location: , 'Thailand year: 2008 source: HSRI

title: Treatment Result of Tuberculosis Patients in Sanam Chaikhet District, Chachoengsao Province

abstract: The objective of this work was to assess the results of tuberculosis patients treated at Sanam Chaikhet District, Chachoengsao Province by comparing the result of treatment between the Group 1 regimen, i.e., with the assistance of family members or public health volunteers in 141 patients and the Group 2 regimen, with treatment assisted by sub-dis trict personnnel, together with family members or volunteers for 38 patients. The data obtained from the patients’ registration (RorBor. 1K04) and treatment cards were analyzed for the number of patients, means, percentage, and the chi-square test. Of the 179 patients, 66.5 percent were male and 33.5 percent female, aged 10 to 88 years, with the average being 53.3 years. About 91.1 percent were cases of lung TB, of which 73.2 percent were registered as new cases, and 88.3 percent had no history of allergy. The majority (76 percent) of patients received treatment for category I, for which only 35.2 percent of the patients completed the treatment. Successful treatment, as cured patients and completed treatment, was obtained in 64 percent of patients. The results of treatment with the adapted regimen were 81.6 percent cured, 18.0 percent unsuccessful, while those treated with the old regimen showed success in 60 percent of patients and 39.7 percent were unsuccessfully treated. The difference between the two regimens was statistically significant at the level of 0.05.


location: , 'Thailand year: 2023 source: HSRI

title: Literature Review Report on Comprehensive Psychiatric Systems

abstract: Objective: To review the literatures and lessons learnt from foreign countries in implementing a comprehensive psychiatric service system, and preliminarily assessing the feasibility of comprehensive psychiatric service system in Thailand. Methods: Searching for literatures, policy documents, research related to the keyword “comprehensive psychiatric service system” for the provision of comprehensive psychiatric services in various countries over the past 5 years were 127 copies, then reviewed and selected based on objectives, leaving final to be reviewed 29 documents. Result: Comprehensive psychiatric service system is a collaboration between policy makers and budget health agencies, as well as personnel specialists in psychiatry, relevant network partners, people involved in community mental health, and including participation of psychiatric patients and relatives. This study presents examples of policy implementation and guidelines for organizing a comprehensive psychiatric service system in various countries, where considered as a recognized prototype such as Australia, United Kingdom, Canada, etc. The situation of psychiatric service system in the Thai context, which still encountered obstacles to development both at the national policy level that should focus on transition to human rights-based approach following the international guidelines, including manpower problems, mental health / psychiatric personnel knowledge and understanding of mental health/psychiatry among health personnel. The policy gap also found on linking systems between psychiatric service units in various affiliations and transferring policies into practice Including participation in policy formulation of stakeholders at each level. Summary: The development of comprehensive psychiatric service system emphasis on developing the potential of public health personnel and related agencies in caring for people with mental/psychiatric problems. Together with the development of the community's potential (including school and workplace) to care for and rehabilitate people with mental/psychiatric problems so that they can live life to the fullest possible.


location: , 'Thailand year: 2023 source: HSRI

title: Evaluation of SASUK OON-CHAI, a Supportive Process for Organizational Health Literacy Improvement for Government Health Care Units

abstract: Organizational health literacy [OHL] helps health care organizations achieve high-quality, efficient, and meaningful care to service users, called health literate health care organizations [HLO]. OHL is defined by the Institute of Medicine as “the degree to which an organization implements policies, practices, and systems that make it easier for people to navigate, understand, and use information and its services to take care of their health.” As OHL was a new term in Thailand, there were needs to raise awareness and promote OHL practices at governmental health care organizations. This study was to evaluate the effect of “SASUK OON-CHAI”, a supportive web-based processes for OHL at governmental health care organizations under the Ministry of Public Health. The supportive processes were initiated by the Division of Health Literacy and Health Communication, Department of Health. An evaluative study design was employed to investigate the effects of SASUK OON-CHAI on OHL of governmental health care organizations that registered to participate in interactive online monthly meetings (group 1) and compared with organizations voluntarily chose to self-study the OHL (group 2). The OHL practices were reflected by the staff and service users before and after each health care organization developed and submitted their development plans. The percentages of staff and service users who perceived the OHL practices were compared between the pre-test and post-test using the Wilcoxon signed rank test, and between the two groups using the Mann-Whitney U test. The significance level is .05. Cohen’s D was calculated to indicate the effect size. Results: 455 organizations assessed their OHL practices at least twice with a minimum time interval of one month and their OHL practices were used for the evaluation. 248 chose to participate in the interactive online monthly meetings and 207 chose to self-study. There were statistically significant improvements in the OHL practices of both groups with a small effect size [group 1: pre-test 95.47%, SD = 5.99, post-test 96.95%, SD = 5.51, p = 0.000; group 2: pre-test 96.61%, SD = 6.77, post-test 97.83%, SD = 4.01, p = 0.002). At the pre-test, group 1 had a significantly lower percentage of the OHL practices (p = 0.000), but at the post-test, this percentage was not statistically different from that of group 2 (p = 0.139). Conclusion: Either OHL practices by registering in SASUK OON-CHAI and participating monthly online meetings or self-studying the OHL practices helped improve OHL.


location: , 'Thailand year: 2015 source: HSRI

title: Cost-effectiveness of thrombolysis service for patient with ST segment elevation myocardial infarction in primary care hospital

abstract: ST segment elevation myocardial infarction (STEMI) is a major cause of death. Recent evidences showed that primary percutaneous coronary intervention (PPCI) can reduce mortality rate. However, in a situation where PPCI is unavailable, facilitated percutaneous coronary intervention (FPCI) using fibrinolytic drug before patient referral could be an important life-saving solution. Since FPCI may increase the risk of major bleeding and it incurred more expenditure, the information on cost-effectiveness of FPCI is useful for policy makers.
A Markov model was used to compare the lifetime cost and quality-adjusted life years (QALYs) accrued to patients receiving FPCI before referral or PPCI at referral center from societal and health system perspective. All analyses were performed using Microsoft Excel. Input data were retrieved from literatures and electronic databases.
We found that FPCI program at community hospital is a dominant alternative given its lower cost and higher effectiveness than PPCI at referral center. This means it is a cost-effective policy option.
Therefore, community hospitals with the capacity to provide FPCI service for STEMI patients should be supported to offer such service for better access to the patients with higher overall quality of life and lower costs to the systems. We suggest that policy makers in the Ministry of Public Health and the hospital administrators should consider these findings and provide support to make FPCI available in community hospitals with existing capacity. Capacity strengthening particularly in terms of manpower, and budget should be provided especially in the areas where there is still shortage of supply.


location: , 'Thailand year: 2018 source: HSRI

title: Future Employment Modalities for doctors, dentists, pharmacists, and nurses in Public Sectors in Thailand in the next 15 years

abstract: At present, the Royal Thai Government tends to instigate policies to downsize civil servant posts with a purpose to reduce its budget burden and increase system flexibility and efficiency. These policies affect not only supporting/administrative health staff, but also the health professionals themselves, including doctors, dentists, pharmacists and nurses. The objective of this study is to explore the current situation and types of employment for the Thai health personnel under the Office of Permanent Secretary of the Ministry of Public Health (MOPH). Cross-sectional mixed-method design was used. Data collection techniques comprised document reviews, indepth individual interviews with policy makers and health personnel users, and group interviews with, and self-administrative questionnaire survey on, health personnel. The interview questions focused on advantages, disadvantages, and recommendations for each employment type. The study also included analysis on health personnel retention and budget implication for paying salary to doctors, dentists, pharmacists and nurses in the next 15 years. The results revealed that according to policy makers’ and health personnel users’ perspectives, hiring health personnel as civil servants faced a number of constraints, including rigid bureaucracy and inflexibility in adjusting personnel’s positions to match their expertise. Yet civil servant posts should continue in certain functions, for instance, those dealing with legal issues and authoritative work. From the views of health personnel, civil servant employment is a crucial determinant in making them retain in the public sector because of work security and attractive benefits, especially treatment benefit for themselves and their family members. In the future, there should not be too many employment alternatives. If new civil servant posts are not available, the replaced employement choices should guarantee increased startup salary and additional benefits that are not inferior to the regular benefits for civil servants. Overall, the design of employment benefits should minimize discrepancy and inequity between employment types and between professionals. The MOPH should shift its role from being health care providers to being health policy regulators. Local health facilities should have more flexibility in designing employment benefits that suit their own staff while engaging local administrative authorities since the inception stage of the design. Besides, there should be mechanisms that provide opportunities for younger generations of health care providers to design and choose their employment benefits that fit their need before entering the labor force.


location: , 'Thailand year: 2009 source: HSRI

title: Alcohol Consumption Behavior and Husbands's Violent Acts against their Wives

abstract: This research is a matched case-control study, the objective of which was to determine the association
between couples’ alcohol consumption and the violence of husbands against their wives, in Khon
Kaen Province. A structured interview questionnaire was used to elicit data from 47 women attending the
One- Stop Crisis Center of Khon Kaen Hospital, who experienced violence at the hand of their drinking
husbands. Ninety-four married women living in the same neighborhood and in the same age group
served as controls. The results revealed that non-drinking wives whose husbands drank alcohol and
drinking wives and husbands were of risk of spousal violence (4.27 times (adjusted OR=4.27, 95%CI=1.10-
16.62) and 8.55 times (adjusted OR=8.55, 95%CI=1.75-41.90) respectively), compared with non-drinking
couples. Drinking more than five glasses (adjusted OR=4.17, 95%CI=1.14-15.28) and substance abuse
(adjusted OR=3.97, 95%CI=1.04-15.07) were also significantly associated with spousal violence.
In conclusion, alcohol consumption is an important activating factor in spousal violence.


location: , 'Thailand year: 2020 source: HSRI

title: Proposed Policy for health management of older persons with Diabetes and Hypertension using health literacy in Primary Care Cluster context: Case study in PCC, Phetchaburi province

abstract: The development of guideline for health management of the older people with diabetes and hypertension based on health literacy model in the context of Primary Care Cluster (PCC) plays a vital activity for effective control of A1c and blood pressure (BP) levels to decrease or retard the complication occurrence. Currently, there is no approach for promotion of the older people’s health literacy with family participation in health management despite the fact that the family’s role in providing helping and supports in every stage of self-management suits in a Thai context. The primary objective of this study was to examine health management situation of the older people with diabetic and hypertension in the context of PCC ; to develop the survey instrument for assessment the health literacy in health management of the older people with diabetic and hypertension patients in the context of PCC; to assess the effectiveness of health literacy program in health management of the older people with diabetic and hypertension in the context of PCC; and to develop policy recommendations on health literacy in health management of the older people with diabetic and hypertension The sample consists of 140 early older people and stakeholders in PCC. The quantitative and qualitative methods were conducted in this study. Questionnaires and in-depth interviews were used for data collection. The results were founded as follows: 1) The health management mean scores in the older people with diabetes and hypertension was moderate level (x ̅= 2.15). The aspect with the highest mean score was ‘Continuing care’ (x ̅= 2.53), following by aspects with a moderate level of mean score, namely, ‘Stress management’ (x ̅= 2.22), ‘Drug use pattern’ (x ̅= 2.13) and ‘Food consumption behavior’ (x ̅= 2.12). The ‘Exercise’ is the aspect with the lowest mean score (x ̅= 2.01) 2) With regard to health literacy in health management of the older people with diabetes and hypertension in the context of PCC, the overall of health literacy level was found to be insufficient at 52.72% (n= 78) and sufficient at 44.28% (n= 62), respectively. 3) Regarding the effectiveness of health literacy program in health management of the older people with diabetic and hypertension in the context of PCC, the average A1c in the experimental group was lower than the control group with statistically significant differences (p < 0.01). The average systolic blood pressure (SBP) of the experimental group was lower than the control group with statistically significant differences (p < 0.001). Likewise, health management mean scores of the experimental group were higher than the control group with statistically significant differences (p < 0.001). With regard to the health literacy, there were statistically significant differences between the intervention and control groups (p < 0.001).Concerning, the average of A1c, systolic and diastolic blood pressure, as well as health management and health literacy mean scores were significantly higher than before receiving the program at statistic significant level of p < 0.001. Indeed, the average A1c and systolic and diastolic blood pressure was decreased by 7.20%, 16.46% and 18.03%, respectively. In addition, the health management and health literacy means scores were increased by 4.80% and 7.20%, respectively.4) With respect to policy recommendations on health literacy in health management of the older people with diabetes and hypertension, the PCC should enhance family members’ role in providing support and care as well as supervision to older people considering food consumption, exercise and more engagement with physical activities, drug use, stress management and continual self-care. This will eventually enable the older people and his/her family to manage diabetes and hypertension or possible complications.


location: , 'Thailand year: 2007 source: HSRI

title: Study on hospital food safety network

abstract: This qualitative research aimed to study hospital food safety development and network, food safety development process, success factors supportive to hospital food safety as well as constraints.  The study was done at 4 food safety model hospitals of Department of Health Service Support, Ministry of Pubic Health; Chiang Rai Prachanukrao, Khon Kaen, Ratchaburi and Songkla hospitals.  Key informants were hospital administrators, nutritionist, multidiscipline health team, support groups from within and outside hospitals.  Data collection used interview, observation, focus group discussion and evidence-based document review, for systematically explaining and synthesizing phenomena.
The study results found all of the four hospitals were tertiary care service level while having 480-1000 beds with food service delivery 500-1000 persons per day.  The Nutrition Department of each hospital produced and managed food services for general, special, case-specific and tube-liquid meal patients.  The food was also serviced for hospital staff, patients’ relative general visitors by the hospital food outlet welfare unit.
For development on hospital food safety policy, this was originated from the hospital accreditation policy while later in 2004 the Thai Government announced to be one of the national development agendas.  The Ministry of Public Health by Department of Health Service Support has launched the food safety pilot project at 4 hospitals, and therefore initiated many model development activities while integrating the food safety with other health care activities.
For the key aim of development of hospital food safety, it found that the hospitals wanted their food service being clean and safe for their customers and staff.  Also, they wished to build customers’ capacity in selection of buying a safe food, to advocate the hospital food service out let to produce hygiene food, and to encourage hospital staff being a good health behavior model and to extend the food safety to other institutions and communities.
For the development of hospital food safety process, this found all hospitals has established the food safety committee and taskforce while being the key human resources who developed food safety model and activity both within and outside hospital.  The activities were firstly finding safe raw materials by incorporating with provincial and district agricultural and poultry offices.  They also explored source and product network as well as coordinator for producing and transporting raw materials to the hospitals.  Development of hospital food safety standard applied the food sanitation standard of Ministry of Public Health 30 items with additional assigned criterion made by the committee and taskforce.  Surveillance was made on raw material contamination, cooked food and utensils, and catering food to the wards.  Follow-up and evaluation was made by sampling food for investigation for health hazard and harmful.  Development and extending food safety network, the hospitals have expanded to other settings, i.e., food safety farmer group, coordinating and technical support network, hospital weekend food market network, food safety hospital network, school network, prison network, monastery and hospital food outlet network.  The development of these network applied participatory process with brainstorming in problem search, co-implementation, organizing knowledge building event for the network.  Also, the hospitals have learnt with the network, done followed-up and evaluation as well as made network visits.
For the supportive factors which leading to the success, these were development and policy translation activities; 1) food safety policy of Ministry of Public Health and province, hospital health service quality policy, the hospitals translated these policy directly and indirectly to committee and taskforce for policy implementation, 2) support of the hospital administrators while all prioritized and provided various resource to the committee and taskforce, 4) clear assignment and support of team work oriented, each hospital clearly appointed the committee and taskforce, which consisted of health team representing from each hospital department with a clear division of job responsibility, 4) resource allocation, the hospital administrators have provided financial support for office and building space set-up for proactive activities to both within and outside hospitals, 5) modification of system and method in support of hospital food safety, which were modifying purchasing procedure, opened system by encouraging the farmer group together with responsible hospital staff setting the price of product, food menu adjustment in line with the raw material availability as well as local vegetable and seasonal fruits, 6) building motivation force, the hospital administrators admired and appraised the hospital food safety team at the hospital meeting, general public and reward, beside the hospitals presented the “Food Safety” and “Clean Food Good Taste” banners to the networks that could pass the hospital food safety assessment criteria, 7) team strength, it found that the core team played a critical role contributing to the project success, the team was at high leadership, continuous and proactive, intentional, devoted, organization beloved, consultation and exchanged ideas even now no new policy and financial support from the central government.
For supportive factors which arisen from outside hospital; these were local policy, provincial food safety and consumer protection policy and collaboration of other agencies.  The limiting factors to the hospital food safety were 1) raw materials produced by local farmers did not meet the hospital demand and listed even the hospital tried to adjust the menu suited to the raw product availability, the remote network lacked of management competency and hardship of transporting raw materials to the hospitals, 2) discontinuous of central policy and financial support, 3) lack of suitable performance indicator used for assessment of the project as well as lack of knowledge on systematic evaluation, 4) implementation by sectoral government agencies could not done in a full integration manner, and 5) the administrators failed to pay attention to the hospital food safety program.
The overall outcome arisen from the hospital food safety program which found mass advocacy to the development of food safety movement within and outside hospital.  These were; origination of many safe food producers supplying to the hospital and increased farmer income, the hospital food service were safe and satisfied by the customers and hospital staff, the hospital adjusted its menu fitted to local seasonal raw product and availability, the food handlers changed their process for hygienic and safe food, advocacy to the emergence on development of food safety in community hospital, school, prison and monastery, and collaboration encouragement between the hospital and local institutions for the development of safe food for consumers.


location: , 'Thailand year: 2019 source: HSRI

title: Situation analysis in providing education services and health promotion and disease promotion activities in schools for   migrant children in Thailand: A case study of Ranong province

abstract: Quality of life of migrants has gained increased attention in the last decade, especially amongst those with vulnerability, such as migrant children. Despite continuous efforts from the Thai government to expand education services to all children on the Thai soil, some migrant children are still left uneducated. Exemplary barriers to education services are miscommunication of national policies, implementation hardship, and problematic attitudes of parents of migrant children. The establishment of ‘Migrants Learning Centers’ (MLCs) in migrant communities helped increase access to education for children of migrants, however, the academic quality remains questionable and hygienic statusin MLCsis still below standard. All in all, this study aims to analyse current education and school health promotion services provided for migrant children through a case study of Ranong province. The objectives of this study are: 1.to assess and understand the management of education services provided for migrant children, 2.to assess and understand the school health promotion services provided for migrant children, 3.to evaluate migrant children’s academic performances, 4.to evaluatenutritional status and hygienic behaviour of migrant children, and 5 to exploreperspectives of parents of migrant children on the access to education and health promotion services. The researchers applied a parallel mixed method design. Objectives 1, 2 and 5 used in-depth interviews with policy makers, service providers, and parents of migrant children. Objective 2 used observation and school health policy checklist as the main data collection tools. Objective 3 used secondary data on student attrition rate. Questionnaire survey was used in objective 4. The study revealed that migrant children did not face serious hurdle inenteringthe Thai public schools. This observation coincided with the government policy that provided per-headcount financial subsidy to schools according to the number of admitted migrant children in the same amount as Thai children. Parents’ intention was a key determinant influencing school enrolment. Parents with the intention to permanently reside in Thailand tended to choose Thai public schools, whereas parents who sent their children to MLCs were more lineated to return to their home country some time in the future. Even though the Thai public schools opened rooms for free education services to migrant children, MLCs seemed to fit the preference of migrants in several angles, such as the provision of curricula currently used in Myanmar, the use of Burmese language in classes, and more importantly, the offering of opportunities for children to continue their education in Myanmar schools or universities (in some MLCs). These features attracted parents’significantly as evidenced by the fact that the number of migrant children in MLCs was almost three times as large as those in Thai publicschools. Nonetheless, many MLCs were facing operational problems. These included non-standardised curricula, limited staffcapacities, insufficient budget, shortage of school lunch and milk for children, and lack of school health surveillance. Besides, some MLCs were operating in poor hygiene environment. Currently, there wasclear official regulatory agency on MLCs and the academic degrees between the two countries (Thailand and Myanmar) remained unlinked.


location: , 'Thailand year: 2013 source: HSRI

title: Institutional capacity of the Civil Servant Medical Benefit Scheme in regulating contracted private hospitals

abstract: The Civil Servant Medical Benefit Scheme has expanded its benefit by poviding access to 77 elective
surgeries in contracted private hospitals since May 2011. This study aimed to assess institutional capacity
of the Civil Servant Medical Benefit Scheme (CSMBS) in regulating contracted private hospitals. Issues of
assessment included system design, factors influencing effectiveness of the regulation, and implementation
of the policy in regard to provider’s responses and medical record audit. We conducted in-depth
interviews with key stakeholders and analyzed medical record audit reports. Content analysis and descriptive
statistic were employed in the analysis.
Results show that the policy aims to increase choices of access and reduce waiting time for elective
surgeries among CSMBS beneficiaries. Moreover, the policy will increase level of patients’ satisfaction
while costs of the scheme remain contained. The policy was carefully designed in order to prevent fraud,
inappropriate care, and protect consumer’s right. Minimal standard regquirement of enrolled hospitals
was set including authorization process, and information needed for claim submission. However, limited
institutional capacity of the Comptroller General’s Department under the Ministry of Finance who manages
the scheme remained a major constraint in policy implementation; moreover, errors coding of diagnosis
and procedure was urgently needed for improvement before scaling up the program.


location: , 'Thailand year: 2009 source: HSRI

title: Farmers’ Expectation Concerning Sustainable Occupation for Agricultural Development : Health Aspects

abstract: This research studied the expectation of agriculturists who had to build a sustainable occupation for agricultural development that would protect natural resources and the environment, decrease the adverse effects of chemicals and produce safe food and a happy social condition, among other positive outcomes. It studied personal factors, the economy, and social aspects, compared with the expectation of sustainable development. The sample comprised 240 persons who were interviewed in order to collect data. The statistics were analyzed by percentage value, average, standard deviation, t-test, and one-way ANOVA.
The study results found that most of the sampled household heads were males, aged 41 to 50 years, with a primary education, lacking social position, living in their village for more than 5 years, and had been trained in agriculture by their parents. Farm size was 11-20 rais, family farm labor averaged 9 persons, the individuals had a yearly income of 50,000 - 99,999 baht, household expenses of 10,000 - 19,999 baht per year, made occupational investments of 20,000 - 40,001 baht per year, and were likely to be members of an agricultural group.
Their expectations with regard to technology transfer, community business development for production, processing and marketing, plant and animal breeding modification were at a moderate level. However, those expectations with regard to technology support, soil, water and environmental resource development were at a high level. As for problems, operational guidelines and suggestions, the respondents
revealed that there were many problems, such as the quality of soil, lack of rain and irrigation, plant and animal breeds, organic fertilizer, labor, knowledge of breed selection, products, markets, investment and governmental support. Agricultural institutes played only a minor role in agricultural occupation development. It was suggested that group members be allowed to participate, to submit their opinions, to plan and to make decisions.


location: , 'Thailand year: 2013 source: HSRI

title: The management of health insurance system for people with citizenship problems-a case study of Ranong province

abstract: This study aimed to assess the management and the operation of health facilities under ”Health
Insurance Policy for People with Citizenship Problems, the Cabinet Resoluion on 23rd March 2013“, which
enabled the target population to have better access to essential health services, through a case study in
Ranong province. Qualitative methods: in-depth interviews, group interviews, observations and document
reviews, were applied. Thematic analysis was employed for data analysis. The results revealed that, before 23rd March 2013, healthcare services were provided for people with
citizenship problems through “Health Card for Displaced Persons”. After the policy was implemeted, the
province set up its own managerial systems by allocating a due proportion of the budget for disease
prevention and health promotion activities, specifying the amount remibursed to be varied by the quantity
of services at the facilities, and encouraging proactive works through “Alien Health Officers” and
“Alien Health Volunteers”. Yet, in practice, there remained problems, e.g., communication insufficiency,
limitation in budget use, failure in registering populations who ever held the health card, and lack of
technical supports in legal academia.
In conclusion, though local mechanism for operating the policy is devised, its effectiveness should
be leveraged through several measures: expanding population coverage in concordnace to their actual
residence, increasing legal knowledge support, elucidating the budget regulation, and endorsing regular
monitoring systems. However, this study still holds some limitations, e.g. a sole approach through providers’
perspectives. Further studies are recommnded to explore the possibilities in developing recommendations
to a real practice.


location: , 'Thailand year: 2008 source: HSRI

title: Self-protective behaviors against drinking alcohol among students in Kanchanaburi Technical college

abstract: Protective behaviors against alcohol drinking were studied in 346 students in
Kanchanaburi Technical College; the studied group was recruited by stratified random
sampling technique. Information was collected by constructed questionnaires and the
data were analyzed by means of percentage, mean, standard deviation, t-test, one-way
ANOVA and stepwise multiple regression analysis. The findings were as follows: social
support and protective behaviors against alcohol drinking were at a moderate level. Selfesteem
and self-awareness concerning the drinking of alcohol were at a high level. Protective
behaviors against drinking alcohol among students with different educational level,
grade point average and alcohol-drinking behavior in their family were significantly different
at the statistical level of 0.05. Social support and self-awareness about drinking
alcohol could predict the protective behaviors against drinking alcohol among students
in 11.3 percent of the cases, with the statistically significant level being 0.05.


location: , 'Thailand year: 2008 source: HSRI

title: A study on costs of social, health and economic consequences of alcohol consumption in Thailand

abstract: This study aims to provide estimate of the economic costs of alcohol consumption in Thailand
2006. It is prevalence-based (i.e. estimate the economic costs of alcohol associated with the past and
current use in the given year, 2006), using the cost-of-illness methodology. Human capital approach
is employed in estimating cost of productivity loss due to premature mortality. The estimated cost in
this study represents the gross cost, in which only the costs associated with negative effects of alcohol
consumption has been estimated.
Both direct cost and indirect cost are included in the estimation. Direct cost includes health
care cost, law enforcement and criminal justice cost, and cost of property loss due to traffic accident
while indirect consists of cost of productivity loss due to premature mortality and cost of reduced
productivity from absenteeism and presenteeism.
According to this study, alcohol consumption costs 156,105 Million Baht or 1.99% of Gross
Domestic Product (GDP), resulting in approximately 2,391 Baht per capita. Indirect cost outweighs the
direct cost, representing 95.8 % of the total cost. The largest cost attributable to alcohol consumption
is cost of productivity loss due to premature mortality (104,128 Million Baht, accounted for 65.7% of
total cost), followed by cost of productivity loss due to reduced productivity (45,464.6 Million Baht,
accounted for 30.1% of total cost), health care cost (5,491.1 Million Baht, accounted for 3.5% of total
cost), cost of property damage due to road traffic accident (779 Million Baht, accounted for 0.5% of
total cost), and cost of laws enforcement and criminal justice (242 Million Baht, accounted for 0.2%
of total cost), which consisted of court cost (156 Million Baht) and police cost (86 Million Baht.),
respectively.
In Thailand 2006, it was found that there were 3,029,427 patients attributable to alcohol
consumption. Of these amounts, 2,675,513 were male while 353,914 were female. When looking at
the number of hospitalization due to alcohol consumption, it was found that there were 218,799
admissions attributable to alcohol. Of this amount, 168,549 hospitalizations were from male while
50,250 were from female. The 5 leading causes of health care cost are road traffic accident (approx.
1,232 Million Baht), HIV/AIDS (approx. 1,088 Million Baht), alcohol abuse (approx. 574 Million Baht),
epilepsy (approx. 537 Million Baht), and alcohol dependence (approx. 430 Million Baht), respectively.
Regarding the cost of productivity loss, it was found that there were 39,459 deaths attributable
to alcohol consumption in Thailand 2006. Of these amount, 33,493 were male, while 5,966 were
female, resulting in the total number of years of life lost due to premature mortality of 1,390,899 years
(male 1,164,551 years, female 226,348 years) Among male, the 3 leading causes of productivity loss
due to premature death were HIV/AIDS (approx. 36,277 millions Baht, 10,204 deaths), traffic
accidents (approx. 26,989 millions Baht, 8,460 deaths), and cirrhosis (approx. 13,044 5,147 deaths), respectively. On the other hand, the 3 leading causes of productivity loss due to
premature death among female are HIV/AIDS (approx. 3,580 millions Baht, 1,877 deaths), traffic
accident (approx. 2,796 millions Baht, 1,848 deaths), and liver cancer (approx 706 millions Baht, 868
death), respectively. In addition, it was found that the cost of productivity loss was highest among
those who were 30-44 years old (13,622 deaths resulting in 49,827 millions Baht) followed by those
who were 15-29 years old (7,275 deaths resulting in 25,912 millions Baht), respectively.
Although this is the current best estimate for Thailand it should be interpret along with the
results of the sensitivity analyses. According to the sensitivity analyses, economic cost of alcohol
consumption ranges between 126,311 to 214,053 millions Baht depending on methodology and value
of parameters employed in the estimation. The result from sensitivity analyses found that the choice of
discount rates makes a considerable difference to the total estimated of economic cost of alcohol,
while the method used in estimating cost of reduced productivity due to absenteeism and presenteeism,
and the inclusion of cost of premature mortality among non-working population have medium effect
to the total estimated cost. On the other hand, proportion of alcohol attributable to road traffic accident
and inclusion of health benefits form alcohol consumption have only minor effect on the total
estimated cost.
This study revealed that direct cost associated with alcohol consumption in term of health
care cost, cost of laws enforcement, and cost of property damage was estimated at 6, 512 Million Baht
or accounted for about 0.1% of Gross Domestic Product (GDP). However, alcohol consumption also
led to the indirect cost in terms of productivity loss due to premature mortality and reduced productivity
which cost approximately 150,000 Million Baht. According to the statistics from Excise Department,
the excise tax generated from alcohol beverage in 2006 was 72,871 Millions Baht or accounted
for 0.93% of GDP. Based on these findings, the Thai government needs to pay more attention to the
implementation of more effective alcohol policies aimed at reducing alcohol consumption and harms
associated with alcohol, including tax policies or other related policies while balancing between
revenues and costs generated from alcohol.
millions Baht,


location: , 'Thailand year: 2005 source: HSRI

title: Management of drinking water system to reduce arsenic contamination using membrane technology

abstract: A mobile membrane filtration unit was installed for 3 months at Moo 2, in Ronpiboon
District, Amphur Ronpiboon, Na-korn-sri-tham-ma-rat Province, from January to March,
2005. It was to produce arsenic free drinking water, serving 550 families in the area. The unit
comprises of 2.2 kW pump, 1 microfiltration unit (0.5µm), and 1 nanofiltration membrane of
4x40 inch. made from polyamide thin film composite. Water supply for the unit was from
rain water reservoir at the Ron-Na Mountain nearby the district through pipeline system. It
was found that arsenic level in the pipeline water gradually increased from 0.10 to 0.16 ppm.
during the period and water pH was between 4.5-5.2, slightly lower than the accepted level
(6.5-8.5). However, no water treatment was made, except caution was taken during rainy
season, due to some fine sand being flushed into the pipeline system.
 The filtration system produced arsenic free (<0.01 ppm) drinking water at 208 L/h at
the beginning and gradually declined to 198 L/h and the end of the project. The decline of the
production rate indicated some fouling on the membrane. After 2 hour washing, the
production rate was resumed. About 10,000 L of drinking water was produced, which was
rather small compared to the number of families. Questionnaires collected by an NGO in the
area revealed that only 34.6% out of 283 families utilized the water. The major problem was
the distance and most families well prepared during the year by having sufficient water
reserves. However, under water shortage only 42% consumed commercial water. Some
families obtained reserved rain water from their neighbors and others still used water directly
from the pipelines, due to poverty. On 0.50 Baht/L bases, this community spent about 11,000
Baht/mth for house-whole use and 97.5% of the questionnaires preferred to own a filtration
system for community health reason. The estimated cost of drinking water was 0.15 Baht/L,
assuming 10 hour operationg/day at 100 Baht/day wage. This was based on 5 day work/week
in 52 weeks/year.
 This community seemed to be alert on health quality and management. There is SubDistrict Committee meeting monthly, where problems can be raised and solved. It is envisaged
that if the community reaches some support from District Committee, clean drinking water
should be available sufficiently for everyday consumption. Towards the ending of this
project, the sub-district community leader in Moo 2 has sent in a request of 200,000 Baht to
the District Committee for a community drinking water unit. This, in return, an amount of
money will circulate in the community, which should benefit finally to everyone under good
management.


location: , 'Thailand year: 2005 source: HSRI

title: Health information radio and television media for the public

abstract: The research “Health Information Radio and Television Media for the Public” is conducted to monitor and analyse radio and television programmes that have health elements for Thais in them. The emphasis is on the Heath programme. The study was started by a survey of the whole layout of the station to analyse proportion of its content. After that sample programmes are picked up to be studied in details about the process of producing a health programme for radio/television. The study focuses on asking producers, in this research we would like to call “Health Communicator”, about their challenges and recommendations.	To make the analysis more comprehensive, the team refers to base line data about the structure of radio and television media in Thailand and followed by interviewing managers who direct and manage the stations which are both owned by government and private, in order to illustrate the policy towards producing a health programme.   	In summary, the research will study the lay-out; study the structure of the media and health programmes and interview health communicators. The outcome will be a linked analysis that shows the whole picture of the broadcasting of health programmes through radio and televisions, particularly about challenges and recommendations that will lead to more studies or policy proposals to the state and the public such as the facilitation of health database and information for health communicators whose majority come from journalism not health background. The open channel that health communicators can access and exchange information with health agencies in both state and private sectors will give a great benefit to producers of these health programmes. Other important recommendations are Change of the government policy on mass communication of health information that will lead to full dissemination of health information to the public. The state should set a policy of supporting producers of health policy and establishing public service media or community media that focus on free service to the public so producers can have freedom in creating programmes while the public gain benefit. In the current situation, media producers face a problem of depending on income from sponsors that lead to hidden promotion of goods and service which control contents of the programme.By giving priority to non-profit programmes made for public service and supporting medium and small producers in gaining an easier access and sponsor will create better and more “health communicators” who will communicate information, knowledge, fact in lively format to the public than the present environment.


location: , 'Thailand year: 2004 source: HSRI

title: Biosafety Law

abstract: Modern biotechnology has developed to a very high extent, nowadays.  It was widely used in many fields of practices, such as medicine, agriculture, or environment.  This technology has assisted in creating many innovative creations, e.g., various kinds of genetically modified organisms (GMOs), especially GM plants, for example, herbicide-resistant and pest-resistant plants.  The advancement of biotechnology in terms of producing genetically modified organisms has been a subject of concern of the Convention on Biological Diversity, which Thailand is one of its members.  Article 8 (g) of the Convention stipulates that there shall be a means to regulate, manage or control the risks associated with the use and release of living modified organisms resulting from biotechnology which are likely to have adverse environmental impacts that could affect the conservation and sustainable use of biological diversity, taking also into account the risks to human health.  In this respect, Thailand has not yet had a particular legal instrument to regulate living modified or genetically modified organisms, whereas on the international level there has been an establishment of the Cartagena Protocol on Biosafety to oversee aspects under Article 8(g) of the CBD, and many countries, such as the USA, European Union, and Australia have already enacted laws that govern biosafety issues.  Thailand, therefore, is on the way of utilizing those existing laws as models or patterns to establish the law on biosafety of the country.


location: , 'Thailand year: 2001 source: HSRI

title: The evaluation of the allowance for the elderly

abstract: The evaluate of the allowance for the elderly	The study of structure of the subsistence allowance for the elderly has the purpose that to evaluate the execution of welfare service for the elderly in the allowance project including the study the problems in the past in qualitative and justice in the society and seeking the guideline to development the desirable pattern of the allowance projects in the future. 	The method of study is the qualitative by interviewing the relevant groups i.e. the elderly who are allowance recipients and non-recipients, family members of the who are allowance recipients and non-recipients elderly including the committees of allowance recipient selection in the village (committee of the village welfare assistance center) and the responsible persons of the allowance in the provincial public assistance. That is the data collection together with the quantitative data collection from the exemplars of 360 persons in 9 provinces (19 districts) i.e. Chiang Mai, Tak, Nakorn Ratchasima, Nong Bualumpu, Phra Nakorn Sri Ayudhya, Trad, Nakorn Srithamarat, Satun, and Nakorn Pathom, by analyzing the data in description with the statistics.	The project of allowance has been paid interested highly as the government is trying to change the pattern of services from the institutional case to the deinstitutional care and make an effort to have the community participate in solving the community’s problems with the concept community-based. The project of allowance has started since the year 1993 under the responsibility of the Department of public assistance with the budget yearly not less than 1,440 Baht for 400,000 persons of the elderly by selecting the poor relatives without relatives and supporters from village 5 persons qualified to receive the allowance. The results of the study are as following.1. the elderly recipients of the allowance can be classified into 3  categories as below1.1 the poor elderly but looked after by descendants, not left lonely, still supported by the family, living at the center of the village. Moreover, the relationship with the village committee They are the group that received the allowance the highest. 	1.2 the elderly with the descendants, not so miserable with  the middle-class income, mostly are close relatives  of the village committee or the head of the village. This group will get the allowance high next            1.3 the poor elderly, miserable without relatives or descendants who left to work elsewhere, mostly living alone by themselves far away from the village center, not participating in the activities of the village, sometimes  looked after by others who sympathized them , mostly will  not receive any social welfare service. As they are regarded as  the “peripheral group” in the community, they will  get the allowance the least	2 the concept of management of the allowance to arranging the allowance for the community is community-based by decentralizing so the community can cope with their own problems, but in the practice it is found out that it lacks the effort in encouraging the real participation of the community. Even the elderly as the residents in the community do not participate in deciding, assessing the   problems of the community by themselves. Therefore,  the village welfare assistance centers  with an aim to considering the allocation of allowance has been established in quantity, lacking the methods to develop, strengthen the centers as the operation of most of the centers is regarded as the additional task, lacking the monitoring and assessment of the problems.	3. the thought in its operation is still based on individual affairs as it is arranged to the poor elderly in the residual welfare model only. However, in the real operation it is not decentralized to the target groups thoroughly. The rules in selection of the elderly still lacks the standard, fairness, and the consideration based on the principle of means-test  	4. the authority’s mind is still attached to the patronage system. The providing the allowance  is unduly considered based personally on intimacy, the intention to expand political power.  While the selection process lacks the investigation, monitoring, the consciousness building of welfare among the selection committee. The unfair allocation of social resources will cause the conflict rather than the stability in the community.	5. the problems of disembursement of the allowance, caused from the unfair process of allowance management i.e.the amount and the period of providing the allowance not regularly counted. The reduction of the allowance as the transportation fee in traveling to get the allowance payment, the lack of knowledge in opening the deposit account at the bank in one’s own names, causing them unable to check the account books by themselves and protect themselves. The lack of the assessment and investigation about the fairness and transparency of  its operation and the support of information system can be raised as the reasons.	6. the accomplishment of diffusion and expansion of service of the elderly i.e. increasing the number of the allowance recipients has been counted in quantity rather than the quality. Even though, the poor elderly still cannot benefit from this increasing  number of allowance recipients   	7. the satisfaction  the elderly are satisfied with the allowance even the amount of the allowance is not enough for their real living. For the real poor elderly, they feel as they have been more socially guaranteed, credited with dignity. The such amount of allowance can respond to their social value, belief and culture as well. 	8. the appropriateness and justice   the welfare allowance is provided in form of the diffused payment as the temporary assistance. Meanwhile, it is used in continuation, cannot fix the period, has no guarantee in the expenditure plan. Moreover, most of the target groups who receiving the allowance are not so qualified, thus this project cannot serve well to solving the social injustice.	9.the participation in operation  it still lacks the process of seeking and mobilizing the participation to help all levels of its operation, including the promotion of welfare consciousness among the concerned persons, that discouraging and weakening the dedicating spirit for the community	10. the self-reliance and sustainability of the project   the pattern of the welfare service cannot sustainably empower and strengthen the elderly for long, as it function as the public assistance only, lacking the reinforcing process or pattern of coordinating  with other organizations, that does not result the desirable self-reliance. Moreover, as the welfare service of public assistance is conducted individually based, it will encourage the individualism rather than complement to the collectivism or communality


location: , 'Thailand year: 2015 source: HSRI

title: Albumin Glycation for Diabetes Mellitus Monitoring

abstract: Measuring combination of blood sugar and glycated hemoglobin (HbA1c) is a way to monitor the diabetes progression. However, HbA1c level in the red blood cell keeps constant during its life cycle (120 days), which is somehow too long to be monitored in severe cases. In addition, in condition effecting red blood cell structure or hemoglobin production (hemolytic anemia, thalassemia, and etc.), HbA1c level can be unreliable. Therefore, monitoring the intermediate indicator outside the red blood cell could improve the way to control diabetes progression and treatment.
	The percentage of GHSA in normal serum is 0.6-3.0% whereas in diabetic patient serum has been found to be 2-5 folds higher than normal level. It has become clear that GHSA can be a marker of intermediate glycation and also a causative agent of the damage of diabetes complications, such as atherosclerosis, coronary artery disease and kidney failure. GHSA testing has been strongly recommended for monitor glycemic control for diabetes mellitus in hemodialysis patient and a test for complications associated with diabetes, which can also serve as a monthly report card for type 1 diabetes in the USA. Several GHSA detection platforms have been developed, which include enzymatic assay, colorimetric assay, high performance liquid chromatography, affinity chromatography and immunoassay. Enzymatic and chromatography based assay have demonstrated higher %GHSA due to nonspecific enzymes and imprecise of the binding site on the resin bead. The lower %GHSA has been observed in the immunoassay using antibody that specifically bind GHSA however using antibody are high cost and easily to be denatured
This research program are focusing on development of aptasensor platform for detection of glycated albumin for diabetes mellitus detection and monitoring. Three platforms, which are graphene oxide-aptamer, electrochemical and nanopore sensors, have been developed.
Considering the graphene oxide-aptamer approach, the fluorescence aptamer was fluorescence labeled and incubated with the graphene oxide (GO) and fluorescence signal was quenched. The fluorescence signal was recovered in the presence of GHSA protein. We tested the approach with three known proteins, which were GHSA, HSA, and streptavidin. HSA structure is similar as GHSA structure but streptavidin structure is totally different from the GHSA structure. These results indicated that GO-aptamer approach is specific method for in vitro GHSA detection. After optimization of the serum dilution, we investigated LOD of the GO-aptamer approach at serum dilution 1:5000. We found the LOD of 50 µg/ml at serum dilution 1:5000 with the linear correlation between 0.05 µg/ml and 3 µg/ml
For the electrochemical sensor development, the aptamer was coated on carbon electrodes and electrochemical signal was detected when the aptamer bind glycated albumin. By using this approach, we could detect glycated albumin in PBS buffer and also in serum with the LOD of 30 µg/ml
For the nanopore analysis, we have set nanopore measurement and prepared all components for the analysis. Next study, all components will be assembled and the sensitivity and specificity of the system will be tested.
These results demonstrated that our GO-aptamer and electrochemical approach could potentially be used for simple and sensitive detection and monitoring of GHSA in human, which is an intermediate protein marker for diabetes mellitus. Next study, we will do field test for both GO-aptamer and electrochemical approach.


location: , 'Thailand year: 2018 source: HSRI

title: The Development of Health Literacy of Producers Organic Food, Uttaradit Province. (Phase 1)

abstract: The objective of this study was to assess health literacy and case studies of organic producers to evaluated changes in a chemical behavior risk of chemical exposure, and responsibility to consumers in the production and consumption of food from people's organic produce, and develop guidelines for educating changing behavior in order to develop health literacy for organic farmers. The study is an action research and reporting the results in phase 1 of the process and determining guidelines for the development of health intelligence for farmers The study was found that : The average score of health literacy of farmers in the production of agro-based production in basic and interactions at a moderate level, while the level of health literacy was at a low level The relationship of educational level and knowledge of self-protection of farmers is related in the same way both in self-protection. Disagree with the use of pesticide chemicals at statistical significance of 0.00 with better self-protection behaviors with statistically significant at 0.05. The study was related to the health literacy of the farmers producing the form Organic agriculture, which found that farmers with higher education levels had higher health intelligence than statistically significant at 0.00 Chemical use training has a relationship with the knowledge of self-protection of farmers. The group that used to train will have better knowledge with statistically significant significance at 0.00. Training on chemical use has a relationship with the attitude of farmers towards the use of pesticides. With statistical significance at 0.005. The study was related to the self-protection behavior of the farmers on the use of pesticides with statistically significance at 0.001. Training on chemical use had no relationship with literacy Farmers' health in the production of organic agriculture has a negative relationship with Knowledge of self-protection of farmers. The attitude of farmers towards the use of pesticides and chemicals. Health literacy of farmers in organic production with the value of the coefficient p <.01. The revenue is not related to knowledge of self-protection of farmers and health literacy of farmers in organic production and has a very low relationship with farmers' attitudes towards the use of pesticides and self-protection behaviors of farmers where the coefficient p <.01. The factors and the development of literacy building of organic farmers, consisting of social context, beliefs, attitudes, age, knowledge seeking, media training / books, awareness of family benefits and health, learning network Support from government agencies by proposing guidelines for educating and changing behavior to develop health literacy of organic producers. There should be support for knowledge sets and potential development of farmers. According to the type of production Support knowledge and management skills Build quality certification system Government support Establishment of an organic agricultural network at the sub-district level.


location: , 'Thailand year: 2008 source: HSRI

title: Mycobacteriosis avium : report of a case of a patient residing in Nongphai district, Phetchabum province

abstract: Mycobacteriosis avium (MV) is a disease rarely diagnosed in community hospitals.
The diagnosis is very difficult to make because it requires specialists and a laboratory
with full facilities for making a diagnosis of the disease. However, such specialized teams
are usually available only in medical schools. Furthermore, the microbiological examination
necessary takes several months before the results can be reported. In the meantime,
patients would inevitably suffer from the disease and the side-effects of the medication
prescribed, i.e., for a case with a provisional diagnosis of pulmonary tuberculosis.
The patient in this report had suffered from a chronic illness for almost seven years
before receiving treatment as a case of pulmonary tuberculosis based on the common
clinical features of tuberculosis coupled with the results of three consecutively positive
direct smear sputa tests. He subsequently suffered from TB drug toxicity adverse reactions,
including hepatotoxicity, renal toxicity, color blindness, nausea, flatulence, diarrhea,
itching, arthralgia, headache and shock. A correct diagnosis was obtained when he
sought an opinion in several hospitals, with a culture of the mycobacteria revealing the
fact.
This article recounts the true story of a doctor and patient written with the intention
to provide lessons for other physicians and health-care workers that mycobacteriosis avium
ought be one of the differential diagnoses for patients with signs and symptoms similar
to tuberculosis.


location: , 'Thailand year: 2008 source: HSRI

title: Satisfaction with Medical and Public Health Services of the Elderly Attending the Public Health Unit of Pakchong District, Nakhon Ratchasima Province, According to the 2003 Act on Thai Older Persons

abstract: According to the 1997 Constitution of the Kingdom of Thailand, all Thai people’s rights are protected.
Particularly, older adults have the right to access health-care services equally as other populations.
Therefore, the Thai Government passed the 2003 Act on Thai Older Persons as law. The purpose of this
study was to describe the satisfaction of older persons with medical and health-care services, according to
the 2003 Act on Thai Older Persons, as those services relate to the Public Health Unit of Pakchong District,
Nakhon Ratchasima Province regarding disease prevention, medical services, and medical treatment. The
study sample consisted of 200 older persons recruited by cluster random sampling and simple random
sampling from a total of 14,135 older adults in Pakchong District, Nakhon Ratchasima Province. A structured interview was used to collect the data, which were analyzed with descriptive statistics and t- test.
The results revealed that the majority of the sample had a high level of satisfaction with overall
services and with services on disease prevention (3.51-4.50, p = 0.05), while they had a moderate level of
satisfaction with medical services and medical treatment (2.51-3.50, p = 0.05). In addition, non-significant
differences in overall satisfaction with medical and health-care services between males and females, occupation
(government officer/non-government officer), and dwelling location (municipal/non-municipal)
were found.
The results of this study are expected to provide useful information for health-care providers in
improving medical/health-care services for older persons, such as annual dental care service, annual
physical examination, elderly club activities, special-track services, and environmental safety. These services
should be established to serve the needs of older persons fairly according to the goal of the 2003 Act
on Thai Older Persons.


location: , 'Thailand year: 2018 source: HSRI

title: A Model of Participation Health Public Policy Development of Long Term Care Fund for the Elders In E-SAN Communities by Community Participation

abstract: This Research and Development research focused on developing the model of Participation Health Public Policy for the Elderly Care Fund in the community at Northeastern of Thailand (E – San) by community participation process. Data were collected by using both qualitative and quantitative methods including survey, observation, in-depth interview, focus group discussion, and documentation reviews. The participants consisted of 11,109 elders, 660 elderly caregivers, 15 elderly care managers, 264 involved people, and 28 observation participants. Data were collected from October 2016 to November 2017 and were analyzed by using content analysis, percentage distribution, 95%CI, and McNemar Test. The study found that: 1) the situation of long-term dependency care needs of in the elders had a prevalence of dependence in the elders 14.14% (95% CI 13.5 - 14.8), with dementia 15.20%. (95% CI 14.6 - 15.9). Only 43% of dependent elders had accessed to long-term care benefits which was followed the long-term care fund policy in the pilot area. The major obstacles were the problem of inadequate provision of personnel to local government organizations and the burden of care manager. 2) The process of driving long-term care policy into public policy to create public participation in elderly care consisted of 3 components: community involvement, creating knowledge for public policy of long term care, and integrating with the policy-making agency in the area that could lead to the public policy to practice in the area. 3) The community participation increased in every componence. This enabled the long-term care fund to be implemented and encouraged the elders with dependency be accessed to long-term care services increased significantly (p-value <.001). The quality of life of caregivers was also improved significantly (p-value <.001). However, it was found the level of disability was no statistically significant difference in the elderly who received care services under long-term care fund before and after the study. Long-term dependence is a problem and long-term care needs in the elders. Health Public Policy of the long-term care for the elderly is a social movement for the cooperation of network partners, especially local governments and primary health care, to drive important government policies, that can lead to practice in the area. This will lead to the development of long-term care for the elders in the community to support the elderly society in the future.


location: , 'Thailand year: 2018 source: HSRI

title: Options for the Reform of Thailand Tobacco Monopoly

abstract: This research aim was threefold. (1) To compare the concepts, situation, and reform patterns of the state tobacco industry in other countries in relation to tobacco control, governance, and trade agreements. (2) To analyse alternative reforms for Thailand in different scenerios of the government administration, trade agreement, and other social movements. (3) To assess the Thai tobacco control civil society’s acceptance of reform patterns of the tobacco industry. This study used qualitative research methodology through document research from domestic and foreign documents, and in-depth interviews with academic and experts from civil society on tobacco control in Thailand. The study indicated that (1) The international trade agreements were used as a tool to obstruct tobacco control policies in many countries. As a result, tobacco consumption worldwide dropped slower than the target. (2) The option for reform of the state-owned tobacco industry can be classified into 4 ways: 1. foreign direct investment, 2. joint venture, 3. privatization of state enterprises, 4. structural reform under state enterprise management. (3) Most of key informants expressed their opinions that the best approach is to manage the state-owned enterprises under the government’s control by separating roles and responsibilities between the policy makers, regulatory organization and owners.


location: , 'Thailand year: 2009 source: HSRI

title: Ignored Citation in the Medical Report Entitled "Occupational Malignant Mesothelioma in Thailand"

abstract: It is not uncommon to encounter medical articles written by Thai authors that fail to cite the readily available, relevant and accomplished works of other Thai investigators. The reasons why they ignore the work of their countrymen may be manifold, but the lack of a local literature review may have an adverse impact on their findings. In a recent article entitled “Occupational Malignant Mesothelioma in Thailand,” published in the March-April 2009 issue of the Journal of Health Science, the researchers, perhaps unwittingly, overlooked a number of Thai publications on mesothelioma and asbestos in this country. While we accept the single reported patient of those investigators as a case of pleural mesothelioma of the malignant variety, reference to it as “occupational” in relation to asbestos exposure has yet to be demonstrated and is therefore unsound.


location: , 'Thailand year: 2008 source: HSRI

title: Competency Assessment of Personnel of Chiang Mai Provincial Health Office

abstract: This research encompassed two objectives: (1) to assess the competencies of the personnel of the
Chiang Mai Provincial Health Office and compare these acquired competencies with expected competencies of the organization; and (2) to compare results of competency assessment by self-assessment with the
results of assessment by peers, by heads of sections and by the Competency Assessment Committee. The
target group comprised personnel of the Chiang Mai Provincial Health Office. Respondents were recruited
by the accidental sampling method during the days that the Committee collected data (between October
1, 2006 and March 31, 2007). The research tool was the competency assessment form adapted from the
competency assessment guideline of the Public Sector Development Commission, which comprised eight
dimensions. Data were collected from 147 respondents (94.2 % of the total staff).  Results showed that:
(1) in the deputy director group, the underdeveloped dimension was mentoring for personnel development; (2) in the assistant director group, heads of clusters and heads of sections/technical experts, the
underdeveloped dimensions were ethical issues, holistic thinking and proactive management; (3) in the
technical operator group, the underdeveloped dimension was proactive management; and (4) from the
overall competency scores, the self-assessment produced similar scores to those assess by the Committee.
These findings will be useful for formulating individual development plans.


location: , 'Thailand year: 2004 source: HSRI

title: The qualitative research for studying the impact of universal coverage insurance policy on the heath promotion and disease prevention in 4 provinces

abstract: The health promotion and disease prevention is the important issue in Ministry of Public Health that has been developed and progressed for a long time.  While, the public health system changed from the Universal coverage insurance policy has also impact on changing in the heath promotion and disease prevention by taking the result of this budget allocation, health personnel allocation, managing administration, achievement evaluation.  The purpose of research is for studying the impact of Universal coverage insurance policy on these health promotion and disease prevention aspects.  Moreover, the result for the quality of health promotion activity in Universal coverage insurance policy by studying in four provinces, which are Surin, Phang-nga, Lumphun, and Nakonsawan emphases on the qualitative method collection from the central hospital, general hospital, and PCU/heath center.	The result of the research found that there are various models of budget allocation in each province in 2002.  Some problems in the system occur from them.  Method in budget allocation was changed in each province in 2003 such as to setting the minimum budget that have to allocate to PCU/health centre.  The directly budget allocation from provincial health office makes administration management in PCU/health centre more flexible in health promotion activity.  The model of budget allocation that helps personnel expect should emphasis on making motivation in health promotion activity in the level of PCU.  The budget allocation in paying out for handling project plan should make it well organizes, and must have strongly monitoring and evaluation unit in CUP level.	The health personnel allocation to health center/PCU is not successful in attempting to have doctor or nurse in PCU.  Perhaps, the cause is the salary budget allocation changed from capitation, which included salary in CUP level in 2002 to included salary in provincial level in 2003. The CUP’s board system also has a problem about personnel administration, health officer especially, in PCU or health centre have the confusion about the line of command and direction of policy, which do not go in the same way.  The health officer is not sure in doing their activities.  However, the Universal coverage insurance policy has not impact on number of health promotion activity, but the impact of quality cannot summarize.This research allots the health promotion and disease prevention activity analysis into 2 groups.The group that has policy and method after having the Universal coverage insurance policy such as family folder, and health examination in risk group.The group that has policy and obvious method before having the Universal coverage insurance policy such as home visit, mother and child care, EPI program, and family planning activity, and health promotion in community.	It found that there are the factors, which has impact on the quality and quantity of health promotion activity after the Universal coverage insurance policy in service provider aspect; example of, the budget allocation form, consistency and supporting factor, resource planning, participating setting same goal in the CUP, continuously monitoring demonstration, supervising, and evaluation, adjustment of attitude in health care personnel in new paradigm of health promotion, making relation with the health volunteer, and efficiency of health report systems.


location: , 'Thailand year: 2009 source: HSRI

title: Epidemiology of Injuries and Deaths Caused by Road Traffic Accidents in Thailand

abstract: Road traffic injuries are a significant problem in developed and developing countries. The trend of
mortality owing to traffic accidents is increasing in Thailand. The objective of this descriptive study is to
describe the trend and characteristics of risky behavior related to road traffic injuries in Thailand during
the period 1998-2007. The study was conducted by using and analyzing data from the national injury
surveillance database within 28 sentinels, these were reported during the period 1998-2007.
The results show that the proportion of road traffic injuries was the highest of all injuries (51.6%).
The percentage of injuries in the age groups between 15 and 24 years was the highest (33.29%). Most of
the injuries occurred among laborers and student groups (35.0% and 20.1%); 75.7 percent of them were
motorcycle injuries and tended to increase. The highest incidence of injury occurred during the evening
between 6 and 8 o’clock (37.7-40.2%). The most severely traumatized parts of the body were the head and
neck (29.3%). The percentage of alcohol use while driving was 36.4 percent and it was highly used in the
age group 20-29 years (40.1%). The high-risk behavior occurred over the New Year holidays and during
the Thai new year (Songkhran festival) during the months of December-January and April. Further, the
drivers and riders had not used seatbelts and helmets while driving and riding . Only 13 percent used
helmets and 18.6 percent used seatbelts. Those injured were referred by a relative or others in 56.2 of the
cases; only 10.4 percent were referred by EMS, although the tendency is increasing.
This study identified the problem of injuries, especially motorcycle injury in younger persons, which
tends to increase every year. The higher fatality rate may relate to risk behavior involving alcohol use, not
wearing a helmet, or using seatbelts and driving at high speed. Traffic accident prevention requires that
drivers be educated and that the laws be enforced in the high-risk group (mainly younger men).


location: , 'Thailand year: 1998 source: HSRI

title: Non-government organization's health promotion programs Thailand's case study : Bicycle Riding club for health

abstract: Non-government Organizations’ Health Promotion Programs Thailand’s Case Study : Bicycle Riding Club for Heatlh	The Riding Club for Health was one of the NGOs having a number of continuous activities to encourage health promotion. This study was to review the club’s activities since its establishment to determine factors supporting its success. Large portion of information was derived through interviewing the club’s committee and members in addition to its bulletin and printed document. Additional information was collected by the use of questionnaire to ask the club participants. The analysis framework was the principles of analyzing organization, work system, organization’s strategies and human resource. The Ottawa’s Charter emphasizing partnership development to support health promotion programs was also used for analysis. 	The Bicycle Riding Club was originated from those who loved bike-riding gathering to do outdoor activities with bike-riding in addition to campaign on environment and health promotion. The club administration was in form of committee with no compensation for them. The club grew up in size of members and activities later networking with domestic and international ridging clubs. The club was a good example of encouraging tourism with bicycles prior to health promotion campaign given that health promotion was a by-product of tourism. The important strategy of the club was to seek partnerships in order to create social power for health policy development. The partnership whose interest was similar was likely to be sustainable. Nevertheless, some activities like the bike pathway and natural environment campaign did not achieve their objectives on account of lacking continuous campaign resulted from the fact that all members were volunteered. Lastly, despite the club nationally accepted as one of the health promotion organizations, the extent of the club members’ health holistic understanding which was the most important principle of promoting health, was still doubted.


location: , 'Thailand year: 2015 source: HSRI

title: Provision of trauma care in Ministry of Public Health hospitals regional health 3

abstract: Road accident tends to rise, resulting in enormous loss of lives and assets. According to statistics of deaths from road accident from The World Health Organization found that Thailand mortality rate was 38.1 deaths per 100,000 populations and 3rd in the world ranking. The purpose of this report was to study the situation of trauma care process in Ministry of Public Health hospitals in regional health 3 through mixed methodology research. 382 traumatic patients were randomized from Emergency Department and 59 of administrators and staffs were interviewed and group discussed.
The result found that most traumatic patients were urgent. The average time of care in Emergency Department was 86.4 minutes. Most were highly satisfied to the services. Most traumatic patients entered to hospital privately. Patients who came with ambulance would communicate directly through emergency call of 1669 in trust of the safety system. The problems of Emergency Room management were insufficient of medical personnel especially emergency physicians and inadequate of referral system, budgets, equipments and information system including lacking of coordinated work and integrations with Fast Responder unit of other local government and foundations.
The policy recommendations from this study were Ministry of Public Health and Emergency Medical Institute should long-term plan to support emergency physicians and other medical personnel for hospitals in any level from A,S,M to F in 5-10 years. Including encouragement of local government to participate in developing of emergency system.


location: , 'Thailand year: 2019 source: HSRI

title: Assessing research questions for drug system and consumer protection on pharmaceutical products

abstract: Background: Situations in the drug system in Thailand have been changing constantly over time, a study to analyze situations in the national level to assess up-to-date research questions in the area of drug system is necessary. Objectives: The primary objective of this study was to summary the situation of national drug system. The secondary objectives were 1) to summarise direct and indirect factors affecting the drug system and 2) to assess research questions for further developing the national drug system. Method: This study employed qualitative research methods including document analysis, semi-structured interview and focus group discussion. Results: The research questions were classified into four areas according to the national strategic plan on drug system: 1) developing the national drug control system, 2) supporting research and development to promote local pharmaceutical manufacturing, 3) promoting access to essential medicines among Thai people, 4) promoting rational drug use. Conclusion: Research questions from this study will be used for guiding potential research topics in the areas of national drug system and consumer protection in drugs.


location: , 'Thailand year: 2004 source: HSRI

title: Community concepts and practices in Thailand's HIV/AIDS responses : a case of the home and community-based care policy

abstract: This paper concerns the conceptualization, the ideology and the practice regarding the community in the HIV/AIDS responses in Thailand. It reviews the community-related HIV/AIDS research, articles, seminar proceedings as well as documents regarding national plans and policies that have been made available since in the early 1990s. Its main aim is to see how the community was conceptualized, understood and utilized by the Thai government, medical community, academic, NGOs, social activists and people living with HIV and AIDS to fight against the impacts of AIDS both at the national and community levels. In particular, it also investigates the community concepts in discourses regarding the home and community-based care’s policy and practice which were recommended for Thailand in the early 1990s in response to the changing AIDS situation.The paper primarily argues that the sets of concept and discourse concerning the community in the HIV/AIDS responses are problematic and are made and remade over times. It reveals that in the course of AIDS responses, Thailand had utilized several approaches ranging from epidemiological-behavioral approach to good governance and civil society approaches in order to alleviate the negative consequences of the epidemic. Throughout this course, two major community concepts were conceptualized and imposed. The first concept necessarily sees community as the social unit encompassing geographical, administrative and social structures such as formal community leaders, informal leaders, temples, schools and other interest groups at a local level. The latter concept understands the community as the process in which individuals voluntarily come together, and through collective actions they resist the oppressions of others and the external forces that affect their lives negatively. Finally, the paper points out that the application of the community concepts at any stage of the HIV/AIDS responses necessarily contributed to the constraints and effectiveness of the home and community-based care approach which has been robustly encouraged by the Thai government since in 1997.


location: , 'Thailand year: 2022 source: HSRI

title: Integrated School-Based Program to Improve Reading Ability and Its Cost-Effectiveness for Screening and Managing Children at Risk of Dyslexia (Third Year)

abstract: This third year research project has the main objective to compare the outcomes of treatment for at-risk of dyslexia children between the supplementary teaching group and the control group, after two years of small group reinforcement teaching with 42 and 77 high-risk students in the supplementary and control group schools entering the experiment in the second year. Teaching for a total of 24 weeks during the 3rd grade has been adjusted for in accordance with the situation of the COVID-19 epidemic. Unfortunately, the school was closed for onsite teaching in the 4th grade level. However, the students was followed up to test reading ability and to measure learning achievement in reading with the WRAT tool at the fifth grade level, with the children in the supplementary group and the control group of 32 and 58 people, respectively. For students in research projects who are not at risk group, the remaining 621 students were monitored for reading ability of elementary school children from grade 1 to grade 5. Reading abilities of not-at risk of dyslexia pupils develop at a faster rate than those of at risk of dyslexia pupils. The result of the reading test when in the fifth grade showed that the children in the at-risk group who received supplemental teaching had higher scores on reading and basic reading skills in almost all areas than the children in the control group, but not reach statistically significance. Learning achievement in reading from the WRAT test showed that 68% of the children in the supplementary teaching group and 58 percent of the children in the control group had a reading domain not lower than the standard value for more than 2 classes as there was a mild reading problem. However, the results showed that more than 90 percent of children from both groups had an achievement of writing domain less than the standard for more than two classes. In addition, reading test scores were highly correlated with WRAT scores. So, scores from the Reading Test at Grade 2 and 5 can be used to help determine the severity of the reading disability.


location: , 'Thailand year: 2009 source: HSRI

title: Usage of Herbal Alternatives to Modern Medicine in Lampang Hospital and Community Hospitals in Lampang Province

abstract: This descriptive study was aimed at comparing the cost of herbal medicine to replace conventional
medicine for the treatment of five health conditions in a five-year period (2002 - 2006). The study was
performed between May 2007 and August 2008. The study samples comprised 65 health care workers
and 260 clients in regional hospitals and 12 community hospitals in Lampang Province. The research
instruments used consisted of (1) a record of the cost of herbal medicine and conventional medicine treatment
of five health conditions: irritable bowel syndrome, sore throat (non-infectious) constipation,
herpes, and musculoskeletal/joint diseases, (2) a questionaire for herbal medical orders, and (3) a satisfaction
form to record the use of herbal medicine. The data were analyzed by descriptive statistics; the cost of
herbal medicine replacing conventional medicine was compared by t-test and clients satisfaction analyzed
by chi-square.
The results indicated that the cost of most herbal medicine compared with conventional medicine
for five health-condition treatments in Lampang Province increased during the period studied. The cost
of Turmeric increased from 85,717 baht in 2002 to 551,272 baht in 2006; Andrographis increased from 28,152
baht to 138,681 baht, Senna alata leaves increased from 2,797 baht to 27,104 baht, and Clinacantus nutans
leaves increased from 3,490 baht to 18,101 baht and Zingiber montanum increased from 14,243 baht to
298,446 baht. The comparative cost of herbal medicine during the period 2002-2006 significantly increased
(p < 0.05), except for Zingiber montanum (p = 0.074).
Concerning the health care workers’ perceptions about herbal medicine, we found that the sample
population experienced increases of 75.4 percent in ordering Turmeric, 63.1 percent for Andrographis, 40
percent for Senna alata leaves, 41.5 percent for Clinacantus nutans leaves and 58.5 percent for zingiber
montanum. The main reasons for the decision to order was a perceived drug indication. For the clients’
satisfaction in using herbal medicine as a replacement for conventional medicine, we found that the
clients had experience in using Turmeric (68.5 percent), Andrographis paniculata (70 percent), Candelabra
bush (15.4 percent), Clinacantus nutans (29.6 percent) and Zingiber montanum (69.2 percent). Satisfaction
was highly significant (p < 0.001); the reasons for satisfaction were knowing the indications and having
experience in using the herbals.
Based on our study results, the herbal medicines used were Turmeric, Andrographis, Senna alata
leaves, Clinacantus nutans leaves and Zingiber montanum for increasingly replacing conventional medicine
in the regional hospital and 12 community hospitals in Lampang Province from 2002 to 2006. The
increasing rate resulted from the supportive policy of promoting herbal medicines in the health delivery
system, organizing herbal medicine symposiums, and reminding healthcare workers by displaying
posters on how to use herbal medicines at dispensing units.


location: , 'Thailand year: 2021 source: HSRI

title: Social Return On Investment (SROI) of District Health Board (DHB): 4 Case Studies

abstract: “The Social Return on Investment Projects (SROI) under the Implementation of the District Health Board (DHB): 4 Case Studies” aimed to analyze social return on investment (SROI) of district health board and to assess the implementation of district health quality development under the drive of 4 DHBs in order to synthesize policy recommendations for the short, intermediate, and long terms of district health quality development through all concerned stakeholders’ engagement. There are 4 projects in the 4 targeted areas, as follows: 1) Elderly care in Bang Kruai DHB, Nonthaburi Province; 2) Waste and environmental management in Phimai DHB, Nakhon Ratchasima Province; 3) Traffic Accident reduction of in Suk Samran DHB, Ranong Province, and; 4) Good agriculture and safe food in Laplae DHB, Uttaradit Province. Mixed methodology was implemented based on the concept of social return on investment (SROI), under the guideline on the implementation of district health board (DHB), through documentary research from secondary data, survey questionnaire, focus group, and in-depth Interviews as data collection process. The results of social value or and the change in the community was transformed into financial proxy by net present value (NPV) analysis, 6% and 3% discount rates, cost-benefit analysis, payback period, and the ratio of SROI. Inputs, activities, outputs and outcomes were also analysed in the establishment of mapping outcome process. The conclusions from the focus group were made into impacts that required deadweight analysis by focusing on the weights of changing activities and other supporting factors that affected attributions. Then, financial proxies of the projects were calculated under the guideline on district health board (DHB). The results of SROI study from the project implementation in 5, 10, and 15 years with the use of discount rate at 6 and 3 percent were revealed as follows. 1) The elderly care project of Bang Kruai DHB, the SROI with 6% discount rate used of this project is -0.18 (in 5 years), 0.15 (in 10 years), and 0.26 (in 15 years). The calculated SROI with 3% discount rate revealed -0.17 in 5 years, 0.22 in 10 years and 0.38 in 15 years. The result showed the payback period in 4.72 years (5 years), 6.43 years (10 years), and 8.73 years (15 years). These implies that the calculation of SROI with 6% and 3% of discount rate mean every 1 THB of investment in the elderly care project of Bang Kruai DHB, - 0.18 THB in 5 years, 0.15 THB in 10 years, and 0.26 THB in 15 years of social value is created when the discount rate is at 6%; however, if the 3% discount rate is used, every 1 THB of investment in the elderly care project of Bang Kruai DHB, - 0.17 THB in 5 years, 0.22 THB in 10 years, and 0.38 THB in 15 years of social value is created, respectively. 2) The waste and environmental management of Phimai DHB, the SROI with 6% discount rate used of this project is 6.80 (5 years), 6.76 (10 years), and 6.18 (15 years). The calculated SROI with 3% discount rate revealed 7.52 in 5 years, 7.98 in 10 years and 7.75 in 15 years. The result showed the payback period in 13 days for 5 years, 26 days for 10 years, and 1.28 months for 15 years. These implies that every 1 THB of investment in the waste and environmental management of Phimai DHB is able to create social values at 6.80 THB in 5 years, 6.76 THB in 10 years, and 6.18 THB in 15 years if the discount rate is at 6%, while the discount rate at 3% explores every 1 THB of investment in the waste and environmental management of Phimai DHB is able to create social values at 7.52 THB in 5 years, 7.98 THB in 10 years, and 7.75 THB in 15 years. 3) The traffic accident reduction project of Suk Samran DHB, the SROI with 6% discount rate used of this project is 13.02 (5 years), 11.38 (10 years), and 10.01 (15 years). The calculated SROI with 3% discount rate revealed 14.16 in 5 years, 13.19 in 10 years and 12.30 in 15 years. The result showed payback period in 0.30 months (5 years), 0.61 months (10 years), and 0.91 months (15 years). These implies that every 1 THB of the traffic accident reduction project of Suk Samran DHB invested, 13.02 THB in 5 years, 11.38 THB in 10 years, and 10.01 THB of social value is created when using 6% discount rate, while if discount rate is at 3%, every 1 THB of the traffic accident reduction project of Suk Samran DHB invested, 14.16 THB in 5 years, 13.19 THB in 10 years, and 12.30 THB in years of social value is created. 4) The good agriculture and safe food project of Laplae DHB, the SROI with 6% discount rate used of this project is 1.10 (in 5 years), 1.36 (in 10 years), 1.34 (in 15 years).The calculated SROI with 3% discount rate revealed 1.21 in 5 years, 1.62 in 10 years and 1.71 in 15 years. The result showed the payback period in 1.70 years (for 5 years), 2.80 years (for 10 years), and 4 years (for 15 years). These implies that every 1 THB of the good agriculture and safe food project of Laplae DHB invested, the social value at 1.10 THB in 5 years, 1.36 THB in 10 years, and 1.34 THB in 15 years is created if calculating with 6% discount rate. However, if 3% of discount rate is used, The investment of every 1 THB of the good agriculture and safe food project of Laplae DHB is likely to create the social value at 1.21 THB in 5 years, 1.62 THB in 10 years, and 1.71 THB in 15 years.


location: , 'Thailand year: 2015 source: HSRI

title: Cost-effectiveness of thrombolysis service for patient with ST segment elevation myocardial infarction in primary care hospital

abstract: ST segment elevation myocardial infarction (STEMI) is a major cause of death. Recent evidences showed that primary percutaneous coronary intervention (PPCI) can reduce mortality rate. However, in a situation where PPCI is unavailable, facilitated percutaneous coronary intervention (FPCI) using fibrinolytic drug before patient referral could be an important life-saving solution. Since FPCI may increase the risk of major bleeding and it incurred more expenditure, the information on cost-effectiveness of FPCI is useful for policy makers.
A Markov model was used to compare the lifetime cost and quality-adjusted life years (QALYs) accrued to patients receiving FPCI before referral or PPCI at referral center from societal and health system perspective. All analyses were performed using Microsoft Excel. Input data were retrieved from literatures and electronic databases.
We found that FPCI program at community hospital is a dominant alternative given its lower cost and higher effectiveness than PPCI at referral center. This means it is a cost-effective policy option.
Therefore, community hospitals with the capacity to provide FPCI service for STEMI patients should be supported to offer such service for better access to the patients with higher overall quality of life and lower costs to the systems. We suggest that policy makers in the Ministry of Public Health and the hospital administrators should consider these findings and provide support to make FPCI available in community hospitals with existing capacity. Capacity strengthening particularly in terms of manpower, and budget should be provided especially in the areas where there is still shortage of supply.