Village Health Volunteers : Unsung Heroes for Thailand's Health Crisis
Strategy and Planning Division, Office of the permanent secretary, Ministry of public health, Thailand
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Government
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#SDGAction33535
Description
Prior to 1970s, the majority of Thai populations lived in rural areas, being poor farmers. Although more than 80% of diseases were not complicated and could easily be prevented and cured, people could not access to basic public health services to inadequate number of public health facilities and health personnel. Less than one third of Thai population can access to basic health-care services. In late 1970s, Thailand adopted the Alma-Ata Declaration. This became the starting point of Thailand for Primary Health Care (PHC) development. The national policy aimed for rural development; the infrastructure development since 1970s led to full geographical coverage of PHC in particular in rural area. The PHC had been well functioning by adequate number of competent and committed health workforce together with village health volunteers (VHV). The strength of Thai public health system lies in VHV network and community based activities in response to disasters and health issues. VHV is a link between people and health personnel and drive public health work at community level. As a result, the initiative not only enables healthy and safe communities, but also reduces vulnerabilities and strengthens resilience.
The 1st period (1977-1996): The Establishment and Development of VHV recruits VHV for each village. A local primary health care center were established and used as workplaces and provided services from VHV. The 2nd period (1997-2016):The Collaboration with Health Network Association VHV worked with, Health Network Association and various agencies to play as institutional link of myriad networks. Furthermore, the role of VHVs was changed from service providers into health managers and professionals; similarly, their role was leveraged to the health security policy so that people would access health security thoroughly. Some villagers were selected and developed into Family Health Volunteers who could maintain their own health and their family members’ ones, as well as Health maintenance was expanded into foreign laborers who worked in Thailand called ‘Foreign Health Volunteers’. The outstanding works of VHVs in this period was the surveillance of dengue fever, rabies and avian influenza that severely spread in 2003-2006. The 3rd period (2017-present): The Development of VHV 4’0 Mechanism for Handling Health Crises in Communities. VHVs are developing to support health crisis management in communities by using advanced technology. They become VHV 4.0 able to use the applications called ‘Smart VHV’ for information taking and ‘AorSorMor Online’ to locate minority and communication including CPR skill. The integrated health management communities are developed into Happy Communities: healthy, happy and wealthy, while quality of life management districts are developed into new normal districts, free from COVID-19. The implementation are as follows: (1)Examine mental health and factors in communities using an online mental health questionnaire prescribed by the Department of Mental Health (2) Set the standard of COVID-19 surveillance and prevention in communities (3) Support people’s and communities’ procedure and role in health management (4) Create communities’ schemes and projects to become a new normal districts, free from COVID-19
The application ‘AorSorMor Online (VHV Online)’, a collaboration between Department of Health Service Support and Advanced Info Service Public Company Limited (AIS), is Thailand’s public health application that was awarded the ITU & UN prize. This application indicates that Thailand has brought digital technology innovation to improve its public health system and raise people’s quality of life. It focuses on sustainable development of all sectors since community public health is necessary for local people especially those who live in remote areas. In a digital era, the connection will be an important tool to raise the standards of people's life in accordance with the policy called ‘Thailand 4.0’, and will promote the liaison among primary care units, sub-districts’ health promoting hospitals and Village Health Volunteers for better performance and communication.
The key obstacles while implementing the initiative are: The crisis cannot be predicted in terms of when and how it will happen. The crisis requires a swift response from various stakeholders to cope with it. Preparing essential human capital and tools is considers to be the best. DHSS handles the aforementioned problems by providing online platform, AorSorMor Online (VHV Online), to inform and communicate with volunteers and strengthen VHV to become VHV 4.0 who can use digital technology, obtain health literacy, shift mindset and be a leader of health changes. How to response crisis situations.
1. Village Health Volunteers were strong, trusted by the locals, ready to perform their duties when health crises occurred, well-developed continuously, and trained for the case a volunteer was passed away or resigned. 2. There was a local agency responded and solved crises according to the duties prescribed by the law including local administration organizations, local health officers and community leaders, as well as supported manpower, budget and instruments. 3.The government had a policy and agency responding for this directly that was Department of Health Service Support that has developed the volunteers’ abilities and supported their performance.
1. Website, Facebook, and Line of Primary Health Care Division 2. Publications, articles, video-link of Primary Health Care Division 3. Brochure, and video clip providing knowledge and instructions
In the situation of the epidemic of COVID-19 in the community, it affects chronic patients Psychiatric patients Unable to continually pick up the drug from a government service facility. Thus solving the problem of accessing such services With the cooperation of volunteers and local health networks It is a saving on travel expenses. And reduce congestion in hospitals or service facilities, such as drug delivery vehicles to patients in the community by volunteers (Grab Drug), etc.
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Stakeholders have worked together systematically for the project’s implementation starting from 1) the Department of Health Service Support which have its affiliated agencies at both regional and district levels has developed the potential of Village Health Volunteers (VHV 4.0), founded the Emergency Operation Centre (EOC) to analyse the crises of the country in overall, designed and formulated strategies to handling problems according to government policies, made decisions, coordinated with other agencies, provided and followed up resources requested from local areas, collected, analysed and distributed information, followed situations and evaluated the project implementation, 2) public health agencies and the Village Health Volunteers Association at the provincial and district levels have participated in analysing problems, designing solutions based on central policies and situations in the area, providing necessary resources to the volunteers to evaluate the performance, and 3) the volunteers have solved the community problems with local agencies including local health officers, local administration organizations and community leaders, examined situations in the area, designed solutions according to local policies and conditions, gathered resources from different sources, performed the action of crisis prevention and control, and evaluated the implementation achievement.
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Thitipat, Village Health Volunteers : Unsung Heroes for Thailand's Health Crisis