location: , 'Thailand year: 2013 source: HSRI

title: Population-based screening for atrial fibrillation (AF) in Thailand

abstract: Atrial fibrillation is the most common type of cardiac arrhythmia that can cause serious complications.
Guidelines for population-based screening of atrial fibrillation in Thailand have not been reviewed,
nor have the benefits and cost-effectiveness been analyzed. This article aims to conduct a systematic review
and panel discussion on the population-based screening for atrial fibrillation in Thailand. Clinical
practice guidelines recommended checking pulses for 65 years or older. The sensitivity of pulse checking
for at least 20 seconds was 95 (95% CI, 84-97), and the specificity was 72 (95% CI, 69-75). There is no
sufficient data for other methods on a population level. Opportunistic screening is recommended since
the detection rates were similar to that of systematic screening (1.62% and 1.64% for opportunistic and
systematic screening, respectively.) Pulse checking was also found to be cost-effective.


location: , 'Thailand year: 2014 source: HSRI

title: National Data Clearing House

abstract: This report presents a draft proposal of the organization, scope,
missions, structures, mechanisms and linkages of a national data clearing
house (NDCH) for the Thai health security schemes. It is drawn from the work
of the assigned taskforce under the supervision of the steering committee
appointed by the Health Insurance Systems Research Office (HISRO), using
brainstorming sessions, extraction of key contents from technical papers written
by selected Thai experts in the field, and reviews by the committee.
In sum, the basic missions of NDCH should include data assessment
and information processing for reimbursement purposes for health services;
research, development and determination of data standards, databases and
information systems to be used in reimbursement processes in order to meet
requirements of health security organizations and related government agencies,
while feasible for providers to comply effectively and efficiently; building and
administering warehouse of reimbursement data, as well as performing data
analysis, review, and creating information applicable for policy management,
system management, utilization review of health resources, and for use in
research and development; information services for other governmental
agencies for academic research; and revenue generating to support its operations
and development. To accomplish the missions, NDCH needs to develop effective
work systems, organization structures and governance.


location: , 'Thailand year: 2022 source: HSRI

title: Effect of Human Resource for Health Allocation under the MOPH Office on Diabetes and Hypertension Care and Related Population Heath Outcomes in 4 Provinces

abstract: This study was conducted to evaluate 1. diabetes and hypertension service delivery, including both curative and preventive approaches, and 2. human resources in health management and coordination between hospitals and other stakeholders in the community using a mixed method study. 8 and 16 high-performance district and sub-district hospitals across four provinces in Thailand were chosen for the study. Quantitative data from questionnaires were analyzed using descriptive analysis where categorical data were reported as number (percent), and numeric data were reported as mean (SD). For qualitative analysis, content analysis was used to identify and summarize three domains as follows
1. The similarities and uniqueness of service deliveries between each health providers
2. The comparison of the job descriptions in district and sub-district hospitals by occupation
3. Human resources in health management focused on the adequateness of the human workforce and methods used for retaining health personnel. All hospitals included in this study were selected appropriately. In 2021, all hospitals recruited in the study received better scores than the country average in multiple diabetes and hypertensive indicators in preventive and curative domains proposed by the Ministry of Public Health. In order to achieve high quality of care. In addition, this study evaluated diabetes and hypertensive services using the framework from the handbook of integrated, people-centered health services in new normal diabetic and hypertensive clinics, a guideline endorsed by the Department of Medical Services, Ministry of Public Health. All hospitals provide almost comprehensive care according to the recommended guideline. Varieties of health professionals performed specific tasks to increase patients' health literacy, stratify patients based on their clinical risks, register patients in the database for continuity of care, reorient the care model according to patient health status, and assess patients when there were changes in blood pressure or blood sugar control. However, most hospitals could not achieve the self-monitoring domain due to insufficient equipment compared to patients' demands. Due to the limited amount and types of health professionals working in sub-district hospitals compared to district hospitals, health professionals working in sub-district hospitals need to be more flexible and perform multiple roles outside their trained professions. In contrast, health professionals in district hospitals only worked on specific tasks they excelled. Therefore, multiple sub-district hospitals asked for temporary pharmacists and dieticians' support from district hospitals which were crucial for operating non-communicable disease clinics but were not regularly stationed in sub-district hospitals. The support could improve the quality of care where patients receive services from trained professionals, and additional support could relieve partial workloads from health professionals in sub-district hospitals. Moreover, village health volunteers were one of the significant human resource components in providing quality diabetes and hypertensive preventive and curative care, especially in sub-district hospitals, where limited human resources in health affected the staff workload. Village health volunteers provided various kinds of support, including performing basic tasks in the clinic, giving preliminary health advice, delivering medicine, and acting as the bridge between patients and health professionals in the community. Furthermore, they also played a significant role in preventive measures. Village health volunteers were the major players in performing diabetes and hypertension screening in the general population every year. Hence, training specific non-communicable disease competencies for village health volunteers to work on more sophisticated tasks with additional financial incentives could maintain sustainable community-oriented diabetes and hypertensive service deliveries.
Lastly, health technology adaptation could play a significant role in increasing the efficiency of care. Telemedicine is the most familiar technology and could be integrated into diabetes and hypertensive consulting services between multiple levels of providers. In addition, personal health records, accompanied by an increase in patients' digital health literacy, could be a potentially significant improvement in diabetes and hypertensive care. The combined technology and knowledge could help patients better understand their current health situation. Hospitals could use integrated information between providers to monitor and determine the best treatment plans for patients continuously.


location: , 'Thailand year: 2001 source: HSRI

title: Diagnosis related group : developments and uses in Thailand

abstract: Diagnosis related group (DRG) has been researched and developed in Thailand since the implementation of the Traffic Accident Protection Act 1992 with support from the Health Systems Research Institute (HSRI). It was aimed to be an alternative of payment apart from fee-for-service and capitation payments. The first research in public and private hospitals in 10 provinces gave about 100 DRGs covered injuries. Later research activities expanded to cover all diseases in the low income patients and finally cover all inpatients by using electronic patient data from well developed hospitals. Success of these activities proved that Thailand was able to use DRG for health financing. In 1998, the Health Insurance Office, Ministry of Public Health adopted DRG as payment method for high cost care for the low income card scheme. This decision has stimulated the flows of individual patient data from hospitals to provincial health offices and the ministry. The information assets have increased from 1.5 million patients in 1998, to 3.0 million in 1999 and more than 3.6 million in 2000.It can be concluded that DRG has brought big changes in health care in Thailand. Information technology has been used for promoting efficiency, equity and quality in health delivery. The first Thai DRG Grouper was launched in 1998 followed by version 2 in 2000. The tests of these groupers against the international groupers showed lots of improvements. When the government made a big decision to provide universal coverage to cover all Thai population in April 2002, the researchers and developers of DRG decided to develop the third version that is compatible with the patterns of diseases in Thailand, especially the tropical diseases. This activity got financial supports from the HSRI, Thailand World Health Organization Office, the Health Insurance Office, and got technical helps from more extensive groups consisting of the royal colleges, colleges and societies of health professionals. It was hoped that the 500 DRGs in version 2 would be expanded to 1,000 DRGs to better reflect different disease severity. Since DRG is the only one case mix being researched in Thailand, DRG is good only for acute inpatient episodes. There are many complex issues in health care reforms or health system developments; e.g. information technology, increasing efficiency within public sector, health care accreditation, health care decentralization, autonomous hospital, and the universal health coverage of the new government (30 baht medical care policy), etc. In the implementation of the 30 baht policy, many issues of health care reforms have been dumped to ride the wave of change. DRG was used inadvertently with decentralization policy but with less understanding. This conflicts with the recommendations of the Working Group on Universal Coverage of HSRI. The working group recommended the split of budget between ambulatory and inpatient care. The capitation payment is good for ambulatory care and DRG for inpatient care. To increase access to efficient and good quality inpatient services to all, DRG should be managed with unity at the central level under the reasonable global budget cap.


location: , 'Thailand year: 2018 source: HSRI

title: Cost of Primary Care Service Network in Health Region 8

abstract: The objective of this study was to estimate total cost of primary care service network. Samples with a proper primary care service system and good administration were selected based on experts’ opinion. They were three main district networks, namely, Namsom in Udonthani province, Wanornniwas in Sakon Nakhon province, and Naklang in Nong Bua Lam Phu province. The data on services and financial information of fiscal year 2015 were gathered. Total cost per network and the unit cost per capita were analyzed. The result shows that labor cost was the main cost driver in primary care system in which some networks was twice higher than material cost, followed by capital cost. The total cost of Namsom network was THB 22.9 million, of Wanornniwas network was THB 49.4 million, and of Naklang network was THB 46.2 million. The cost per capita of Namsom network was THB 612.61 followed closely by Naklang and Wanornniwas networks at THB 603.08 and 461.52, respectively. However, it should be noted that only one district network could collect all cost information needed was the main limitation of the present study. While, cost data are very different in each network, more primary care networks are needed to get more accurate unit cost.


location: , 'Thailand year: 2023 source: HSRI

title: A Study of the Capabilities in Management and Response of Organizations Established Under a Special Act During a State of Crisis

abstract: The objective of this research is fourfold as follows: 1) to study and analyze the various dimensions of organizations established by special acts, which enables them to manage and respond to crises effectively, 2) to study the management effectiveness and crisis responsiveness of organizations established by special acts, 3) to identify the unique characteristics of organizations with special acts that are highly capable of managing and achieving their missions in the context of Thai society, and 4) to synthesize policy proposals for improving the management of organizations established by special acts to be more flexible and responsive to the needs of the country and its people. This research employs qualitative methods through document analysis, in-depth interviews, and focus group discussions with a purposive sample of nine organizations. The data analysis involves creating summaries of data to find patterns and relationships between variables to understand and synthesize the findings in a meaningful and appropriate manner. The results of the study indicate that: 1. Characteristics in various dimensions of organizations established by special acts that enable them to manage and respond to crises: From studying the organizations, the important characteristics are as follows: 1) The work management structure and format of organizations established by special acts are clear, and most organizations are adaptable and flexible in their operations. 2) The objectives of the establishment, roles, missions, and overlap are generally in accordance with the objectives of the establishment stated in the special acts. 3) The supervision, monitoring, and evaluation of organizations established by special acts have evaluation systems specified in the law. However, the state also creates regulations to monitor these organizations. 4) There is a continuous trend of organizations established by special acts in the future, as the state has new missions that arise from changes in the economy and society. 2. Effectiveness in crisis management and respond (i.e. COVID-19 pandemic) of organizations established by special acts: The lessons learned indicates that these organizations are equipped with: 1) Readiness to receive and respond to crisis situations, with a continuous management plan that can be promptly adjusted. 2) Adjustment of work processes, using more technology, as the pandemic situation has accelerated the transition to digitalization. 3) Adjustment of operations to be more efficient and effective, focusing on solving problems and providing effective solutions. 4) Capability of Coordination and collaboration with relevant organizations and stakeholders, utilizing and sharing resources and knowledge to overcome the crisis. 3. The distinctive features of an organization that has a special act in the context of Thai society, which are important factors that make it a high-performance organization in managing to achieve the organization's mission are as follows: 1) Organizational structure - the organization has the ability to quickly adapt to changes (Adaptability), is flexible (Agility), responds to stakeholders, and develops work processes and technology. 2) Organizational culture - the organization aims to make its personnel aware of the quality of service, emphasizes continuous learning, focuses on competencies and values that adhere to the country's benefits. 3) Importance of responding to stakeholders - this will help understand the real needs of the service recipients, and gain strength from the public and networked communities. 4) Member behavior in the organization - members must respond to external factors and recognize the importance of stakeholders. If this response aligns with the organizational culture, the behavior of each person in the organization will go in the same direction towards achieving the goals. 4. Policy proposals for improving the management of organizations with specific acts to be more flexible and responsive to the needs of the country and its people. From the study, the following suggestions are made: 1) Develop a database system to enable organizations to efficiently set directions and strategies. 2) Establish mechanisms or guidelines to ensure that chartered organizations have flexibility in achieving their objectives. 3) Promote communication and publicize the achievements of the organizations. 4) Ensure that organizations are ready for evaluations of their value. 5) Encourage each organization to understand its Core Mission, Core Asset, and Core Competence, and adhere to these principles. 6) Promote data sharing and collaboration. 7) Encourage employees to work together to create shared values, culture, and mindset that align with the organization's identity and goals. 8) Apply new concepts of public sector management to the organization. In addition to this, based on the results of the study, it is possible to synthesize the environmental success system of the organizations established by special acts, which consists of internal and external factors. For internal factors, both individual and organizational levels are involved. At the individual level, effective collaboration and ethical conduct are required. At the organizational level, the structure should be flexible, adaptable, and seek cooperation and opportunities for involvement from other stakeholders. As for the external factors, the organization should be free from politics and receive support from the government and network partners.


location: , 'Thailand year: 2002 source: HSRI

title: The effectiveness of structural shared care for patients with epilepsy in Nakhonratchasima province

abstract: The effectiveness of Structural Shared Care for patients with epilepsyin Nakhonratchasima ProvinceThis study aims to evaluate outcomes of treatment in terms of patient with seizure free and with regular follow-up between the conventional care and shared care with specialist's advice given to GP and letter reminder given to the patientsMaterial and Method: The study was conducted between June 1999 and September 2001. Two community hospitals were chosen: one for control and the other for intervention group. Before the beginning of the study, guideline of management for GP was created between GP and specialist. All patients with informed consent were treated and asked to fill data in the registration and follow-up form. All the data was sent to the investigator to register and audit the treatment only for intervention group. Advice (if any) would be sent to the GP and the patients would be received the letter reminder for the next coming schedule appointment. After one-year study, all data recorded in the forms and in the OPD card would be gathered for analysis with SPSS version 8. Some information not presented both in the forms and the OPD card would ask to the patients by letter. Results: The number of patients in control group and intervention group was 45 and 55, respectively. All each patient's characteristics between two groups was not different but patient's age, number of mentally retard patients and type of seizure (p-value < 0.05, 0.05 and 0.01, respectively). At the beginning of the study, patients with seizure free in the previous 3 month in control group were 46.7% (21 cases) and 56.4 % (31 cases) in intervention group. After the study, this figure has an increase to 72.7 in intervention group and 60% in control group. For follow-up analysis, the factors which might influence patient’s regular follow-up were not different between two groups including Univariate and Multivariate Analysis (Cox proportional hazards regression). There was no statistical difference in an average of the duration of follow-up (mean in control group = 9.61 months; in intervention group = 10.31 months) and in the proportion of patients with regular follow-up (64.4% in control and 67.3% in intervention) (p-value = 0.87 and 0.86, respectively). However, for survival analysis, no difference in proportion of patient with regular follow-up between two groups (p = 0.46, Log rank statistic).   Limitation and suggestion: Too small samples and few interventions might be the reason for no difference between two groups. The system should be corrected as a whole.


location: , 'Thailand year: 2009 source: HSRI

title: Competencies of Health Research Managers: A Case Study of Health Research System

abstract: This study was aimed at developing a framework for assessing the competencies of health research managers and conducting self-assessment of 20 health research managers working for the-Health Systems Research Institute and its affiliates. The research managers were purposively sampled and self-assessment was conducted through a self-administered questionnaire. The average age of the persons sampled was 44.16 years and the average duration of working as a health research manager was 2 years and 5 months.
The self-assessment framework was developed by reviewing relevant documents. The Health Research Management Modules produced by WHO were considered as providing the conceptual framework for drafting the self-assessment questionnaire, which was later improved by the working group comprising a number of experienced health research managers. The self-assessment framework included eight domains of competencies as follows: 1) organization analysis; 2) research program planning and management; 3) research project planning and management; 4) capacity-building of the health research system; 5) information system for research and knowledge management; 6) financial management system for research projects; 7) management for research utilization; and 8) general management.
Results show no competency domain was assessed as good or best (average score equal to or more than 3). Competency for capacity-building of the health research system was scaled as the poorest (2.40), while the competency of research project planning and management was scored as the highest (2.67). The average score of every domain was higher for more experienced health research managers (over 3 years of working in this position) than for the less experienced ones (less than 3 years’ experience).
This study helped to identify clearer roles and competencies of health research managers. However, the competency framework needs improvement since its validity and reliability have not been tested, and the number of subjects sampled in this study was small.


location: , 'Thailand year: 2004 source: HSRI

title: The public scoping on the health impact assessment in the separation on the gold mine, Khao Phanom Pha, Wang Sai Poon, Phichit province

abstract: “Khao Phanom Pha” located in the area of Ban Khao Phanom Pha, Village No. 7, Nong Pra Sub-district, Wang Sai Poon District, Phichit Province, is a little hill with the height above the mean sea-level of 50-155 meters, covering the area of around 200 rais, considered as mixed deciduous forest and commercial forest with houses scattering thoroughly. Most local people earn their living by doing agricultural work and general wages during the dry season. The area of Wang Sai Poon District and Phichit Province are situated in the basin of Nan River with canals and branch rivers. In the rainy season, it is usually flooded, on contrarily, in the dry season some areas face the problem of water short and cannot be used for agricultural advantage.In 1999, gold ledges were surveyed and found. This caused lots of trespassers from both the province and the neighborhood into the area of Khao Phanom Pha to search for nuggets and this led to the problem of natural resources and environment destruction, injury and death due to landslide. Though the prohibition of trespass was announced, sneaking mining of nuggets still continues.Phichit Provincial Administrative Organization receives the concession to mine nuggets in the area of Khao Phanom Pha in order that the local people can have mutual benefits in mining. This can solve a degree of some problems. Anyway, it cannot respond the people since the amount of nuggets is incomparable with the investment. The sneaking mining of nuggets in private lands in front of the mine of Phichit Provincial Administrative Organization still continues. The nuggets are washed to remove dirt out along river, natural canals. Some people dig ponds and build concrete wells to separate, wash and select nuggets.From the study, it is found that the activities involving nuggets mining are at two places: the mine of  Phichit Provincial Administrative Organization (PAO) and the private land (A famous temple). Both areas are immediate but the excavation in the latter is illegal, lacks of facilities, measures or regulations. Garbage, wasted, refuse occuring are not correctly executed and natural resources and environment do not receive any protection. This may cause problem in the future.The three effecting areas to health and environment are considered as follows: 1) serious effecting areas where the possibility of injury and death from landslide is acute and serious are the area of Khao Phanom Pha including its vicinity, gold mine of Phichit PAO, the area of Wang Sai Poon District where people separate, wash and select laterite for nuggets  2) intermediate effecting area namely all areas of Wang Sai Poon District where no activity of gold mining is found  and 3) low effecting area namely all areas of Phichit Province excluding Wang Sai Poon District.The impact can be summerized as follows:  the private area is excavated until it becomes a huge hole for dumping waste. Its size increases and it probably collapses and is harmful to excavators. It may also damage the hedge of the neighber and the dispute may arise. Excavated soil or stone are piled up in many places without covering or are contained in decayed sack. Separated, washed and selected soil or stone piled up throughout rice field, garden, yard and other areas cover the ground surface until the abundance of soil and landscape are destroyed. There are new careers such as separator, washer, soil porter, excavator, soil seller or queue seller, mill worker, workers who use mercury to select nuggets, nuggets buyer, vender etc. All expect to have higher income, to have enough money for their children’s education, to have additional income, to discharge debts, to have a free-lance profession without going to work for wages in Bangkok, to gain rent from gliding area, to sell land, to get free soil for filling up and to develop their land to be tourist attraction. The economics will be better. Tools and equipment used for selecting nuggets, grinder,driver, scooper are invented and modified. This indicates the history of nuggets searching.The way of life is changed from that of agricultural society to that of struggling for exercise from the morning till the evening. Each lives in each own way, show a clean pair of huts, has no time for others. Society is broken and family loses either life, injury or freedom. Criminal problem occurs. There are problems of drug addiction. People do not consider the right and the wrong not even their own health. In addition, we can find other changes in the community. The old location of Kha Phanom Pha Temple was bought and the temple was moved to another place. People are distant from temple and monk. Only a few people go to make merit at a temple except in funeral or when gamble is made. Cooperation becomes less. Soil and stone in some areas of the temple are grinded for nuggets. Some little students have to take their younger siblings to school since their parents go to work in the mine. Most children do not continue their higher education because they have to help their family in the mine. People or community rarely participate in policy directing. They are not interested in meetings which are left to be the duty of local administrative organization or official units.Mercury is a toxic heavy metal introduced for the process of gold separation from contaminants. It is weighed 40.09 grams a day and 1,202.7 grams a month. The real amount of mercury could be higher since it is used in every area of gold separation, wash and selection.People who separate,wash and select nuggets are often sick with symptoms of asthma, hypertension, headache, anxiety, insomnia, leg pain and most of them also develop a symptom of itchiness and skin disease.  This is due to their long hours of work in water.  They find and buy medicine to treat themselves.  Most of them rarely have interest in taking care of their own health, overtax themselves and do not take enough rest.  Also, they eat unuseful food such as, coffee, energy-added drink, and beverage with mixture of alcohol and liquors etc. Some of them work until they forget their appointment and also forget to take their children to receive vaccination or forget to have pregnancy check at public health center.  A trend of health status is deteriorated or not favorable.  The disease/symptom that are expected to become problems of the area in the future are those derived from food and water, accident/disease from occupation, disease/mental symptom.  The environment changes in hardship and deteriorated direction.  The plan to restructure natural resources and environment in the local level of every area also lacks clarity. No operational plan/project to support the problems are mentioned by Nongphra Subdivisional Administrative Organization, the district where is the source of nuggets and where the nuggets selection is mostly performed.The separation, wash and selection of nuggets from Kao Phanom Pha will be proceeded continuously with relations to an individual, enforceable law and a large numbers of administration and management systems.  There are also other factors.  The arising problems are complicated and have linkage to one another. Phichit PAO cannot entirely solve the problems due to a small quantity of nuggets,complicated rules and regulations, brokers and inefficient services provided, etc. in comparison with a private area, where lower investment is required and no regulation is determined.The way of life, thinking system, household/community economics, various kinds of behavior, health status of people, natural resource and environment administration and management system, pollution, public participation and others are affected in both good and bad sides.  In regard to public health, some people died due to the landslide, some become crippled and some suffer illness from hard work with a lack of enough rest.  There are several types of impact on health.  That is to say 1) A direct impact, such as, accidents, arising illness. 2) An indirect impact, such as,  impact  on changes in the community or ecological system.  3) An accumulated impact, such as, that of chemical substance used in the process, the accumulation of tension and weariness from work and occupationFor the strength of government organizations and agents, there is a lack of major department or organization to solve the problem and the officials are not sufficient. Cooperation from public is also enough. Local administrative organizations is also short of clarity in solving the arising problems as well as short of cooperative plan with relevant agents in order to prevent and solve the problems, promote and improve every matter.The evaluation of impact on health is considered a procedure for building and promoting the occurrence of body of knowledge and measures in taking care and protecting one’s own health, the health of family and community health from factors or provisions that shall affect such health. Also, there is an adjustment of oneself to survive in the changeable society.  The procedure for evaluating health impact should be promoted in terms of knowledge, public and community participation as well as individuals and relevant units in order to be as the same system.  Due to the fact that the study has been done in a short time by methods of surveying, inquiry, interviewing and conversation and each of them has been done in a short period of time, it cannot provide enough knowledge, understanding and explanation of such matter to public. Moreover, it cannot cause the occurrence of public organization as a studying unit or operational units for evaluating the impact on health from activities, projects, policies or others.The study should determine the scope of academic content covering all details for the view of linkage in various factors, by determining which factors should be studied firstly or lastly.  Also, it should cover the extent of area because it is involved in the levels of severity and relations or pursuant to the types of impact.Nevertheless, this studying still consists of several defects which may cause an incomplete study. The improvement and correction of this study should be as follows: the determination of low or basic index which is suitably applied to the explanation of impact on health, the condition of work and the quantity of concentrate mercury in environment and living creatures should be examined, the local administrative organization should issue regulations enforced in local or some private areas of nuggets excavation, any entry to execute any activities should be approved by the landlord and local officials, such as, Governor, District chief and Chairman of Subdivisional Administrative Organization should exercise their rights pursuant to the relating law in order to suppress any events that may have caused danger to lives and properties of public.Local administrative organization that has been affected should cooperate to issue studying approach and seek impact control measures, support and promote the observation of public health and environment quality.  In terms of human resources,  curriculum concerning the impact of nuggets separating, washing and selection activities and toxicity and danger of mercury should be determined.  The monitoring and evaluation should cover all levels of affected areas.  It is also required to arrange strategic plan and operational plan for the administration, prevention, improvement of natural resources and environment.  The emphasis should be made in all sectors in order to create community, strength and evaluation system on health impact in the region should be promoted and other careers should be provided and planned in case that nuggets come to the end to reach the option and lead to the sustainable problem solving.


location: , 'Thailand year: 2011 source: HSRI

title: Effectiveness of Health Screening and Health Program for Prediabetes and Prehypertension Individuals at the Municipal Branch of a University Pharmacy

abstract: The objectives of this study were to evaluate the effectiveness of health screening and education for
prediabetes and prehypertension individuals by randomized controlled trial. The samples were randomized
into an experimental group that received health education and a control group that had not received
follow-up for two months. Outcomes were the modifying of health behaviors, blood pressure, fasting blood sugar (FBS) and knowledge. There were 367 participants who attended the health-screening process;
6.56 percent were prediabetes, 33.75 percent prehypertension and 13.75 percent prediabetes and
prehypertension. Thirty-one of the prediabetes (15 in the experimental group and 16 in the control group)
and 49 of prehypertension (24 in the experimental group and 25 in the control group) were followed up.
The result showed that eating, alcohol drinking and exercise behavior of those who were prehypertensive
individuals in the experimental group were significantly changed (P-value <0.05) and that eating salt and
drinking alcohol among those who were prediabetic significantly decreased (P-value <0.05). Blood pressure
levels and FBS were significantly decreased from the baseline (P-value <0.05) in both experimental
groups but there was no difference in the control group. The knowledge scores were significantly higher
in the experimental group than in the control group (p-value <0.05). The results indicated that effectiveness
of health screening and education for prediabetes and prehypertension individuals could help subjects
realize the need to modify their health behaviors and reduce blood pressure and blood sugar levels.


location: , 'Thailand year: 2008 source: HSRI

title: Local health communication: concept, procedures and expansion

abstract: The objectives of this project were to empower “Health Communicators” (NorSorSor) who communicate information on health in Phrae and Kanchanaburi Provinces as well as to enable NSS groups to operate independently. Additional objectives were to train some NSS members as “facilitators” in order to establish a new generation of NSS, to extend the principles of local health communication to people in nearby provinces, and to analyze results in preparation for policy recommendations. This research was conducted under the principle of Participatory Action Research.
	As part of a one-year operation establishing the NorSorSor Clubs, both in Phrae and Kanchanaburi provinces, the selected committees managed the groups by focusing on understanding the objectives of the work, providing communication channels, holding meetings, conducting regular unofficial meetings, and providing the lists of NSS members. From these initiatives, the NSS members were able to work together. In addition, an opening ceremony was held to introduce the NSS group and to extend the communicator networks in the area. Some potential health communicators were additionally trained to become facilitators which will enable this group to successfully establish a new generation of NorSorSor. In addition, they disseminated their ideas and local work experiences through various media such as an advertising spot, a brochure, a video and a special meeting with relevant persons from 8 nearby provinces; Nan, Lamphun, Lampang, Uttaradit, Phayao, Nakhon Pathom, Rachaburi, and Phetchaburi. This meeting attracted much interest and encouraged coordinated expansion into other areas.
	The result from the operation shows that the features of local health communication work consist of 1) Health Communicators (NorSorSor) who pay attention and possess a sense of public spirit, including abilities to support and co-operate together and link this work with their everyday responsibilities; 2) integration of NorSorSor as a significant working force in the community; 3) information and knowledge about health; 4) communication channels through personal and local media; and 5) the support of society at large, especially at a provincial level.
	In order to communicate local health communication in Thai society, the need for local health communicators and local health communication must be recognized and established as a part of health management system. In addition, mechanism should be created to enhance the pride of health communicators by offering a chance to show their results, to provide sustainable networks which are supported by society of both local and national levels.


location: , 'Thailand year: 2021 source: HSRI

title: The impact of Corona Virus Disease 2019 (COVID-19) outbreak on TB Control outcomes, Thailand

abstract: Since the novel coronavirus outbreak (COVID-19) was identified for the first time in China during December, 2019. The world faces the COVID-19 epidemic including Thailand. The Royal Thai Government has announced an Emergency Decree on Public Administration in an Emergency Situation B.E. 2548 which had been effected from 26 March 2020 onwards. The Royal Thai Government Gazette published an announcement prohibiting any person throughout the Kingdom from leaving their residence between 10:00 PM and 4:00 AM starting on April 3, 2020. It may impact national tuberculosis program. The main objective of this study was to compare the TB treatment outcomes during pre-and post-COVID-19 outbreak. The secondary objectives were 1. To evaluate the number of TB diagnosis test during pre- and post-COVID-19 outbreak, 2. To compare TB case notification during pre- and post-COVID-19 outbreak, and 3. To compare TB treatment outcomes during pre and post COVID-19 outbreak. A cross-sectional study was conducted in this research by using the secondary data which TB patients were registered into the NTIP program. Comparing the data of the first cohort of the fiscal year 2019 and the first cohort of the fiscal year 2020 for the topic of TB treatment outcomes pre- and post- of the first wave of outbreaks in 2019 and 2020. TB diagnosis analysis we used the data of the two cohorts (second and third cohort of the fiscal year 2019) and the data of two cohorts (second and third cohort of the fiscal year 2020) representing pre-and post- of the first wave of outbreaks in 2019 and 2020. The results of this study showed that the number of all TB cases during pre- and post- of the first wave of COVID-19 outbreak in 2019 and 2020 were 40,544 and 40,848 cases, respectively with slightly increase but not statistically different (p= 0.275). The case notification number of new and relapse cases were 38,875 and 39,231 cases, respectively with an increase but not statistically different (p=1.00). Before and after the lockdown (between the same year between cohort Q2/2020 and 3/20), there were 21,358 and 17,873 cases, respectively, a decrease of -16.3%. The number of TB patients who diagnosed by AFB smear of 23,792 (61.2%) and 25,731 (65.6%) cases, respectively showed a statistically significant increase (p<0.001). In contrast, the number of TB patients who diagnosed by only Xpert MTB/RIF of 717 (1.8%) and 577 (1.5%) cases, respectively showed a statistically significant reduction (p<0.001). In addition, during pre- and post- of the first wave of outbreaks in 2019 and 2020, the number of patients diagnosed by both AFB and Xpert MTB/RIF (AFB smear is initiated test for TB diagnosis, if AFB negative was founded the Xpert MTB/RIF is done) wirh 8,838 (22.7%) and 6,808 (17.4%), respectively showed a statistically significant reduction (p<0.001). The number of TB patients without results were 5,528 (14.2%) and 6,115 (15.6%), respectively, a statistically significant increase (p<0.001). The TB treatment outcomes of new and relapse cases during pre-and post- of the first wave of COVID-19 outbreaks in 2019 and 2020 showed that the success rate were 80.8% and 86.4%, respectively. There was a statistically significant decrease (p<0.001). Transferred-out were 0.7% and 1.3% with a statistically significant increase (p<0.001). Lost-to-follow up rate were 4.3% and 3.7%, respectively with a statistically significant reduction (p<0.001). On-treatment rate accounted for 0.8% and 6.2% with a statistically significant increase (p<0.001). In summary, this study is the first national study that presented the evidence of impact of the Covid-19 outbreak situation to TB programmes and services. Case notification number among new and relapse cases during post of the first wave of COVID-19 outbreak was lower, especially lockdown period, but not statistically different. The number of diagnosis examinations by Xpert MTB/RIF was declined. Moreover, treatment success rate trended to reduction. In order to operate TB programme effectively during the COVID-19 epidemic, an intensive TB cases finding especially among the high risk groups, for examples; out-patients and the prisoners should be done as well as screen COVID-19 in the same time. The results of this study provided the useful information of the trend of case notification, TB diagnosis test and TB treatment outcomes for prepare the TB strategies for the next wave of COVID-19 outbreaks.


location: , 'Thailand year: 2015 source: HSRI

title: A Development of Community Participation Model to Reduce Alcohol Consumption Behavior

abstract: The purpose of the research was to investigate model and study the effects of the community participation model to reduce alcohol consumption behavior. The study was
research and development, included 3 phases: the first phase was to review documents and urban context study, the second phase was to investigate community participation model and the final phase was to the effects of the community participation model to reduce alcohol consumption behavior. The sample consisted of 30 leaders and others. The research instrument was empowerment participation action research. Data were analyzed by the content analysis was also used.
The results indicated that the process for development of community participation model of reduce alcohol consumption behavior, the sample consisted of village leader, headman, village health volunteers, teachers, health officer, health leader and the other have a top level participation and more than 80 percentage of samples participated in all processes. The result of the community participation model to reduce alcohol consumption behavior included social measures by community, strong of community and network, people in community to reduce alcohol consumption behavior, the alcohol free zone in school temple and official place, many shops in the community not for sale alcohol drinking, the people have knowledge about toxic alcohol and innovation of community to reduce alcohol consumption behavior.


location: , 'Thailand year: 2000 source: HSRI

title: Important factors influencing readiness, barriers and supporting crateria for Good Manufacturing Practice(GMP) among pharmaceutical manufacturers

abstract: Important Factors Influencing Readiness, Barriers and Supporting Criteria for Good Manufacturing Practice (GMP) Among Pharmaceutical Manufacturers	The objectives of this project were to investigate the problems and barriers in performing the GMP encountered by local pharmaceutical manufacturers ; to follow up the GMP inspection process ; and to find out the readiness and supporting criteria for conforming to the new GMP regulations. The target group of this study was 176 local modern pharmaceutical manufacturers ( 129 GMP-approved and 47 non-approved). The sample was obtained by stratified sampling technique, and the data was collected using questionnaires, interviews, focus group discussions and brain-storming processes.   	The GMP-approved manufacturers stated that budget was the most important factor for GMP approval ; this factor covered the cost of premises, personnel and documentation. Once the GMP was obtained, as pressure was put on those manufacturers to maintain their GMP performance, inevitably an increase of budget was required. The GMP non-approved manufacturers reported that lack of GMP consultant was the most important problem. They responded that the criteria of GMP inspection was unclear and inaccurate, since each inspector followed different standards, and this resulted in the repeated correcting of the same subject matter. About 58 % of the manufacturers agreed to have GMP enforcement so that the Thai manufacturers and Thai medicines could be upgraded to international level. Those who did not agree reasoned that the current problems or limitations regarding the GMP criteria should be solved as the first priority. Moreover, the declare of GMP regulation may bring unforeseen costs.  	GMP performance in the pharmaceutical manufacturers must be supported with full process i.e. problem solving and specification of development direction. The following issues should be reconsidered : reviewing of government policy relevant to international standard GMP ; import of pharmaceuticals ; promoting the pharmaceutical market nationwide and internationally ; and the roles of the Government Pharmaceutical Organization (GPO). The suggestion for further development were as follows : to set up a GMP guideline and consultant team, and to further support and assist the manufacturers to strengthen their potential in pharmaceutical exports.


location: , 'Thailand year: 2022 source: HSRI

title: Developing a Web Application for Reducing Stress and Anxiety from the Impact of COVID-19 for the General Public

abstract: The World Health Organization was announced that a major pandemic a health emergency in April 2020 due to the COVID-19 pandemic. This evidence was impacted many people to stress and anxiety. Self-care is important. For reducing interpersonal interactions, technology is now increasingly active. Objectives: To develop a web application that reduces stress and anxiety resulting from the effects of the COVID-19 pandemic. This web application was designed to (1) Assess satisfaction with the use of the application website. (2) Measure the levels of stress and anxiety, and coping mechanisms. (3) Compare the effects of using a website application with a positive thinking program on reducing anxiety. (4) Synthesizing people's self-help approaches to stress and anxiety from the COVID-19 pandemic. Methodologies: Phase I was a mixed - method research to analyze data from the web application (N = 400) collected in Pathum Thani province. The instruments were the satisfaction survey, GHQ-28 Tool, Anxiety questionnaires, Coping questionnaires, and Positive Thinking Program, with the web application usage. Phase II was a quasi-experimental research method. The sample (N = 80) was randomly selected from Phase I into the experimental group (N = 40) and control group (N = 40). The experimental group completed the 15-Positive Thinking Program exercises within 20 days. Data collection was conducted from February 2022 to April 2022. The data analysis used were descriptive statistics, percentages, frequencies, averages, standard deviations, t-test dependent, and t-test independent. The content analysis used Atlast.ti software to synthesizing people's self-help Results: The sample consisted of individuals of working age, 21-30 years old (23%), 41-50 years old (19%), and 31-40 years old (18.5%). The satisfaction of using the web application was evaluated in three parts, the most satisfaction with the benefits (x ̅ = 4.04, S.D. + 0.83). The satisfaction with design, and performance were x ̅ = 4.00, S.D. + 0.78 and x ̅ = 3.14, S.D. + 1.64 respectively. The stress levels were categorized as normal (86.3 %) and abnormal levels (13.8 %). The anxiety levels were categorized as high (4.5%), moderate (49%), and low (46.5%). The coping methods used by the sampled individuals were distractions (x ̅ = 2.72, S.D. + 0.61) and positive thinking (x ̅ = 2.70, S.D. + 0.61). As a result of using web applications to reduce anxiety, anxiety scores were found within the trial group before and after using web applications with positive thinking training programs. Statistically significant differences at .05 (= 3.47, S.D. + 0.29) and (= 3.18, S.D. + 0.17) respectively, and anxiety scores between the trial group and the control group after using web applications with positive thinking training programs differed statistically significantly at .05 (= 3.18, S.D. + 0.16) and (= 3.48, S.D. + 0.33) respectively. People's self-help approaches to stress and anxiety from the COVID-19 pandemic which can reduce stress and anxiety, including relaxing by watching movies, listening to music. Cooking, planting trees, living with nature, and adjusting ideas in a positive way. Self-defense in the form of prevention of direct infection and indirect were reducing to read news which causing anxiety, choose useful news, get enough rest. exercise, eat healthy foods, and other methods, such as using mindfulness to solve problems. Promoting mental health, acceptance, etc. On the other hand, Self-help practices that have been done but rarely effect to reduce stress and anxiety include not being able to adjust your mindset, trying to forget about stress but not being able to. can't stay focused or calm your mind and can't let go. too much news. not being able to avoid risky places because it is necessary to go to work and go about daily life.


location: , 'Thailand year: 2021 source: HSRI

title: Evaluation of Primary Care Service System Models for Diabetic and Hypertensive Patients in Khon Kaen Province

abstract: Primary care is a crucial quality health care system in achieving health for all people. This study
aimed to evaluate the provisioning and supporting systems, and also compare the provisioning and
supporting systems to the district areas of primary care services for diabetic and hypertensive patients
in Khon Kaen province covering the pilot and non-pilot primary care clusters (PCCs), the non-communicable
disease (NCD) clinics of hospitals, and the health-promoting hospitals of Mueang, Nam Phong and
Ubolratana districts. A cross-sectional study was conducted with 170 health personnel via purposive
sampling. Data were collected by self-administered questionnaire with 0.84 Cronbach’s alpha coefficient.
Data were analyzed using descriptive statistics in terms of percentage, mean and standard deviation, and
inferential statistics in terms of ANOVA and least-significant difference. The findings showed that mean
score of the provisioning and supporting system of the primary care service of NCD clinics of the hospitals
was higher than the PCCs and health-promoting hospitals at both province and district levels. The mean
scores of the NCD clinics were higher than the others in all dimensions of the provisioning system, including
the relationship between clients and family medicine or family doctor, shared care plan for the
individual patient, health information system, and self-management supports of the patients. However,
the mean score of continuity of care and coordination provided by the pilot PCCs was higher than the
NCD clinic of the hospitals. In terms of the supporting process associated with the family care team and
multi-disciplinary team, and the understanding of primary care service principles, the mean score of the
NCD clinics was higher than the PCCs and health-promoting hospitals. However, regarding the aspect of
trust in time allocation of the team in providing care to patients, the mean score of the non-pilot PCCs
was the highest, while the another aspect of continuity of health care service development served by
the pilot and non-pilot PCCs and the NCD clinic had the same level of mean scores. When considering
the dimension of the provisioning system of all three districts, in particular, the pilot PCCs of Nam Phong
and Ubolratana districts had a higher mean score than the pilot PCCs of Mueang district. The pilot PCC
of Nam Phong district had the highest mean score in two aspects: relationship between clients and
family medicine or family doctor, and self-management supports of the patients. The pilot PCC of Ubol-ratana district had the highest mean score in two aspects: shared care plan for the individual patient,
and continuity of care and coordination. In addition, the remaining aspect linked to the health information
system provided by the pilot PCCs of Nam Phong and Ubolratana districts had the same mean.
There were significant differences in all aspects in all three districts, except the relationships between
clients and family medicine team (no significant difference in all districts). The present evaluation of the
primary care models was an early assessment set by the central national project that needed longer
time after implementation to learn more lessons for further improvement. Moreover, the present study
was biased on the opinions of health care providers and did not include the opinions of clients and
clinical outcomes of the service provision.


location: , 'Thailand year: 2015 source: HSRI

title: Prevalence and risk factor for medication non-adherence in patients with type 2 diabetes mellitus

abstract: This study was conducted to determine the prevalence of medication non-adherence and identify
factors associated with medication non-adherence among 230 patients with type 2 diabetes mellitus in
Nongjik Hospital, Pattani province from August 2013 to December 2013. Medication adherence was assessed
by self-report patients in term of taking medications. Frequency, percentage, mean and standard
deviation were used to present the analysis results. Multiple logistic regression analysis was used to determine
factors associated with medication non-adherence. Adjusted odds ratios (aOR) and their 95%
confidence interval (CI) were used to present the strength of association.
Of the 230 study patients, 64.8% had medication non-adherence. Factors associated with medication
non-adherence included religion (aOR 2.68, 95% CI 1.10, 6.48) self- management (aOR 8.41, 95% CI 1.13,
62.72) combination of oral anti-diabetic drug and Insulin (aOR 7.16, 95% CI 1.35, 38.13) frequency twice
daily (aOR 4.44, 95% CI 1.51, 13.06) frequency three times daily (aOR 13.80, 95% CI 3.19, 59.78) and number
of tablets per day (aOR 2.28, 95% CI 1.16, 4.51)
The high prevalence of medication non-adherence among the study group needs corrective measures.
These may include assessment of medication adherence and modify treatment for each case especially
in Muslim patient with medication adherence.


location: , 'Thailand year: 2022 source: HSRI

title: Urban Migrant Health Survey and Enhancing Private Sector Role in Migrant Health System Development

abstract: Migration is a global phenomenon. Thailand is currently the destination country with the largest population of migrant workers in ASEAN. Urbanization has attracted large numbers of migrants to cities and/or metropolis. Three main urban health challenges are infectious disease outbreaks due to overcrowded housing, chronic NCDs due to unhealthy urban lifestyle, and accidental injuries due to work risks. The Urban Migrant Health Survey and Enhancing Private Sector Role in Migrant Health System Development research project aims to develop the health service system that meet the health needs of migrant workers in urban areas, and promote the participation of private sector. The research methodology was a combination of quantitative and qualitative with documentary research. It consists of an assessment of migrant workers' health problems in Bangkok Metropolitan region, interviews, focus groups, and literature review. The data collection include face-to-face surveys from 432 migrant workers, 54 entrepreneurs and 81 health service providers, interviews with 20 migrant workers, 49 entrepreneurs, 3 health service providers, and 3 government officials, as well as 3 focus group meetings among expert and 2 future scenario meetings among entrepreneurs. Literature review emphasizes on six building block of migrant health system in developed countries and Bangkok Metropolitan. The documentary research findings are that the core idea underlying established migrant health system in developed countries is allocating migrant health rights according to their level of economic and social participation. Two major obstacles of migrant health system in Thai metropolis are the lack of migrant health policy in urban development policy and bias towards migrant workers in policy processes and health service provision. Therefore, it is necessary to tackle both by establish the share vision of an urban health system integrating migrant workers and promote the paradigm shift towards migrant workers integration as a participant in the urban economic and social development. In parallel, policies on proactive health service provision to cover dense urban migrant communities and health finance that covers all groups of migrant workers are introduced. These are supported by systematic management of migrant health database management system and enhancing the participation level of employers and migrants in the inclusive urban health system development.


location: , 'Thailand year: 2020 source: HSRI

title: Automated Screening System for Diabetic Retinopathy and Age-related Macular Degeneration Patients

abstract: Diabetic Retinopathy (DR) and Age-related Macular Degeneration (AMD) can prevent or reduce the severity of the disease if the diseases are found early.  This can lead to a treatment to reduce loss, reduce medical expenses, and increase the quality of life for the elderly.  Diagnosis of DR and AMD must be examined by an ophthalmologist by retinal examination. However, ophthalmologists in Thailand are still inadequate for their needs, especially in remote areas. With such restrictions, patients do not receive proper treatment on time and that can cause vision loss. Therefore, our research team developed DeepEye using deep learning, a technique in artificial intelligence that is very accurate. By developing it to be easy to use in the form of application on smartphone that can connect to any portable fundus cameras, can be screened quickly, and provide very high accuracy equivalent to an ophthalmologist.  Specifically, it can be used to screen DR and classified into three types of retinal images that are normal, DR, and other diseases. If detecting a diabetic retinopathy, DeepEye can also accurately identify the severity of DR into 4 levels, i.e., mild, moderate non-proliferative DR (moderate NPDR), severe (severe non-proliferative DR: severe NPDR), and severe with new blood vessels (proliferative diabetic retinopathy: PDR) which is a very dangerous stage of DR.  Moreover, DeepEye can be used to screen AMD, which can be classified into dry age-related macular degeneration (dry AMD) and wet age-related macular degeneration (wet AMD).


location: , 'Thailand year: 2021 source: HSRI

title: Applying Google Sheet for Action Plan of Sirindhorn College of Public Health Chonburi

abstract: Background & Rationale: The previous format of data collection to formulate an action plan had many problems and obstacles. While the features of Google Sheet as a tool in Google for Education on the cloud system are fascinating. The purpose of this research was to develop an application for importing budget plan data on projects for the preparation of the annual fiscal action plan of the Sirindhorn College of Public Health Chonburi for the faculty of Public Health and Allied Health Sciences. Methodology: The process of system development life cycle (SDLC) was applied in 6 steps. 1. Google Sheet application development meeting was first launched to the planning and strategy committee of the college administrators (planning). 2. Set the scope of the system in detail covering the system requirements in terms of access and security of the system and data management functions to allow the system to collect and export data (defining). 3. Detailed information of the program was analyzed to design the work order and verify data integrity at the system boundaries (designing). 4. Created the database in Google Sheet as designed in the action plans with HTML, CSS, and JavaScript languages (building). 5. Evaluated the usability and functions of the program to improve the program (testing). 6. Installed the program, created user manuals for hands-on training, trained and evaluated user satisfaction for the final improvement of the system (deployment). Result: The developed web application had user interfaces for data import, data processing, data storage, and result presentation. The program used the Google Apps Script language that needed no installation of servers and database systems to the server. However, users were able to access it and collaborate simultaneously at any location with Internet connection. The overall satisfaction rating was high (average 4.1) for the efficiency of using Google Sheet to deliver the action plan of the College. Conclusion: The Google Sheet made it easy to import data, update and edit project plan information to create an action plan for Sirindhorn College of Public Health Chonburi. The process was simple, suitable, reduced duplicate work, and done with the same database consistent with the digital policy of the Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute.


location: , 'Thailand year: 2022 source: HSRI

title: Pharmacogenomics and Pharmacokinetic Study of Mycophenolic Acid and Its Metabolite

abstract: Mycophenolic acid (MPA) is an immunosuppressant medication used to prevent rejection following organ transplantation and is under investigation for its efficacy against osteosarcoma. We investigated the genetic variability of whole-exome sequencing (WES) data from osteosarcoma patients and healthy volunteers who receive mycophenolate mofetil (MMF), a prodrug of MPA. Using the whole-exome sequencing (WES), we found 95 single nucleotide polymorphisms (SNPs) in osteosarcoma patients and 118 SNPs in healthy volunteers based on the list of genes related to MPA and its metabolite (MPAG) metabolism. For osteosarcoma patients, variants located in the gene UGT1A8, SLCO1B3, IMPDH1, ABCC3, UGT1A6, and UGT1A7 were related to some pharmacokinetic parameters of MPA and MPAG. For healthy volunteers, variants located in the gene SLCO1B3, SLCO1B1, and CYP2C8 were found to be in relation to some pharmacokinetic parameters of MPA and MPAG. In addition, we examined the effects of trimethoprim-sulfamethoxazole (TMP-SMX) on gut microbiota and the pharmacokinetics of MPA and MPAG when co-administered with MMF in healthy volunteers. The results have shown that TMP-SMX could alter the structure of the gut bacterial community. TMP-SMX treatment significantly decreased the relative abundance of genus Bacteroides, a major group of β-glucuronidase-producing bacteria in the gut. Moreover, concomitant administration of TMP-SMX with MMF also significantly reduced the area under the concentration-time curve from time 0 extrapolated to infinite time (AUC0-∞) of MPA. These results imply that TMP-SMX may interfere with the enterohepatic recirculation of MPA by decreasing gut bacterial β-glucuronidase enzymes that are responsible for regenerating MPA from its glucuronide metabolite MPAG, resulting in the reduction of MPA exposure.


location: , 'Thailand year: 2022 source: HSRI

title: Development of an Emulsifying Gel-Based Quorum Sensing Molecules, Tryptophol, as a Prototype for Combination Therapy Against   Infections of Scedosporium spp. and Common Drug-Resistant Fungal Pathogens

abstract: Fungal pathogens in humans have now been increasingly reported worldwide. In addition, the most common pathogenic fungi that are resistant to standard antifungal agents, particularly azole group, are Candida albicans, Aspergillus fumigatus, and Scedosporium spp., causing the need to develop various antifungal drugs and pharmaceutical products to co-treat such infections. Several active antifungal compounds are obtained from medicinal plants and fungal metabolites known as fungal quorum-sensing molecules, which have been shown to inhibit the growth of another fungal species. One of the fungal quorum-sensing molecules is tryptophol. This study aimed to develop a topical product as tryptophol-containing emulgel for inhibiting the growth of Candida albicans, Aspergillus fumigatus, and Scedosporium species complex as Scedosporium apiospermum, which is the most reported cases of infections and deaths. The preliminary results showed the minimum inhibitory concentration (MIC) of tryptophol against three fungal species were 0.5, 1, and 2.5 mM, respectively, while the minimum fungicidal concentration (MFC) was 3, 6, and 6 mM, respectively. Tryptophol at the concentration of 6mM, which was the maximum inhibitory effect of the three fungal concentrations, was not found to induce toxicity in the fibroblast (HFF-1) cells and had no effect on the life cycle of the Caenorhabditis elegans worms. The results from the laboratory have led to the development of a prototype topical product as tryptophol-containing emulgel at a concentration of 6 mM. When examining the cosmeceutical properties, it was found that the properties were good according to the cosmeceutical standards. It is also stable in both accelerated testing and at room temperature. Tryptophol-containing emulgel was used to reduce the size of eumycetoma from S. apiospermum infection in rats with a significant reduction in the eumycetoma size after at least 14 days of treatment. Moreover, the prototype product had no stimulant effect in rats when tested histologically (40/40 animals), consistent with the results obtained in human volunteers, with no cream-induced irritation using closed patch test for 96 hours in 30/30 volunteers. The results showed that tryptophol-containing emulgel at a concentration of 6 mM was able to reduce the number of pathogenic fungi in humans Candida albicans and Aspergillus fumigatus (in vitro study), as well as to reduce eumycetoma size caused by S. apiospermum infections. Moreover, tryptophol-containing emulgel did not cause irritation in rats and in human volunteers. These laboratory results can be used as the basis knowledge for further application in clinical studies for the acquisition of co-treatments to treat mycoses or other skin pathogens.


location: , 'Thailand year: 2000 source: HSRI

title: Development  of pharmacy vision for health system reform

abstract: Development of Pharmacy Vision for Health System ReformObjectives: The major objectives of the project are:To brainstorm from pharmacy-related group, their thoughts and to synthesize as vision of the new national health system;To synthesize the new role of pharmacist that can drive the new national health system; and To show an initiative of a new drug system for national health system reform.MethodologySample and sampling technique	Both pharmacists and non-pharmacists from several sectors are invited to participate in the meetings.  They are opinion leader and are stakeholders in the system, and (for non-pharmacists) have been interacted with pharmacists before.  They are drug store owners, non-governmental organizations (NGOs), physicians, nurses, journalists, community leaders, as well as the general public.  Samples are selected by judgemental sampling by the investigators.  Representatives are from all four regions, the north, northeast, south, and central.  Altogether, the ratio of pharmacists to non-pharmacists is 2.17 to 1 (152 to 70, with a ratio of 36:7 (5.14:1), 29:12 (2.42:1), 20:11 (1.82:1), 28:23 (1.22:1), and 39:17 (2.29:1) for the central, north, northeast, south, and combined 4-region, respectively.Data collection	Five meetings of brainstorming are held, each in the central, north, northeast, south, and the last one, the combined 4-region, during 28 April and July 8, 2000.  The places are Nakorn Pathom, Chiang Mai, Udorn Thani, Songkhla, and Kanchanaburi Province respectively.  Future Search Conference (FSC) technique, a participatory method for mutual learning, is used as a means to get information from the participants.  Except for the meeting at Udorn Thani for the northeast region, where the Appreciation, Influence, Control (AIC) technique is used.Health System SummaryThinking process and health problemsThe general publicAre dependent on physicians'services and drugs, not self-sufficient,Are influenced by western way of life which impacted upon all aspects of Thai society, economics, politics, social, as well as cultural.  Evidences are the changing health behavior such as eating fast food and not taking good care of personal health.Are not aware of consumer’s right.  An example is being passive when consulting with physicians.Health personnel such as physician, pharmacistFocus on treating a disease, not the person who is sick.Lack a holistic approach in treating patients, as well as lack of a team approach.Emphasize treatment rather than prevention and health promotion,Health becomes a business enterprise,Based on western thinking process, local wisdom on health and drug are neglected,Lack of professional ethics.Management systemInefficiency, particularly the centralized government bureaucracy.Under political influence.Inaccessibility to services among the population.Lack of health insurance for the general public as well as inequity to services.Pharmacy Vision for the New Thai Health SystemFour different aspects of vision will be discussed: policy, services, personnel and management system.Policy.  Priorities are: change in paradigm of all parties involved, health participation among the general public, decentralization of power, self-reliance by going back to community wisdom and heritage, and promote consumer’s right.Services.  Included are: quality assurance for consumer protection and improve quality of life, health promotion and prevention rather than treatment, optimization of health information among the population, community involvement is services provision, and a network of health services to all the people.Personnel.  Characteristics of health personnel are: public service, patient-focused care, holistic approach with bio-psychosocial and spiritual dimension, quality service, team-work, equitable distribution of personnel throughout the country, and professional ethics.Management system.  The new system should:  have universal health coverage with equity and efficiency, be an efficient drug system with a strong research and development foundations on community wisdom, be accountable, and with strong community development approach.Strategies for pharmacy toward health system reformProfessional organization.  A multidisciplinary professional organization should be established with the obligations to: policy development, promote multidisciplinary research of health service, promote the multidisciplinary health approach to the population, and serve as a center for public grievance.Pharmacy personnel.  Future pharmacists should possess the following characteristics:  have value system based on eastern culture, be a knowledgeable pharmacist with professional ethics, competent in practice skills, and act as a team of primary care provider in community health services.A community health insurance fund.  This is a community insurance scheme, funded by and for community with the goal to health provision to members.  Participation from the community in setting up the policy as well as operation decision is essential.  Primary missions are health promotion and prevention.  Services for the members are purchased from health providers such as drug stores, traditional medicine, etc.Drug system.  The new system should: be an integrated system among eastern and western philosophy, focus on research and development for self-reliance (such as herbal medicine), have standard quality assurance.  Also needed is an effective and accountable drug distribution system, promotion of rational and cost-effective drug utilization, a health information network accessible by the public,, and promotion of pharmacist as primary care provider.


location: , 'Thailand year: 2012 source: HSRI

title: Newly medical graduates’ confidence in medical and public-health competency: exploratory factor analysis and multiple regression

abstract: This study aimed to determine the level of confidence in medical and public-health competency, and
identify the relationship between such confidence with the Collaborative Project to Increase Production of
Rural Doctor (CPIRD) programme, regional medical school graduation and individual attributes. A crosssectional survey was conducted amongst newly medical graduates, who were making a contract with the
Ministry of Public Health for compulsory rural service in 2012, by using self-administered questionnaires.
Factor analysis and multiple regression were applied for data analysis.
The results showed that medical graduates were more confident in communication skill and
interprofessional collaboration, but less confident in obstretics, public-health and administrative competency.
Doctors in the CPIRD programme and those graduating from regional medical schools were more
confident in operative procedure skill and general medical knowledge than graduates in the normal track
and those graduating from medical schools in Bangkok and vicinity. In addition, being male and rural
high school graduation tended to increase the confidence in public-health and administrative competency.
Likewise, increasing age had a tendency to enhance the confidence in obstetrics competency.


location: , 'Thailand year: 2013 source: HSRI

title: Disease awareness activities of HPV vaccines for preventing cervical cancer through mass media in Thailand

abstract: The objective of this study was to examine the pattern of drug companies in promoting disease
awareness activities in relation to HPV vaccines through various media channels in Thailand including
television, magazines and the internet. Using content analysis of media content from 1st January 2006 to
31th December 2008, 47 disease awareness activities were found, of which 23 (48.94%) were on the internet,
22 (46.80%) in magazines, and two (4.26%) in television programs. The primary source of information was
from government agencies (36.67%) and the most common presentation pattern was in the form of academic
paper (36.17%). A fear appeal was the most typical communication method (59.57%). Five activities
contained incorrect data about the vaccine (10.64%). On websites, the connection of the disease awareness
activities and the sponsoring drug companies could be identified by the brand logo, the theme color, and
the product packaging linking to specific HPV strands covered by the vaccine. Hotline numbers, sponsored
by the pharmaceutical companies, were also available on the websites and magazines for consumers.
We thus propose that responsible authorities, including the Thai Food and Drug Administration,
regulate the drug advertisement policy more proactively


location: , 'Thailand year: 2003 source: HSRI

title: Health impact assessment from organic and iorganic farming in the Northeast Thailand  : Scoping and methodology

abstract: This is a literature review of chemical and organic agriculture form secondary data: academic materials, articles and reports.  These consisted of government policies related to the agricultural sector; ecological and environmental situation, pesticide and chemical usage in agriculture and agriculturists’ health.  The study refers back to before the year 1960, From the above literature review, it revealed that incidents occurred from government policies which were tremendously related to environmental changes and life-style of the N.E. people.  The death rate of infants and pregnant women decreased to a satisfactory level.  Almost all diseases that occurred from improving immunity were eliminated after public health had been in service, but these diseases were replaced with accidents, cancer, gastroenteritis diseases, skin diseases, muscle system, stress, allergies, obesity, diabetes, high blood pressure, AIDS, and lack of some nutritious substance.  These diseases are conducting one’s life which was “earn a living’ became ‘make money’.  Money was of main importance, forests were destroyed to make a living and to do the farm to increase income to meet the end needs.  From a report, production increased by expanding land was don more than increasing production effectiveness.  Lack of agricultural labour caused high wages; also not that much technology was used.  So Small Scale agriculture was not worth it.  Contracted farming was augmented gradually; and in this production system the usage of chemicals was rather high.  Chemicals and non-organic fertilizer is one of the factors that the government must give directions and see the importance of production increase and prevent damages from pests.  This is because agriculturists do not have far vision, lack potentiality assessment, do not realize the effect toward food sources, habitations environment, and health in the long term.  However, this study is a literature review.  All data were from each period but there was no concrete evidence that affected health.  There were likely to be reports about diseases symptoms such as poison, loss of life from poisons or toxins, etc. in various places, times and conditions.	Suggestions were as follows:	Data should be analysed before determining national policy including effects that might happen in the future by focussing on the public health both mentally and physically as a main issue, and collective happiness in the society.  And effects toward health, which may be created as examples of effecting health so they, can be solved promptly.


location: , 'Thailand year: 2022 source: HSRI

title: Development of Policy Recommendations and Situation Analysis of Education Management, Health Promotion and Prevention for Primary School Children, and Family’s Well-Being During Covid-19 Pandemic in Thailand

abstract: Since the year 2019 till present (2022), all countries around the world have confronted with the Covid-19 pandemic. The Government of each country has launched several public health measures in responsive to the changes of the Covid situation as well as its own country context. The main objectives of this study were to prevent the spread of the disease and to reduce the infected cases and deaths. Public health measures included social distancing, city lockdown, travel restriction, and closure of public service places, restaurants, or schools. Those measures could cause negative impacts in several sectors, such as economic, environmental, and educational sectors. The Covid impact on education was of het concern as education is the foundation of human capital development. It has been found that approximately 1.6 billion children and adolescents (more than 90% of the total learners) in 190 countries could not physically attend their schools for several months due to school closure. In addition, above 100 million teachers and school staff had been affected by the rapid closures of schools. School closures resulted in the dropouts of about 24 million students. During the pandemic, many countries had adopted the online education approach in order to k continue the study activities for children. This study aimed to investigate the education management and health promotion and prevention activities for primary school children during the Covid-19 pandemic, and to develop policy recommendations for improving the quality of primary school education management and health promotion and prevention activities for children and parents for better preparation and responsiveness given any outbreaks in the future.


location: , 'Thailand year: 2002 source: HSRI

title: The situation of dental health service management regarding the universal health insurance policy

abstract: This study aimed at exploring the situation of dental health service management since the first launch of universal health insurance policy, and to determine the impact of the policy on utilization and provision of the treatment service including the dental benefit package of the hospitals as well as health promotion and prevention program. The result is used partly for further implementation and for policy recommendation on dental health service. Three provinces : Payao, Pathumthani, and Yala were selected as target areas of which universal health insurance policy was implemented since 1 April 2001. This study includes 1 regional/general hospital and 1 community hospital in each of the 3 province, making totally 6 health facilities in this study. The data on treatment service was secondary data collected, by statistical package program, from the daily client’s record attending the dental clinic at the hospitals in the workdays of odd numbers in April - December 2001 and 2002. The data on health promotion derived from interviewing dental health personnel in each province. The data was then processed, analyzed, concluded and reported. The result on treatment service revealed that the number of hospital visits at the 6 health facilities has increased by 26.6 %, and the number of clients has risen by 20.2 %. In overall, the service coverage was 6.36 %, the regional/general hospitals coverage was 5.44 % and the community hospital coverage was 9.06 %. In regional/general hospitals, the population group with highest increasing rate of hospital visits at 30.2 % was those over 60 years of age who received basic health care service not the dental care. The proportion of those aged over 60 years having hospital visits was about 6 – 7 % of the total population, while the visits was declined to 6.0 % among those aged 0 – 4 years and 5 – 9 years. The percentage of those shifting from buying health insurance card to the gold health insurance cards in this project and receiving hospital service has somewhat increased from 9.1 % to 10.2 %, while the percentage has risen from 1.5 % to 22.2 % for community hospitals. Those shifted from the low income card to the gold cards have increased hospital visits from 15.4 % to 18.5 %, of which have increased among the low income group and the elderly. However the percentage of visiting community hospitals has reduced from 46.0 % to 35.2 % among the disable, the elderly, and those aged 0 – 12 years. Regarding repeated dental health service, it was found that the average visit of one client is 1.29 and 1.35 times in 2001 and 2002. The proportion of those having only one visit somewhat reduced from 81.2 % in 2001 and 78.0 % in 2002. The increasing rate was higher among the old patients than the new ones.With respect to the service types provided, the first 3 types of dental service provided were the basic service, i.e. tooth extraction, tooth filling, scaling, and the proportion of each type has not changed during 2001 and 2002.Considering the service types received at each visit, the percentage of those receiving only dental check up has increased about 41.1 %. If the dental check up is not regarded as a type of service, then almost 80 % had attended only one service type at each visit which was 31.8 % higher than the last year rate.The type of services under the health insurance benefit package was classified by population groups : pre-school age (0 – 5 years), school age (6 – 12 years), youth and working age (13 – 59 years), and the old age (over 60 years). The result suggested that there has been an increase of all types of basic service, i.e. tooth extraction, tooth filling, scaling, (including periodontitis treatment in the clients aged over 13 years), accounting for more than 90 % of the services under the benefit package. Whereas other services such as wearing acrylic base denture, root canal treatment presented less proportion. For dental health promotion and prevention service, the dental section of each hospital provides oral check up for pregnant women at ante-natal clinic and well-baby clinic, included in the dental health program for the target groups continuously implemented since before 2001. Each hospital does not change this activity but differs in implementing methods and duration. Regarding pre-school age service in Amphur Mueng, all hospitals have not yet implemented dental health promotion in the child development center and in kindergarten classes of primary schools. For school age children service, prior to 2001, primary schools were included in responsible area of various health service facilities. After the launch of universal health insurance policy, regional/general hospitals remain their responsibility to those schools under the catchment area of the hospital but cover more numbers of schools. These hospitals accept and commit health promotion and prevention as hospital functions. However, regional/general hospital personnel thought that school health promotion and prevention should be implemented by dental workers. In the areas outside Amphur Mueng, the dental health section of some community hospitals did not implement dental health promotion and prevention program in child development center, however, all of them have carried out dental health surveillance and prevention program in primary schools covering the same numbers of schools and activities during 2001 and 2002.Regarding home service and visit, the dentists working in the dentistry group and dental health section did not involve in preparing family files. These health facilities did not arrange certain service activities that support self reliance of the people. According to the findings, the treatment service is 6.36 % coverage of the total population. The analysis suggested that since the first implementation of dental health project in the 4th National Economic and Social Development Plan, it would yield 10 % coverage. Considering the service access classified by age, it was found that the proportion of children and the elderly receiving dental care, comparing to the total population, is less than those of other groups. Thus, it should be taken into consideration on the issue of service management that identifies specific targets with suitable proportion. Taking into account the needs and desire for treatment service in comparison with the service result, and the data on human resources, budget and time, the guidelines for identifying direction of dental health service system at provincial level could be developed particularly on the output standard of dental health service benefit package. It is noted that regional and community hospital have different patterns of providing service types in the benefit package. It is thus recommended that dental health service system assessment at national level is to be undertaken to monitor and reflect the actual picture of the service to the province and the administrators. An outreach preventive implementation at community level is a crucial answer to effectively solve the dental problem of the people. Hence, service system management without focussing on the community and prevention cannot stop the rapid increase of the problems.


location: , 'Thailand year: 2022 source: HSRI

title: A Study of Adverse Events and Unsafety After Receiving Covid-19 Vaccine of Chronically Ill Patients and Elderly : Case Study of Ramathibodi Hospital, Bangkok, Thailand

abstract: This cross-sectional research study aimed to study adverse events and unsafety after receiving types of Covid-19 vaccine. The sample of the study was people with sevem groups of chronic illnesses and older adults who received the Covid-19 vaccine from Ramathiodi Hospital, Bangkok. Purposive sampling was 1,254 cases. Data were collected by face-to-face interview, telephone, or online using the personal questionnaire and the Adverse Events questionnaire. Results showed that almost half of the participants received AstraZeneca+AstraZeneca of 48.79 %. Participants with chronic illnesses and older adults who received the different types of Covid-19 vaccine had the significant difference of adverse events both first dose (χ2=20.21, p<0.001), second dose (χ2=47.7, p<0.001), and the two-dose crossover vaccine (χ2=50.3, p<0.001). The participants who received the two-dose crossover vaccine of Astrazeneca+Pfizer/Moderna had the most adverse events of 67.7%. However, the two-dose from the same group vaccine of Sinovac/Sinopharm+Sinovac/Sinopharm reported only 28% of adverse events. People who were younger than 60 years old with chronic disease had a statistically significant difference in the greatest adverse events compared to healthy older adults with chronic disease who received both the first and second doses of the Covid-19 vaccine (χ2=24.36, p<0.001; χ2=18.31, p<0.001). In addition, Pfizer/Moderna reported the greatest adverse events of 17.4-38.7% such as local symptoms (pain, swelling, redness, hotness, itchy at the injection site), fever, and muscle pain. Moreover, twenty-two participants reported severe adverse events and need to receive first aid and visit the doctor. The results of this study suggested continuing the policy recommendations for vaccination by using the same type of vaccine Sinovac/Sinopharm or AstraZeneca. Using the cross-over type of vaccine is not recommended, especially, in-group of people who were less than 60 years old and had chronic illnesses to decrease adverse events and increase safety.


location: , 'Thailand year: 2017 source: HSRI

title: Unmet Health Need: Outpatient, Inpatient and Dental Services in Thai Population by 2015

abstract: Since 2002, Thailand has achieved Universal Health Coverage (UHC) under the three main
public health insurance schemes. UHC enabled Thai population to access essential healthcare services
regardless of income. Patient would not be worried about negative financial impacts from medical
bills to their household however the unmet health need can be found. Therefore, there is a study
on unmet health need conducted in order to monitor UHC on another aspect and to demonstrate
whether or not Thailand has patients who cannot access health service when needed, if yes, how
many; who are they and why? The objective of this study is to analyze prevalence of unmet health
need, to describe profile of patients with unmet health need and to identify factors and reasons for
unmet health need. Descriptive statistics and logit model were applied for analysis of Health and
Welfare Survey (HWS) in 2015 with 55,920 sampled households representing Thai populations.
Prevalence of unmet health need for outpatient, inpatient and dental service were 1.50 percent,
0.14 percent and 0.99 percent of all population, respectively. Main factors of being unmet health
need were age, especially elderly; uninsured people; and the poorest household economic group.
In addition, people living in Bangkok had more unmet health need for outpatient services than other
regions. The main reasons of unmet health need were inadequate time of patient for seeking care,
too long queue at health facilities, and too far to travel to health facilities.
Ministry of Public Health, National Health Security Office and other relevant agencies should
collectively work together for a policy and strategy to reduce unmet health need of Thai population,
especially for elderly. Primary health care service delivery system should be strengthened to cover
all urban areas in particular in Bangkok. “Close to client health services” should be developed for
improving access to health services.


location: , 'Thailand year: 2010 source: HSRI

title: Effect of a Preparatory Program on Social and Inappropriate Group Behaviors of Children with Pervasive Developmental Disorders

abstract: The purpose of this study was to examine effects of “The Preparatory Program” on social and inappropriate
group behavior of children with pervasive developmental disorders (PDDs). Participants comprised
20 children with PPDs, randomized into two groups of 10 children each: one in the experimental
group, and the other in the control group. The Preparatory Program was used as a research instrument,
and t-test, one-way ANOVA and post-hoc methods were utilized for statistical analysis in this study. Results:
1. After participating in the Program, children in the experimental group showed a significant increase
in social behavior (t(9) = 7.060, p < 0.001) and had significantly more social behavior than the ones in
the control group (t(9) = 4.529, p < 0.001).
2. After participating in the Program, children in the experimental group showed a significant weekly
reduction of inappropriate crying behavior and inappropriate walking behavior only between week 1 and
4 with no continuous weekly reduction.


location: , 'Thailand year: 2017 source: HSRI

title: System management and budget estimation for supporting health promotion and disease prevention services for migrant children in Thailand

abstract: An attempt to expand health insurance to cover ‘everybody’ on the Thai soil has been
implemented for years, as evidenced in the Vision of the National Health Security Office (NHSO) and the Border Health Plan of the Ministry of Public Health (MOPH). One of the issues that have caught political attention is a continuing growth in the volume of migrant children born in Thailand. However, the number of migrant children, who have been enrolled in the public insurance is quite limited. Such a situation creates a concern as to whether these migrant children received adequate immunization. This point also links to a risk of emerging and reemerging diseases that cause public health threats. Therefore, the objectives of this study are (1) to draw lessons from international experiences in managing health promotion and disease prevention services for migrant children, (2) to explore the current situation in managing health promotion and disease prevention services for migrant children in Thailand in terms of pros, cons, and challenges from the perspectives of policy makers, local implementers, and service users, and (3) to estimate budget impact for supporting vaccination program for migrant children in Thailand. The researchers applied parallel mixed methods design. Objective 1 employed narrative literature review approach as the main data collection tool. The majority of literature was retrieved from grey literature databases in the European Union. Objective 2 used in-depth interviews with policy makers, local implementers, and service users. Objective 3 applied quantitative analysis on secondary data (43 standard folders of the MOPH). Fieldwork was conducted in 4 provinces where migrants are concentrated.  This study still faces some limitations as follows. Firstly, a narrative literature review is more prone to bias than a systematic review. This is because the narrative literature review lacks rigorous quality screening process on the selected articles. Secondly, the interviews in Objective 2 involved a small number of participants, and other qualitative data-collection techniues, such as participant observation, were not extensively exercised. Moreover, it is difficult to blind the interviewees to the professional status and workplace of the researchers. These factors more or less affected the validity of the interviewed information. Thirdly, the study involved only 4 provinces. Thus generalization ability of the findings is quite limited. Lastly, the calculation in Objective 3 relies on many presumptions. Some postulations used fingures or numbers from previous studies that were conducted long ago, and the analysis was confined to material cost only. Hence, if the findings in this study are to be used for policy advocacy, there should be a process that allows all stakeholders to discuss and agree on the assumptions since the beginning, before delving into the calculation. Besides more updated figures should be used as references and the calculation should include other incurred costs (such as administrative cost and labour cost).