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Looking at Health Promotion and Disease Prevention Services for Children 0-5 Years Old in the Periods before and after the Introduction of the Universal Health Coverage System

ประคิณ สุจฉายา; Prakin Suchaxaya; ศรีมนา นิยมค้า; Srimana Niyomkar; อมรรัตน์ งามสวย; Amornrat Ngamsuoy;
Date: 2550
Abstract
Children under five years old normally grow and develop rapidly; during that process they are at risk of failing to reach the vital goal. Therefore, health promotion and disease prevention comprise potential means for taking care of such children. This study was aimed at studying a profile of the health promotion and disease prevention (HP-DP) services for them, regarding the utilization of the Universal Health Coverage System, and the attendants’ behavior. Descriptive design with in-depth interview was employed for data collection in the period from April 2003 to March 2004. The materials and the subjects studied included documents, 1,000 selected children and their parents who attended HP-DP clinics, 12 health-care providers, and experts. Questionnaires and interview guidelines were used for collecting information. The findings revealed the following: 1. All university hospitals, regional and community hospitals, as well as community primary care units were providing HP-DP services in those settings both before and after the implementation of the Universal Health Coverage policy, apparently without establishing institutional policies and practice guidelines, manpower allocation, staff development or resource planning. Services were also extended to the community despite the limitations of personnel and time constraints. The majority of health-care providers did not understand much about the newly introduced benefit package for children under five years old. In addition, limitations remained on practices in the assessment of childhood development, in developmental stimulation or promotion, the arrangement of the developmental promotion corner and counselling on child-rearing. Thalassemia screening for children whose parents showed traits or were diseased, and thyroid hormone testing for children with indications were seldom practiced. 2. The old and new benefit packages of health promotion and disease prevention in children under five years old did not differ much. Although the known services in the United Kingdom and the United States were included, the practices of recording family history, genetic history, vision and hearing tests, mother-child interaction, parental advice regarding food, oral care, accident prevention, and child development promotion and empowering parents in child care were covered. 3. General information on children and their parents’ behavior on attending the HP-DP service noted that the mothers were mostly the persons who brought their children to the well baby clinic. Most of them were workers, housewives and civil servants. They preferred the hospital’s HP-DP service as it was the place where their child was delivered and was in the vicinity of their residence. However, the services included mainly weight and height measurements, and vaccination. Seldom included were child development assessment and advice on child-rearing and child development promotion. Satisfaction with the health service was 53.3 percent of the samples before and after the introduction of the Universal Health Coverage policy, denoting no difference. Satisfaction with the services related to height measurement, vaccination, developmental promotion, health assessment and advice on child care did not differ significantly statistically (p <0.001).
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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