Abstract
This participatory action research aimed to study and develop a primary health care service model based on the social and cultural context of the northern part of Thailand, roles of professional nurses and health teams as well as conditions that reflect the health outcome of people. This study was conducted in the area that is the responsibility of the Khun Khong health center, Hang-dong District, Chiang Mai Province. Data were collected from health care providers and clients, who were health personnel, community leaders, and villagers, by observation, interview and focus group discussion. Data were used to develop a primary health care service model. Data analysis was made by summarsing the developmental process and lessons learned. Results: It was found that the primary health care unit lacked support in term of human resources and health personnel lacked experience in providing proactive holistic health care services and primary medical care. Participation from villagers and the local community committee was limited. In terms of management, financial support from the primary health care contractor was delayed. From the findings, with cooperation from health personnel, community leaders and research team, a plan was developed to enhance the ability of health personnel and community leaders to be more understanding and confident of providing proactive holistic health services. The developmental process was done by reflecting on data and needs, training, learning from best practice communities and creating understanding among villagers in the communities. As a result, health personnel had more understanding and had more ability to provide care for the villagers. However, the guidelines and management of primary health care from the province health office was unstable therefore, the proactive health care services at the health center level was not well supported, which resulted in ineffective services.Regarding the roles of the health team in the primary health care unit, it was found that nurses had a major role in providing care because of the number of other health professionals was still limited even though all professions are needed at primary health care units. Therefore, nurses are the major professionals in providing holistic health care services.The results from the study suggested that for enabling primary health care service to be more effective, there was a need for clear policies for the development of health personnel in health promotion services by focusing on participation from the community, planning, implemention and continuing supervision by the primary health care contractor. Personnel development should have various activities such as training, reflecting and conducting forums, and learning from best practice communities.
