รูปแบบการผสมผสานงานป้องกันและควบคุมโรคติดต่อในระดับจังหวัด

Abstract

Model development for intregration of communicable and non-communicable disease control at the provincial levelThis project is aimed to develop and test an appropriate model or models for integration of communicable disease (CD) and non-communicable disease (NCD) at the provincial level, with an expectation that the results from this project will be beneficial for the development of policy options and structural planning of disease control in Thailand. There are essentially twelve steps of activities in this project. set up of the project office and management system.reviews of models of CD and NCD control in Thailand and elsewhere and selection of model development areas.analysis of situation, policy and strategies of CD and NCD control in the areas. meeting of investigators of the project. meeting with provincial staff in each of the project areas.workshops and capacity-strengthening activities.procurement of supplies and equipment for the provinces.model development activities.monitoring and supervisory visits by project investigators.project evaluation by external evaluators.workshop for adoption and expansion of the project results.preparation and disemination of project reports.The model used by the Phitsanulok province is set-up of a provincial board for disease control. This board assumes the overall responsibility for coordinating and implementing CD and NCD control activities in the province. Nakorn Si Thammarat used a working group model. The working group was posed with a challenge of integration importance CD and NCD in some communities in the province. It is through the activities of the working group that the province learned about how to integrate the CD and NCD control activities. Phrae set up a superasection of CD and NCD control (so-called Disease Control Section). This section is responsible for prevention and control of CD, NCD, sexually-transmitted disease and AIDS in the province. The model employed by Yasothon is restructuring of existing CD and NCD control sections by set-up of data and planning group, implementation supports group, and human resources development and implemention evaluation group. Several conclusion can be drawn from this study. There is no lest model. Rather, models can be varies, depending on local conditions and organization culture and leadership, with their own strengths and weaknesses. Although medel development of the integration has been shown to be feasible at the provincial level, no pararell demonstration at the central level, i.e. the departmental and ministrial levels has been seen. This separation can be a major obstacle to realization of the provincial-level integration in a sustainable and/or expanded fashion.Centralized budgeting system has proved to be an important impediment to theintegration. Reforming the budgeting system to a more modern manner, e.g. global budgeting, could be a sine-eqa-non component for integration of public health activities at all levels.The feasibility of the integration, as demonstrated by this project, should convince concerned people the changes, however major they seem to be, are possible if we serious about them.