Abstract
This study aims to assess the existing potentials of village health volunteers in
Thailand in the context of changes. The research process involved the review of
related situation both from relevant documents and from a technical workshop with
experienced health workers. Commissioned papers were assigned to potential
researchers in various areas of inquiry such as the changing situation in community
health, the historical evolution of the concept of health volunteers in Thailand,
community volunteer in the context of emerging diseases, as well as the review of
supporting system for village heatlh volunteers. A quantitative study was also
undertaken to identify existing performance, incentives, and obstacles of village
health volunteers. In addition, in order to identify future potential of health volunteers,
interesting volunteer works in related health fields were identified. 15 case studies
were documented and used as input for the final synthesis of developmental
strategies.
Findings of the study can be summarized in an eight-point synopsis. (1)
Concept and operational model of village health volunteer was the product of
historical development. As health situation and political landscape has changed in the
past few decades, there was a need to reconceptualize the idea of health volunteer; (2)
Village health volunteers in Thailand numbered almost a total of 800,000. It was an
extremely valuable health resource. Village health volunteers were mostly selected by
local communities. Although the recruitment of a number of them was relatively
problematic, village health volunteers were mostly well respected by local villagers.
Volunteers were generally selected because local people knew them as ones who
devoted to collective affair and people trusted them. (3) Existing system of village
health volunteer in Thailand was still very much alive and has become increasingly
famininized. More than 35% of existing volunteers were recruited in less than five
years, while the number of female volunteers rosed to almost 70%. (4) Existing
village health volunteers performed comparatively well on short-termed task such as
ad hoc health survey, periodic collecting data, or disease prevention campaign. They
did not fare well in the area of work that need long-term, continuing devotion, such as
caring of chronically ill patients.
(5) Existing volunteer workforce was recruited from comparatively low
educational and economic background. This poses the question, how could higher
quality of volunteer workforce with an economic status more prepared to dedicate be
recruited? (6) The changing supporting system and decentralization has greatly
affected the relationship between health volunteers, local administration, and the role
of Ministry of Health. Although a coordination mechanism was recently created at
various levels, local health volunteers have little participation above the district level.
(7) Village health volunteer has been apparently politicized and become instrumental
in local and national politics. (8) A number of case studies suggested an increasing
innovative roles and forms of volunteers in health development, ranging from
volunteers in hospital settings to diaster relief volunteers. This strongly indicated that
the idea of volunteer has been progressively more accepted in Thai society.
The followings are recommendation for future development of health
volunteers. (1) The Ministry of Public Health needs to shift its role from being the
possessor of health volunteers to the role of promoting the idea of health volunteers in
various appearances. (2) Support the formation of health volunteers in every field of
health activities. Each and every organization in public health should be encouraged
to create and organize its own network of volunteer workforce, rather than depending
solely on village health volunteers as the only form of people participation. (3) Creat
more spaces for volunteer work in various public health offices by promoting health
organizations to open up more opportunity for volunteer work in the organizations (4)
Pluralize forms of health volunteers in local communities. The standard operational
model of village health volunteers, while contributed greatly to last few decades’
health accomplishment, has reached its limit. (5) Encourage public health officers to
work as volunteer themselves as a way to promote volunteer spirit in public health
organization. (6) Develop self-governing mechanism to make health volunteer a nonpartisan
organization.
