Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from...Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.展开更多
Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guid...Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guided by community-based participatory research(CBPR).The peer-training program was developed by engaging diverse stakeholders,including community organizations,healthcare services,VHVs,older adults with chronic illnesses,and folk scholars in remote communities with high healthcare needs.The peer-training program comprised a three-day training workshop that convened once a week for three weeks with the following six sessions:knowledge sharing,peer support and empowerment,health literacy and health behavior,the general caring procedure for older adults with chronic illnesses,information sharing and communication,and home visit.From January to April 2021,a total of 28 VHVs completed the peer training program in a rural area in Chiang Rai province,Thailand.The Health Literacy and Health Behavior-3E2S(HLHB-3E2S),the Management of Non-Communicable Diseases Questionnaire(MNCDQ),and a self-confidence questionnaire were used to survey pre(week 1)and post-intervention(week 12),respectively.Then VHVs were interviewed to collect attitudes,and opinions about the intervention.Results After the intervention,the HLHB-3E2S scores(49.39±5.54 vs.52.35±4.26,P=0.001),the MNCDQ scores(44.10±6.27 vs.50.60±4.84,P<0.001),and the self-confidence questionnaire scores(22.28±2.46 vs.23.21±1.81,P=0.01)of VHVs significantly increased.VHVS also reported that the peer-training program enhanced their healthcare services,including health education,chronic disease management,leadership skills,and improving their relationship with healthcare providers.Conclusion Peer training programs are a practical strategy to improve VHVs’capacities.Healthcare professionals should provide a continuous training program for VHVs with their peers to increase capacities,confidence,and satisfaction in caring for the older adults with chronic diseases in the community.展开更多
Background:In addition to healthcare entitlements,‘migrant-friendly health services’in Thailand include interpretation and cultural mediation services which aim to reduce language and cultural barriers between healt...Background:In addition to healthcare entitlements,‘migrant-friendly health services’in Thailand include interpretation and cultural mediation services which aim to reduce language and cultural barriers between health personnel and migrants.Although the Thai Government started implementing these services in 2003,challenges in providing them still remain.This study aims to analyse the health system functions which support the interpretation and cultural mediation services of migrant health worker(MHW)and migrant health volunteer(MHV)programmes in Thailand.Methods:In-depth interviews were conducted in two migrant-populated provinces using purposive and snowball sampling.A total of fifty key informants were recruited,including MHWs,MHVs,health professionals,non-governmental organisation(NGO)staff and policy stakeholders.Data were triangulated using information from policy documents.The deductive thematic analysis was classified into three main themes of evolving structure of MHW and MHV programmes,roles and responsibilities of MHWs and MHVs,and supporting systems.Results:The introduction of the MHW and MHV programmes was one of the most prominent steps taken to improve the migrant-friendliness of Thai health services.MHWs mainly served as interpreters in public facilities,while MHVs served as cultural mediators in migrant communities.Operational challenges in providing services included insufficient budgets for employment and training,diverse training curricula,and lack of legal provisions to sustain the MHW and MHV programmes.Conclusion:Interpretation and cultural mediation services are hugely beneficial in addressing the health needs of migrants.To ensure the sustainability of current service provision,clear policy regulation and standardised training courses should be in place,alongside adequate and sustainable financial support from central government,NGOs,employers and migrant workers themselves.Moreover,regular monitoring and evaluation of the quality of services are recommended.Finally,a lead agency should be mandated to collaborate with stakeholders in planning the overall structure and resource allocation for the programmes.展开更多
文摘Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.
基金This study was funded by National Research Council of Thailand(NRCT106/2562)Mae Fah Luang University.The funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guided by community-based participatory research(CBPR).The peer-training program was developed by engaging diverse stakeholders,including community organizations,healthcare services,VHVs,older adults with chronic illnesses,and folk scholars in remote communities with high healthcare needs.The peer-training program comprised a three-day training workshop that convened once a week for three weeks with the following six sessions:knowledge sharing,peer support and empowerment,health literacy and health behavior,the general caring procedure for older adults with chronic illnesses,information sharing and communication,and home visit.From January to April 2021,a total of 28 VHVs completed the peer training program in a rural area in Chiang Rai province,Thailand.The Health Literacy and Health Behavior-3E2S(HLHB-3E2S),the Management of Non-Communicable Diseases Questionnaire(MNCDQ),and a self-confidence questionnaire were used to survey pre(week 1)and post-intervention(week 12),respectively.Then VHVs were interviewed to collect attitudes,and opinions about the intervention.Results After the intervention,the HLHB-3E2S scores(49.39±5.54 vs.52.35±4.26,P=0.001),the MNCDQ scores(44.10±6.27 vs.50.60±4.84,P<0.001),and the self-confidence questionnaire scores(22.28±2.46 vs.23.21±1.81,P=0.01)of VHVs significantly increased.VHVS also reported that the peer-training program enhanced their healthcare services,including health education,chronic disease management,leadership skills,and improving their relationship with healthcare providers.Conclusion Peer training programs are a practical strategy to improve VHVs’capacities.Healthcare professionals should provide a continuous training program for VHVs with their peers to increase capacities,confidence,and satisfaction in caring for the older adults with chronic diseases in the community.
基金funded by Asia-Pacific Observatory on Health Systems and Policies(APO).
文摘Background:In addition to healthcare entitlements,‘migrant-friendly health services’in Thailand include interpretation and cultural mediation services which aim to reduce language and cultural barriers between health personnel and migrants.Although the Thai Government started implementing these services in 2003,challenges in providing them still remain.This study aims to analyse the health system functions which support the interpretation and cultural mediation services of migrant health worker(MHW)and migrant health volunteer(MHV)programmes in Thailand.Methods:In-depth interviews were conducted in two migrant-populated provinces using purposive and snowball sampling.A total of fifty key informants were recruited,including MHWs,MHVs,health professionals,non-governmental organisation(NGO)staff and policy stakeholders.Data were triangulated using information from policy documents.The deductive thematic analysis was classified into three main themes of evolving structure of MHW and MHV programmes,roles and responsibilities of MHWs and MHVs,and supporting systems.Results:The introduction of the MHW and MHV programmes was one of the most prominent steps taken to improve the migrant-friendliness of Thai health services.MHWs mainly served as interpreters in public facilities,while MHVs served as cultural mediators in migrant communities.Operational challenges in providing services included insufficient budgets for employment and training,diverse training curricula,and lack of legal provisions to sustain the MHW and MHV programmes.Conclusion:Interpretation and cultural mediation services are hugely beneficial in addressing the health needs of migrants.To ensure the sustainability of current service provision,clear policy regulation and standardised training courses should be in place,alongside adequate and sustainable financial support from central government,NGOs,employers and migrant workers themselves.Moreover,regular monitoring and evaluation of the quality of services are recommended.Finally,a lead agency should be mandated to collaborate with stakeholders in planning the overall structure and resource allocation for the programmes.
