The First Phase Implementation of Health Clinic for Farmer Policy in Tambon Health Promoting Hospital in the 8 Upper Northern Provinces, 2013

Abstract

In 2013, Offce of Disease Prevention and Control 1 ChiangMai has applied the health clinic for farmer
policy into practice in Tambon Health Promoting Hospital (THPH) that located in the 8 northern most provinces of Thailand. The objectives of this study were to know about the progression of frst phase implementation of the service provision of the health clinic for farmer in THPH and to recognize the problems in operating the clinics. This study was conducted using both quantitative and qualitative methods (mixed method). The 8 THPHs under studied were sampled by the provincial public health offce of each province, one site per one province. The study was conducted during May-June 2013. The data collection tools included the evaluation form on health clinic for farmer issued by the Bureau of Occupational and Environmental Diseases, the interview guide,and the observation check list form. Quantitative data was analyzed using descriptive statistics and qualitative data was analyzed using content analysis technique. The result showed that none of the 8 THPHs was able to operate all 6 standard activities of the basic level health clinic for farmer. The activity that was able to operate the most was health screening per risk from work (75%), report the performance of the clinic(75%), and screening for health risk from farming/workplace in the community (37.5%). The activities that none of the THPHs could operate included: provision of one clinic day per week; inclusion of occupational health database into THPH’s database system; and provision prevention and
control of health hazard activities. The main obstacle for the implementation of health clinic for farmer were the unsettled policy, lack and delayed delivery of needed support materials, lack of budget and supervision, inadequate staffng, lack of refresh training for the staff, and lack of awareness on the self-care and disease prevention among the community members.This un-achievement might happen because of delayed deployment of policy from central level to provincial level, the unsettled policy on the operation with no proper instruction, no study on the capacity of THPH sprior to policy implementation. Suggestions for future operation included evaluation of the operating bodies before launching any new policy, clear dispatch to provincial public health offces nationwide at the central level. There should be adequate monitoring and technical support especially at the beginning phase of the operation. This would help learning the obstacle
which would lead to proper advice and guideline to improve the service for the operating bodies. The operation pattern at the clinic should be flexible and take into account the local context. The frst phase of implementation hould emphasize on the quality of the health clinic for farmer and capacity building of the THPH staff to adapt for the specifc need of the locality. This would lead to sustainable operation.