Abstract
Village Health Volunteers (VHV) were the hallmark of primary health care during the past three
decades. The volunteer exemplifies the concept of “community participation,” one of the most important
strategies for achieving the goal of “Health for All by the Year 2000”. As the health situation and political
landscape have changed, there was a need to re-conceptualize the roles and functions of the health volunteer
in health development. This study is aimed at assessing the roles and potentials of village health volunteers in the changing contexts of Thailand. Village health volunteers in Thailand, numbering almost
800,000, are an extremely valuable health resource. Although the recruitment of village health volunteers
has occasionally been questioned as being nepotistic or incentive-driven, village health volunteers are
those chosen by their communities for not only being public minded, generous, and willing to help those
in need, but also comparatively knowledgeable and concerned about health matters.
The study found that village health workforces were still very much active and have increasingly
become femininized. More than 35 percent of existing volunteers were recruited not more than five years
ago, while the number of female volunteers rose to almost 70 percent of the total. These volunteers performed
comparatively well on short-term tasks such as taking ad hoc health surveys, collecting periodic
data, or conducting disease prevention campaigns. They did not fare well, however, in the areas of work
that need long-term, continuous dedication, such as caring for chronically ill patients. Existing volunteer
workforces were found to be from a comparatively low educational and economic background. As health
issues have become more complicated, this finding poses the question of how could a volunteer workforce
with higher attributes and economic status more prepared for dedicated work be recruited. The changing
administrative system and decentralization has resulted in the village health volunteer being increasingly
implicated in local and national politics. Changing contexts and concerns call into question the relevance
of conventional model of VHVs. Case studies, however, suggest increasingly innovative roles and forms
of volunteers in health development, ranging from volunteers in hospital settings to disaster relief volunteers.
This strongly indicates that the idea of volunteering has been progressively more accepted and will
play an increasing role in Thai society in the future.
