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International NGO Established in 1989 Supported by UNFPA and the Kobe City Government |
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1. Project Management
2. Objectives of the Project To study the situation of reproductive health
and implementation of Primary Health Care (PHC) programs in urban areas
in Khon Kaen Province, Thailand. 2.1 To study population characteristics, use of
family planning services, situations of reproductive health and primary
health care, structure of public health administration, health care
service and public health services in urban settings. 2.2 To study the concepts and policies for
health care and public health services of political and technical
leaders in the province (the mayor, members of the municipal council,
the Director of the Provincial Management Board, the Chief Provincial
Public Health Officer and others) and health service providers at
various levels (physicians, nurses and public health officers). 2.3 To study the perceptions and satisfaction
levels of health care service users who come to receive those services. 4.2.1 Interviews of
Administrators 4.2.2 Interviews of Health Service Providers Twelve health service providers including physicians, pharmacists and professional nurses at various levels were interviewed on the following issues: 4.3 Surveys of Respondents 346 people who come to receive services at public health centers were interviewed regarding their opinion and satisfaction level of the services (type of services, quality of care, time for travelling, expenses and others). 5. Final Report The report consists of three main findings: Part 1. Description of the province and the study areas (population characteristics, medical and public health system, major diseases, reproductive health services and primary health care programs) Part 2. Findings on the interviews of key informants (administrators and health service providers) Part 3. Results of the survey of respondents (satisfaction of the people) 6. Research Results Research results are presented according to the final report of three main findings as mentioned above: Part 1. This descriptive research was conducted from February to March 2002 in urban areas of Khon Kaen province. Khon Kaen city has a population of 129,581 out of 1.67 million population of the whole province, Seventy percent of the provincial population are primarily agricultural. Sixty percent of land is cultivated Many health care facilities are available in Khon Kaen province. These facilities consist of ; General Hospitals (2), Srinakarin Hospital (1), Kai Sripacharin Military Hospital (1), private hospitals (7) Public Health Technical Centers 91, Maternity and Child Care Hospital (1), Centers for Control of Communicable Diseases (3), Psychiatric Hospital (1), private Clinics (250) and many others. Maternal Mortality rate (MMR) is about 80 per 100,000 and infant mortality rate (IMR) is about 10.6 per 1000 births. Survey of the concepts and policies for health care as held by political and administrative leaders showed that they were forward looking as well as progressive and such policies were pursued by successive leaders. Ideals and targets for primary health in the ninth plan were pursued. These include the attempt to develop a "caring society", enhancement of creation of opportunities for the poor, peoples' participation, and extension of health insurance coverage to all. Concepts and policies regarding same as held by health service providers reflect those of the national leaders and policy makers, and these were stated as progressive. The users of the health services have a positive perception and are fairly satisfied with the health care they received (I hope this is picture of the urban areas). Part 2. Local health service providers considered social and behavioral problems and reproductive health to be major concerns. They felt the need for health system reform to reduce bureaucracy, improve personnel and management policies and increase coordination among levels. In addition, Khon Kaen Municipality Administrators considered pollution, inadequate health insurance, inequity and low self-reliance to be major problems. Intersectoral collaboration by health personnel with clear roles, coordination by health personnel with new policies, more local and less centralized authority and budget reform are considered solutions. Finally integrating PHC and increasing the number and capabilities of VHVs with ongoing skill-building were perceived as needed to raise the quality of life of rural people to that of urban population. Part 3. This descriptive research was conducted in urban areas of Khon Kaen Municipality which the total target population was 364 persons from February to March of the year 2002. The respondents were mostly female, Buddhists and had the education of primary school level with income less than 5,000 baht. Most respondents married between 20-24 years of age and practiced contraception with a preference for sterilization at a government hospital. Abortions were seldom. The Municipality Health Services Center (MHSC) and the Community Primary Health Care Center (CPHCC) had similar pregnancy rates and MHSC ANC visits were higher. The delivery site preference was based on convenience, nearness and safety. The MHSC reported higher birth weights, more vaccinations, more services, higher staff capabilities, better equipment and better human relations. The performance of VHVs was perceived as quite well. MHSC services were rated good, especially convenience coverage, equity and quality. They were more accepted and the users had a much high knowledge level. Least known were handicapped and consumer services. While CPHCC services were rated good only equity and population coverage but quality, ongoing and resources management for services were rated low, they were less familiar to users. However, all health services were perceived to be essential at both centers. |
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