Development of Maternal and Child Health Services in Remote Areas along the Thai–Lao Border
Keywords:
Maternal and Child Health, Remote Healthcare Services, Thai–Lao Border, Bokeo Province, Healthcare Personnel TrainingAbstract
Many countries worldwide continue to face challenges in maternal and child health, including the Lao People's Democratic Republic (Lao PDR). This study aimed to examine existing issues, explore the perspectives of healthcare personnel, and develop strategies to address maternal and child health challenges in Bokeo Province, Lao PDR. A mixed-methods research approach was employed. In Phase 1, in-depth interviews were conducted to assess current issues, semi-structured interviews were used to propose solutions, and field observation records were collected from a sample of 45 healthcare personnel selected through purposive sampling. In Phase 2, a training program, knowledge assessments, and practice evaluations were conducted among 296 healthcare personnel using a quota sampling method. Data collection took place between March and October 2023. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were examined through content analysis.
The findings revealed that key maternal and child health indicators showed an improving trend, including reductions in maternal mortality rates and under-five mortality rates, increased antenatal care attendance (at least four visits), a higher proportion of deliveries assisted by medical personnel, and improved vaccination rates among children under one year of age. However, maternal and child health remains a challenge in Bokeo Province, Lao PDR. This aligns with findings from Phase 1, in which healthcare personnel demonstrated familiarity with the government's maternal and child health policies. Despite this awareness, major challenges persist, including barriers faced by minority groups, inadequate transportation infrastructure, shortages of skilled medical personnel, insufficient medical equipment and medications, limited training and professional development opportunities, and inadequate government funding which remain significant challenges. Furthermore, after participating in the training programs, nursing assistants, medical assistants, and nurses showed statistically significant increases in their average knowledge and practical skill scores (p-value <0.001). Therefore, issues in maternal and child health continue to be challenging and require development in multiple aspects, and continuous training programs should be implemented to enhance the capacity of personnel in maternal and child health work.
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