. Due to the severity of COVID-19 that affects the health of the infected persons and the limitation of NPIs, agencies around the world, both public and private, have accelerated research studies to develop anti-COVID-19 vaccines. While many vaccines have been developed and proven to be effective in humans, there are still challenges and difficulties in implementing them at the population level. This is because newly developed vaccines need to be certified and allowed before being used for a larger population. There are also limitations in terms of its long-term safety that have not been comprehensively assessed. Some of the vaccines being developed by new technologies that require specialized storage and transportation that may not be suitable for use in many contexts. Lastly, the number of vaccines produced at an early stage is still insufficient to meet both global and national demands. Therefore, without a well-informed policy decision to manage the COVID-19 vaccine supply chain, the policy makers not even achieve the effectiveness of disease control, may cause unnecessary loss of life, and even create health inequity. Not only the COVID-19 pandemic is a complex problem with high dynamics, policy decisions regarding the anti-COVID-19 vaccines are also very complex with uncertain results. We applied systems thinking process to deal with complexities and uncertainties by reviewing the related vaccine literature and conducting system dynamics modeling of the epidemic situations with vaccinating the anti-COVID-19 in Thailand’s populations. Group model building (GMB) process was used to work with policymakers and stakeholders of the COVID-19 vaccine policies. 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 simulated the scenarios emerging from various COVID-19 vaccine policy decisions. The target populations and the prioritization among the target groups were considered when considering which options can lead to the most effectiveness, and with the least unexpected results. We found that the data needed for developing simulation modeling of the anti-COVID-19 vaccines in Thailand had been very limited. But our literature review and consultations with experts led to sufficient data to construct a system dynamics model. We modeled the epidemiological scenarios during the April 2021 outbreak in Thailand, where the vaccines was somewhat effective in preventing infection but only limited supplies of vaccines available domestically, not enough for all population groups. The findings from our simulation model suggested that, deaths would be lower if the policymakers prioritized vaccines to people living in hyperendemic rather than distributing them across the country. Even though empirical evidence suggests that the vulnerable populations had a greater risk of developing severe symptoms and deaths if infected, allocating the vaccines to both the healthy and vulnerable populations can lead to less number of deaths than vaccinating only the vulnerable. As for the results from a situational model during the January 2022 outbreak with Omicron strain, as Thailand started to secure sufficient doses of vaccines yet the vaccines become less effective in preventing COVID-19 infections. This, the policy option of procuring and allocating a booster dose of COVID-19 vaccine to vulnerable populations becomes critical to reducing the COVID-19 case-fatality rate. Lastly, after the populations fully vaccinated or the immune levels of the previously infected reduced over time (vaccination waning), there is a chance of a new wave of outbreaks domestically. Therefore, policymakers should continue monitoring a set of indicators for effective policy decision-making on vaccination and other disease control policies in the first quarter of 2022, particularly when the vaccination coverage of the booster-dose vaccine was still less than desirable. With the Omicron strain, two doses of vaccination became not sufficient to prevent the symptomatic infections caused by infection. Other policy deployment mechanism to speed up the vaccination coverage, especially in the health-sensitive population groups, would reduce the severity of another wave of severe infections and deaths in 2022. The preliminary results of our research have been presented to policymakers at different levels to support their decision-making process. These 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. Yet, using system dynamics modeling as a policy decision support tool (DST) 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 issues related to the management of the COVID-19 vaccine supply chain still persists, including confusing communication of the risks of vaccination versus no vaccination to the public. 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 focusing more on the evidence-informed policy-making process under the country's emergency management systems. 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. But it is vital to work on this complex problem-solving process to prepare for any soon emerging public health emergencies.


location: , 'Thailand year: 2011 source: HSRI

title: Characteristics of Ideal Wives before and during Marriage from the Perspective of Married Men

abstract: This research was a survey of the characteristics of ideal women before and during married life from
the perspective of a group of married men. Two hundred twenty-six legally first-time married Bangkokian
men, aged 25-40 years, were surveyed using a 25-item questionnaire on the characteristics of ideal wives
in order to obtain opinions on their spouses before they got married and during their married lives. The
samples were grouped into three categories by the number of years of marriage, i.e., married for <3 years
(n=50), married 3-<5 years (n=90), and married for 5-10 years (n=86). The results were as follows:
1. The characteristics that the men considered ideal and desired their wives to have comprised the
following: honesty and loyalty; showing care for family members; loving mindfulness, with understanding
of her husband; and morality.
2. The characteristics of the ideal wife changed significantly during married life ( p<0.001, p<0.01,
p<0.05):
- Those married for <3 years were concerned less with facial appearance, general appearance,
aging, education status, and unmarried status;
- Those married for 3-5 years were concerned less with appearance, personality, intelligence, and
virginity;
- Those married for more than 5 years showed less concern about facial appearance, personality,
attractiveness, honesty and loyalty, financial prospects, social status, occupation, unmarried status, sexuality,
and virginity.
3. The characteristics considered ideal, which increased after marriage, appeared significantly
(p<0.01, p<0.05) only among those men who had been married for more than 3 years but not more than 5
years. Those characteristics were financial prospects, education, social status, and occupation, all of which related to findings of the SES.
4. The ideal characteristics that the men wanted in their wives, which had not changed from the
time before marriage to that throughout married life and were answered by all groups of married men,
were listed in descending order as follows: (1) care of family members; (2) loving mindfulness and understanding
of the husband; (3) morality; (4) emotional stability; (5) relationship with husband’s family; (6)
self-responsibility; (7) relationship with wife’s family; (8) social manners; and (9) similar hobby or activity
in leisure time. It should be noted that loving mindfulness and understanding of the husband, morality,
emotional stability, relationship with the wife’s family and care of family members were the five most
important ideal characteristics that all men desired in their wives.


location: , 'Thailand year: 2002 source: HSRI

title: Roles of subdistrict administration organization (SAO) in environmental health management 2001

abstract: The objectives of this research were to evaluate the roles and problems of Subdistrict Administration Organization (SAO) in environmental health management. Study issues included the roles, capabilities and obstacles in solid waste management, village water supply management and DHF control. Data collection was done using a questionnaire self-completed by the secretary of SAOs of each of the 514 SAOs. 498 responded (96.9%). Site visitation and in-depth interview of executive board members and the secretaries of SAOs were carried out in 20 subdistricts. Data were analyzed using percentage, mean and standard deviation and content analysis. The results from the questionnaire showed a high level of complaints about solid waste (78.1%) than the problems of clean water and DHF control. (63.3% and 34.5%) The site visitations revealed that solid waste was often dumped on the side of the road. Slow elimination and lack of land for treatment were important problems. Some sites were near water sources. Water supply was often insufficient and there was poor public participation and DHF control. Generally SAOs did not have enough manpower, budget and technology for environmental health management. 73.3% did not have an environmental health committee. The actual income of most SAOs was below the criteria set by law. Although there were many problems as those mentioned above, some SAOs were quite successful in reducing the disposal load, promoting the recycling process and producing bio-fertilizer from garbage. It is recommended that personnel competent in environmental health management are needed for most SAOs. The government should produce a manual for these works and train the personnel properly.


location: , 'Thailand year: 2023 source: HSRI

title: Cultural Competency of Hospital Pharmacists under the Office of the Permanent Secretary, Ministry of Public Health

abstract: Objective: To study the cultural competency among hospital pharmacists, under the Office of the Permanent Secretary, Ministry of Public Health, Thailand. The findings would serve as an input for cultural competency development plans for Thai pharmacists. Method: The researchers used the online Thai Pharmacists’ Cultural Competency Self-Assessment Scale (TPCCS) developed by the researchers to perform a cross-sectional survey to hospital pharmacists under the Office of the Permanent Secretary, Ministry of Public Health Thailand. Stratified sampling was carried out based on the health service region and the size of the facility. Between March and August 2021, 241 pharmacists responded to the survey (response rate 31.26%). The TPCCS had 16 factors, 92 questions and 5 cultural competency dimensions: 1. cultural awareness, 2. cultural skills, 3. cultural knowledge, 4. cultural encounter, and 5. cultural desire. On a 5-point Likert scale, pharmacists were asked to rate their ability to practice. Results: Thai hospital pharmacists had a moderate level of cultural competency. On the full scale of 5, the mean values for each dimension ranged from 2.39 to 4.24. On average, they had low scores on some cultural awareness dimension. They had the highest score on cultural desire. Conclusion: There was a need to improve pharmacists’ cultural competency, particularly in terms of cultural awareness. A strong desire for cultural competency may be an excellent foundation for continuing growth.


location: , 'Thailand year: 2022 source: HSRI

title: Cohort Study of COVID-19 Humoral and Cellular Immunity in Pattani Province's Community

abstract: Background Thailand was firstly imported SARS-CoV-2 from Travelers from China in January 2020. As COVID-19 has transmitted globally as pandemic to cause more than 500 million cases and 6 million deaths in last 2 years. Emergency disaster measure has been enforced which has impacted to social-economic crisis in most of the countries. Thus, every country redirect effort to modify its disease prevention and control measures to compensate for social and economic downturn. Purposes In the first year of pandemic, surveillance of COVID-19 in Thailand has been constrained by focusing to mobility populations at the screening immigration ports for imported travelers and tested by RT-PCR technic. The surveillance information has been daily reported for public. Thus, the disease control managers at local level would never have sufficient intelligence for planning and adjust intervention measures to facilitate their own community socio-economic resilience. The study aims to modify tests from medical laboratory as biomarkers for monitor rapid genomic variation of SARS-CoV-2; Immunological status of population from both natural infection and variation type of vaccination; as well as effectiveness of each social and public health measures applied to each community. Such intelligence should be strong basis for planning at national as well as local level. Methodology Community from Thungyangdaeng District and Yarang District, Pattani Province has been selected to represent an area-based population which were infected and studied since 2020 as longitudinal cohort study of RT-PCR test and Immunity study for 2 years. The study included the preparatory phase of the 2 community hospitals and teams for collecting information and specimens; conveyance of specimens to central laboratory in Bangkok; modification technic of laboratory procedures to fit with the test requirement; and feedback the analysis to depict the existing epidemic situation of COVID-19 in local area. The immunity status of population will be tested by ELISA. The incidence and prevalence of COVID-19 in community has been estimated from the RT-PCR test and immunological study. Specific T cell Immunity and Cytokines reaction in the populations’ specimens has been study in the Central Lab. Throat gargle from the population has been tested through Mass Spectrometry to identify protein of SARS-CoV-2 in the central lab as well. Literature review have been conducted to study the evolution of COVID-19 Surveillance and Monitoring system employed in international recommendation and emerging technology for evaluate the situation of local disease control management. These novel technology and systems might be applied to be recommendation to improve the country’s and local level’s COVID-19 surveillance and monitoring systems in Thailand. Result ELISA based Immunological test, Antigen Test Kit (ATK), RT-PCR can be main tools for monitor of Incidence of infection, and sustainable immunology in individual community and at the country level. Specific T cell Immunity and Cytokine Th1 test requires further modification in transportation to Laboratory and adjustment of Lab technic. These 2 tests would be benefit to justification of the duration of immunity and prediction of severity of infection as well as durable prevention of individual and community Immunity. However, Mass Spectrometry has not been well supported for application in Thailand. Systematic surveillance of SARS-CoV-2 and its variants in wastewater may be trialed for sequencing analysis as environment surveillance. Conclusion Modification of 4 tests have been recommended to be feasible to be applied to COVID-19 Surveillance and Monitoring in Thailand. Environmental surveillance (SARS-CoV-2 variants in Wastewater) may be experimented in high-risk area. Definition of systematic COVID-19 surveillance and its strategy and wholistic scope of monitoring in all related sectors in area-based and National level should be established


location: , 'Thailand year: 2021 source: HSRI

title: Review of Access to High-Cost Essential Medicines through Drug Selection Process of the National List of Essential Medicines in Thailand: Subcategory E (2)

abstract: Thailand has “the National List of Essential Medicines (NLEM)” as an important tool of the drug
system. It is a referenced pharmaceutical benefit package of the public health insurance systems of
accessing to essential medicines. This retrospective review aimed to review access to high-cost essential
medicines through a drug selection process of subcategory E (2) during 2007-2019, to analyze the developments
of drug selection process including stakeholders, and to provide suggestions to stakeholders
further developments of the NLEM process. The results found that the subcategory E (2) process enhanced
access to high-cost essential medicines through the drug selection process developed and designed
specifically for subcategory E (2). The guideline for regulating drug use and the process of determining
the affordability and the budget capacity were included to subcategory E (2) selection process. Despite
stricter control in drug use and reimbursement of subcategory E (2) compared to other subcategories,
many challenges were found. Drug items and indications listed under the subcategory E (2) have been
increased with an annual increase of budget. However, the monitoring and evaluation (M&E) of drug use
in subcategory E (2) were lacking. Therefore, it is important to suggest development of the national M&E
system to be beneficial for policy decision making of access to high-cost essential medicines through the
drug selection process of the NLEM.


location: , 'Thailand year: 2016 source: HSRI

title: Fiscal Year 2014 Dental Service Cost of Rajanukul Institute

abstract: The purpose of this descriptive study was to analyze unit cost of dental services by service group
which were promotive, preventive and curative services of Rajanukul Institute. This study was retrospective,
collecting data from dental service quantity, material disbursement, dental personnel’s remuneration
and welfare, lists of durable dental equipment and building-construction in fiscal year 2014. The data was
analyzed by using descriptive statistics. The unit cost of dental services was 554.22 baht per visit which
the labour, material and capital costs of 79.41%, 14.94% and 5.65%, respectively. The costs of promotive,
preventive and curative services were 189.61, 613.34, 657.58 baht per visit. The proportion of cost of promotive,
preventive and curative services was 1.00 : 3.23 : 3.46. Oral health promotion was the lowest cost
service group and necessary for children, especially children with developmental and intellectual disabilities.
Educating parents how to care children’s oral health effectively would reduce oral diseases and
high cost curative service.


location: , 'Thailand year: 2001 source: HSRI

title: The reporting system of adverse drug reaction in Medicine unit of Sappasittiprasong hospital by multidisplinary approach

abstract: The reporting system of adverse drug reaction in medicine unit of Sappasittiprasong hospital by multidisplinary approach	The study intended to increase the efficiency of in-patient ADR reporting, that emphasized on moderate and severe cases. Multidisciplinary medical team had been established and run the quasi-experiment in 8 medicine wards. The variables were numbers of ADR case report compared with numbers of ADR case between before and after the experiment. ADR cases were assessed the causality by Naranjo’s Algorithm. The efficiency of ADR reporting was evaluated in 3 period time, followed at before study, 3 months and 8 months after implementation. The results were analyzed in descriptive statistics.Results:  Moderate ADR reports increase in term of efficiency, 0 % (0/12) before study to 75 % (6/8) after 3 month and 100 % (6/6) after 8 month. Severe ADR reports increase from 0 % (0/0) before study to 100 % (1/1) after 3 month but not found any case after 8 month. The number of moderate ADR reports increased 74 reports and severe ADR reports increased 16 reports after implementation of multidisciplinary team. Rare ADR and ADR occurred from new drugs were reported too.  79 patients were notified ADR history in those patient drug profile and advised them  to aware by themselves. In 2000, 149 ADR case reports have been reported compare with only 7 case reports in 1999.Conclusions:   Multidisciplinary team could improve an efficiency of moderate and severe ADR case reports and showed that this developed system trend to run continuously. So multidisciplinary team should be used in full system of Sappasittiprasong Hospital and should be studied in another hospitals in the next time. ADR reporting in the hospital should be run in more proactive manner.


location: , 'Thailand year: 2017 source: HSRI

title: Zika Incidence among Patients with Suspected Dengue Fever (Preliminary Report)

abstract: Introduction: Zika virus infection and its consequences have become increasingly concerned
recently. As a member of Flaviviruses, zika virus shares some clinical dengue fever manifestations. The
actual burden of zika virus infection in Thailand is unclear, and could be underestimated due to nonspecific
clinical pictures and the diagnostic testing has not been routinely available. We aim to study
the zika incidence among the suspected dengue fever patients. Methodology: From December 2016
to August 2017, adult and children who had clinical diagnosis of dengue fever at Bamrasnaradura Infectious
Diseases Institute were prospectively enrolled. After informed consent, a urine sample would
be collected for zika molecular testing by polymerase chain reaction (PCR). At 2 weeks later, a blood
sample was collected for zika and dengue serologic tests by ELISA. Results: A total of 73 suspected
dengue fever patients were enrolled; 64 were hospitalized, 46 cases were children (< 15 years of age).
The ratio of children to adult was 1.7:1. There were 3 confirmed zika-infected cases by urine PCR, a
4.1% incidence. All were adult treated as outpatients. The cases were found during June–August. All 3
cases had positive anti zika IgG (mean titer of 4.43 unit, range: 2.6-6.9 unit), but anti-zika IgM was found
to be positive (titer 2.9 unit), indeterminate (titer 0.9 unit) and negative (0.4 unit), one case each. All
had negative anti-dengue IgG or IgM titer. Conclusions: The patients presented with dengue fever may
actually had zika infection, although at low rate. The anti-zika IgM was not useful in making diagnosis.
High risk group such as pregnant women who presented with dengue fever should be tested for zika
infection.


location: , 'Thailand year: 2013 source: HSRI

title: Hospital Infection Control and Antimicrobial Stewardship Programs among Public and Private Hospitals in Thailand

abstract: An increase in antimicrobial drug resistance is a big concern for all hospitals. Thus, effective infection
control (IC) policy and antibiotic stewardship programs (ASP) are crucial to managing the problem.
However, data on such measures in Thai hospitals are limited. This cross-sectional study aims to explore
hospital IC measures, ASP, and barriers to implementation in public tertiary care hospitals (TH), district
hospitals (DH), and private hospitals (PH) in Thailand. The study was conducted during April and May
2012 in nine provinces, purposely selected to represent 5 regions. Among 102 hospitals included (13 TH,
69DH, 6 large PH, 14 small PH), the IC measures were implemented more than the ASP (96% vs. 88%)
with different focus in each hospital group. Non-cooperation from relevant health providers was the
most common barriers to IC and ASP implementation in all groups (38-70%). Inclusion of IC as the
criteria for hospital accreditation had the strongest effect that could introduce IC activities into more than
80% of hospitals. Strengths of the TH were microbiology laboratories and antibiotic susceptibility test.
Concerning ASPs, the TH was a good performer in using antibiograms for the selection of antimicrobials
in hospital formulary. They had IC committee as the core group and tended to implement antibiotic
restrictive strategies. TH’s limitations were staff shortage and disagreement from medical staff towards
some antibiotic guidelines. As for DH, strengths were persuasive measures developed from the
Antibiotics Smart Use program. Plus, DH had Pharmacy & Therapeutics Committee as the core driver.
Limitations were lack of budget, frequent staff rotation and discontinuation of the activities. For PH,
strengths were microbiology laboratories and persuasive measures. In conclusions, hospitals had
different strengths and limitations, thus careful selection of appropriate IC measures and ASP is needed
with participation of stakeholders to tailor the measures to hospital context. Policymakers might start
with activity that raise concern in relevant health providers, support their strengths, alert private
hospitals, and help reducing obstacles that limit further development and sustainability of the IC and
ASP.


location: , 'Thailand year: 2023 source: HSRI

title: A Mobile Online Platform and Deep-Learning AI for Oral Cancer Screening

abstract: The research in this online mobile platform and deep learning artificial intelligence for oral cancer screening project aims 1) To develop an online platform for collecting clinical images of lesions at may change into oral cancer and oral cancer 2) To develop deep learning artificial intelligence technology for the screening of lesions that may turn into oral cancer and oral cancer from a database of clinical photographs and biopsy results in a developed online platform; and 3) To develop an automated oral cancer screening system for assisting medical personnel in oral cancer screening for oral cancer surveillance in areas lacking specialists using a qualitative research model. The samples were patients at risk of developing oral cancer and medical personnel/dentists/medical students which brings the oral cancer screening application to trial use. The results of this research revealed the development of an online platform for collecting clinical images of lesions that may change into oral cancer and oral cancer. There are 350 images of oral cancer images, 300 images of lesions that may be transformed into oral cancer, and 300 images of lesions that may be transformed into oral cancer, and 300 images of normal tissues in the oral cavity, 350 mouth images (this is the minimum number of images that can be used to create a deep learning model. The number of images will increase in the future according to the use of the developed system, which will make the automatic screening system more accurate), with the entry criteria being intraoral photographs of oral cancer and lesions. Before all oral cancers were confirmed by standard lesion diagnostic methods, namely pathological biopsy and the exclusion criterion was intraoral photograph data without pathological confirmation and incomplete oral photographic data for use as prototype images for the development of automatic screening systems. Development of deep-learning artificial intelligence technology for the screening of lesions that may turn into oral cancer and oral cancer. From a database of clinical photographs and biopsy results in a developed online platform, the analysis process is to mark the location of the lesion from the image (annotate) before analyzing the lesion with a program by a dental specialist in oral surgery. Then, a deep-learning artificial intelligence program was used to classify clinical images of oral cancer and oral precancerous lesions. And development of an automated oral cancer screening system assists medical personnel in oral cancer screening for oral cancer surveillance in areas lacking specialists by medical personnel able to take oral pictures of patients at risk of developing oral cancer with a smartphone. And can choose the picture to send to the server for analysis for preliminary diagnosis including being able to contact experts to consult the analysis results. From the development of mobile online platforms and deep learning artificial intelligence. For oral cancer screening PrimeKG (Precision Medicine Knowledge Graph) has been shown to have the potential to help a new generation of dentists and researchers understand the relationship between risk factors and oral cancer. Deep learning (Deep Learning) to detect oral cancer from pictures taken by smartphones. It has added significant potential to this application for effective diagnostics. A new generation of dentists and researchers can compare their own diagnoses with the results obtained from the model. In addition, the usability and utility of the application was evaluated by 100 subjects, showing good results in increasing the knowledge and diagnostic skills of young dentists and researchers. By evaluation, it was found that the application is highly effective in adding new knowledge and is useful in identifying associations between risk factors and oral cancer.


location: , 'Thailand year: 2016 source: HSRI

title: A Survey of Thai Traditional and Alternative Medicine Services of Ministry of Public Health Hospitals in 2014

abstract: Background: Increasing trend of traditional and alternative medicine use has been documented
worldwide. In many developing countries, the majority of the population continues to use traditional
medicine to meet its primary health care needs. In Thailand, the Thai traditional medicine service using is
a fundamental right for all Thais according to the constitution as well as Universal Health Care Coverage
program. However, none of the study has been conducted to survey for Thai traditional and alternative
medicine (TT & AM) services together. This study therefore aimed to survey the data of TT & AM services
as well as to study the factors influencing utilization of TT & AM services in the outpatient department of
the hospitals under Ministry of Public Health. Method: The data of TT & AM services were collected
from October 2013 to March 2014. 456 data collecting forms were distributed through representatives of
Thai Traditional services in 76 Provincial Health Offices under Ministry of Public Health. The factors
influencing the utilization of TT & AM services at the outpatient department were analyzed with multiple
linear regressions. Results: 266 out of 456 data collecting forms were filled and sent back. The response
rate was 58.33%. Only 231 hospital responses (86.84%) could be analyzed. 186 hospitals (80.52%) provided
only Thai traditional medicine services while 45 hospitals (19.48%) provided Thai traditional medicine
services together with alternative medicine service. 10.93% of the total outpatient department (OPD) visits
was the utilization of TT & AM services. Factors influencing outpatient department utilization of TT &
AM services were the number of staffs (p-value < 0.001), clinical competency for inpatient services
(p-value = 0.002), the number of staff receiving wage at least 15,000 Baht per month (p-value = 0.017),
being a study/visiting site for education (p-value = 0.011), continuing year of services (p-value = 0.004)
and herbal consumption value (p-value < 0.001). Recommendations: To strengthen the support of TT &
AM service, the relevant agency should develop more suitable workforce in service units and pay them
appropriate salary. In addition, the practitioners need to be developed in their clinical competency and
academic networking with universities is also crucial for implementation.


location: , 'Thailand year: 2011 source: HSRI

title: Development of Friendship Networks and Potential of Self-help Groups to Promote Healthy Aging among Community-dwelling Older Adults

abstract: Older persons are an important resource of the nation; however, they previously had been viewed as
persons only receiving support from family and society. This research project was aimed at developing
friendship networks and increasing the potential of self-help groups to promote healthy aging among
community-dwelling older adults. Participatory action research was applied to older adults in
Woranakhorn subdistrict, Pua district, Nan Province. Data were collected using focus group discussion
and questionnaires. Content analysis was performed for qualitative data. For quantitative data analysis,
the mean, standard deviation, and paired t-test were used. The development of friendship networks and potential self-help groups resulted in several self-care
activities, including performing basic physical examinations and health evaluations, reciprocal caring
and taking care of each other within the community, and creating health-promoting activities applying
folk art and local wisdom. Compared with changes in older adults after developing friendship networks
and self-help groups, it was found that, after project intervention, the older adults who regularly participated
in the friendship group activities had friendship networks, friendship support, self-efficacy, healthpromoting
behaviors, and healthy aging greater than before the intervention, with statistical significance
at the 0.05 level. Therefore, promoting the potential of elderly individuals, empowering and using social
capital within the community can promote friendship group activities and self-help groups among community-
dwelling elders, thus facilitating the achievement of healthy aging.


location: , 'Thailand year: 2013 source: HSRI

title: Effectiveness and cost-effectiveness of the population-based prostate cancer screening

abstract: Prostate cancer is a common malignancy in elderly men in western countries. It is the leading cause
of mortality and morbidity worldwide. Two main tools for screening, digital rectal examination (DRA)
and prostate-specific antigen (PSA), are still controversial with regards to effectiveness and cost-effectiveness.
The study aimed to examine whether screening for prostate cancer reduces prostate cancer specific
mortality and all-cause mortality and whether population-based screening for prostate cancer is costeffective.
Literature search of randomized controlled trials (RCTs) and economic evaluation articles was
conducted through Medline and Cochrane library to assess the effectiveness and cost-effectiveness of the
prostate cancer screening. Five RCT with a total of 321,644 participants were included in this review. The
meta-analysis showed no statistically significant differences in prostate cancer-specific mortality and allcauses
mortality between screening and no-screening groups. Relative risks for mortality from prostate
cancer and all cause mortality were 0.99 (95%CI; 0.83-1.17) and 0.98 (95%CI; 0.97-1.00) respectively. Nor
was screening found to be cost-effective.


location: , 'Thailand year: 2016 source: HSRI

title: Health Insurance Schemes and Dental Health Care Utilization in Thai Working-Age Population

abstract: This descriptive study aimed to know the situation and pattern of dental health care utilization in
Thai working-age population related to health insurance coverage. Data of population aged 15-59 years
were selected from the Health and Welfare Surveys 2009-2013. Descriptive statistics were used in terms of
percentage and rate. Results showed that in 2013 dental health care utilization rate was very low despite
all of population had health insurance coverage. Population in Universal Coverage Scheme always had
lowest utilization rate. Female, urbanites and graduated adults were high utilization rate groups while
people in the central and north-eastern regions were low utilization rate groups. Self-employed, family
business and private employees always had low utilization rates too. Most utilization was for basic dental
care in the one to one ratio of public and private health care services. Private dental clinics were the most popular. The utilization with insurance cover ranged between 57.1%-70.0% of each health insurance scheme.
Main reasons of service utilization without using their insurance cover were “long waiting”, “limited
service time” and “limited insurance benefit”. Unmet rates were 1.0% in 2011 and 1.1% in 2013. Main
unmet reasons were “time constraint”, “unable to pay for service”, “long waiting” and “others such as
fear”. The results from this study suggest that the dental health care service be developed to match needs
of the working-age populations. The regulation system for private dental clinic should be standardized.
Competency of dental staff on each service level should be reviewed and updated. Other dental health
aspects should be researched as well.


location: , 'Thailand year: 2023 source: HSRI

title: Key Performance Indicators for Refill Prescription Operations in the Drugstore Network of Lamphun Province

abstract: The universal coverage scheme has included drugstores as health care provider networks running refill prescriptions from October 1, 2019. The evaluation of the pilot program focused on lessening hospital congestion and waiting time by displaying the number of hospitals, pharmacies, patients, and prescriptions filled. The purpose of this study was to expand key performance indicators (KPIs) for evaluating the drugstore networks. The study design was a mixed method, with a qualitative analysis comprising in-depth interviews and observations and a quantitative assessment of data in the form of a pharmacy operations report. The findings indicated that all drugstores used a five-step operation management process. The highest operation management efficacy (25.7%) was in the process of dispensing and counseling. This process also provided value to the project. The process of data handling for reimbursement and patient’s pharmacy information update to the hospital’s database achieved the second highest operation management (22.0%). The pharmacists commented on process complexity and non-value added to the project. The present study proposed that the simplified standard pharmacy information practice of drugstore network to reduce the length of this operation but increase efficacious time duration.


location: , 'Thailand year: 2007 source: HSRI

title: The Effectiveness of a Health Education Program with Social Support for Knowledge and Behavior in Promoting Health in Wangpong District, Phetchabun Province

abstract: The living behaviors of people change in line with their economic and social status,
among others, often leading to incorrect health behavior with regard to nutrition, exercise,
and elimination of stress. This was a quasi-experimental research study. The sample
comprised 120 people from village 4 Banwangyai and village 5 Banwangplub is Tambon
Wanghin, Wangpong District, Petchabun Province. A multistage random sampling method
was used, with the sample divided into an experimental group and a comparison group,
each comprising 60 people. The experimental group was exposed to a health education
program with social support. The research instruments for data collection were questionnaires assessing knowledge of health-promotion behavior concerning susceptibility to
various types of diseases caused by behavior, severity of the diseases, social support by
public health volunteers, and health promotion behavior, among others. The statistical
methods used were means, standard deviation, paired-sample t-test, student’s t-test, and
Pearson’s correlation coefficient.
The findings showed that the experimental group had higher scores than the comparison
groups on these aspects following the program and the increase was statistically
significant.