โครงการวิจัยพัฒนางานชันสูตรสาธารณสุขในสถานีอนามัยอย่างเป็นระบบ

Abstract

This research studied about laboratory needs at Health Centers, potential of health officers and appropriate in systemic laboratory development. The researchers had mailed questionaires to all provincial medical offices for basic data at Health Centers. Collecting questionaires were 81.23 percent of on-service Health Centers. The data revealed that patients who came to visit health centers would received laboratory service only 8.31 percent - mostly by using lab kit 37.1 percent, by using laboratory instuments 18.9 percent, and refer samples to other health service 44.0 percent. By studied about laboratory needs at Health Centers in 20 Health Centers and 10 Community Hospitals, in 5 target provinces ; the researchers had collected 6,757 OPD cases at Health Centers. The data revealed that most of the OPD diagnosis were respiratory system diseases 29.6 percent, digestive system diseases 11.6 percent, skeletal system diseases 7.9 percent, infectious and parasitic diseases 7.6 percent, abnormal from laboratory tests 13.0 percent. By doctor's opinions - needs of laboratory tests at Health Centers were 32.2 percent while 67.8 percent was not 5 laboratory tests were recommended in Health Centers. And from 955 OPD cases at Community Hospitals in the same districts revealed that most of OPD were muscular system diseases 14.0 percent, respiratory system diseases 13.7 percent, digestive system diseases 13.0 percent, with 34.5 percent need laboratory services while doctor's opinions agreed that 20.9 percent could receive at Health Centers before referring. The need for laboratory tests other than physical examination, by brainstorming experts from Division/Departments of the Ministry of Public Health, showed that laboratory development in Health Centers should include in promotive services, disease control services, primary screening for consumer protection and for environment surveillance. Training for quality control should be provided intermittently. In this study, by interviewed key persons plans and provided focal persons at 86.8 percent and 80.3 percent, respectively. Training for Health Officers in laboratory courses was 31.9 percent, and supporting activites by District Health Committee was only 17.1 percent. By indepth interviewed key persons about the potency of Health Officers in laboratory service-such as Community Hospital doctors, OPD nurses, chiefs of Health Center-revealed that Health Officers had enough knowledge to diagnose simple diseases, and they had potency to screen and refer the patients to sophisticated centers after they had advanced training. Health officers were ready to service and realized the need of laboratory tests in their services. And Health Centers needed to be supported by higher organizations. The researchers had made policy recommendations for systemic laboratory developing at Health Centers in 4 aspects ; standard laboratories in Health Centers, supportive system, Knowledge and personel training and quality control in laboratory development.