Abstract
Diabetes Mellitus(DM) is a chronic disease which needs long term care. Main problems happened to the patient are complication causing decreasing in quality of life. Early deteetion can result in controlling disease. One of the main measures used is screening for DM both at peripheral health facility, so called ‘health center’, and primary health care community center (PHCC). However, the effective of this measure would rely on the number of client attending the service which is no voluntary basis. According to low reported DM cases in comparison with others, Khun Han hospital conducted a research to investigate community participation on screening for DM from March 2001 to February 2002 which place emphasis on ‘real participation’ at all step of the intervention program including situation analysis, identifying activities, implementing identified activities and conclusion and evaluation. This program involved related organizations and units. By convening group discussion, the core participants included village leaders 2 persons, representatives of village health volunteers 3 persons, member of Tambon Administrative Organization (TAO) 1 person, representatives of villagers aged 25-60 years old 8 persons facilitating by health personnel both from health center and hospital. According to the group discussion, identified obstacles or problems of low attending screening test were insufficient or wrong perception, knowledge and understanding on DM as well as wrong attitude toward the disease. For instance, ‘DM can not be cured’ so they are afraid to know or ‘we are so strong and healthy. It’s not necessary to be tested’. Furthermore, some thought that complications of diabetes are so severe. Patient will die soon. Regarding in-corrected knowledge, some villagers believe that some kind of herbs can cure the disease. Apart from the client side, problems on services were insufficient of urine strip for testing urine sugar in addition to villagers did not trust on the capability of the village health volunteers who provided service. Based on the findings, the group defined the necessary activities including announcement of campaign of screening for DM via person to person and broadcasting on village loud speakers. To provide knowledge and activate the awareness of the villagers, a meeting were convened at the village hall. The main contributors were village health volunteers and the one who has direct experiences on caring the diabetes patients. The session was organized as group discussion and sharing experiences among the participants and ended with ‘question & answer’. This differs from the former health education activities which was mostly done by health personnel. After being motivated the awareness, campaign of screening for DM was conducted. Out of 96 risk group, 70 villagers (72.9%) were tested for DM. There were 17 persons having positive results with urine strip. These positive cases were confirmed by fasting blood sugar determination. Out of 17 cases, one was diagnosed as DM. After finding new case, the community was aware of DM. Following activities were identified, namely, providing weekly service on screening for DM at PHCC, organizing refreshing course on diabetes mellitus to village health volunteer, registering DM cases living in the community, screening test for diabetes in risk group at least once a year, submitting request to TAO for blood glucose testing equipment.Being conducting research emphasizing on community participation has effects on attitude of health personnel and community regarding to health matter. The community perceive that health is their own matter not the matter for health personnel only. In addition, health personnel realize on the potentials and capacity of the community in managing problem solving.
