Abstract
This participatory action research aimed to study model for the to development of a primary health care service system at NhongTong Primary Care Unit, Hangdong District, Chiang Mai Province. Data were collected from health personnel and clients (community leaders and people), by focus group discussion, in-depth interview, and observation.The participatory approach was focused by brain-stroming, reflecting on problems and needs, capacity building of health personnel, and development of the health care service system. Content analysis was used for data analysis. Results: It was found that the health care service system did not reach the standard for a primary care service system. For example, the management system did not function well, equipment was inadequate, and office space was not well organized, health personnels lacked of confidence in providing proactive services and primary medical care and participation from local authorities and village health volunteers was limited. As the result of the findings, health personnel were trained, health service management was conducted and office space was organized and equipment provided. Furthermore, understanding was created and empowered the community, attitudes were changed towards the health service among people in the communities, learning from best practice communities, the village health volunteers were encouraged to be more confident, and was provided support for health promoting activities of the people. As a result, health personnel have developed their potential as follows: office space was better organized, cooperation from local authorities, village health volunteers, and community leaders has been increased in terms of budgeting and participating in community activities such as elderly clubs, health promoting clubs, Thai massage clubs, mobile clinics, training of drug-users, and the prevention of hemorrhagic fever. Suggestion: The results of the study suggested that the development of a health care service system will be successful by using a participatory approach and integrated methods such as training, supervision, conducting forums, suggestions and learning from best practice communities.
