Abstract
This study was aimed to study the health promotion and disease prevention (HP-DP) service for children from birth to five years old, and the health service behavior of children under universal health coverage policy. Descriptive design with indepth interviewing was used for data collection. Subjects were documents, 1000 parents who brought the children to receive HP-DP service, 12 health care providers, and experts. Data were obtained by using questionnaires and interview guidelines. Findings were as follow: 1. All levels of health care service, university, regional and community hospitals and primary care units, have provided HP-DP service in the settings both before and after the institution of the universal health coverage policy. New institutional policies, guidelines, manpower allocation, staff development or resource allocation were not implemented to support the national policy. Service was extended to the community as well. However there was limitation of personnel and time. Many health care providers did not know about the new benefit package for children from birth to 5 years old. In addition they had limitations in developmental assessment, developmental stimulation or promotion, developmental promotion corner arrangement and providing recommendations on child rearing. Thalassemia screening for children whose parents showed traits or had the disease, and hypothyroid hormone testing for children with indicators, were rarely done. 2. The old and new benefit packages for health promotion and disease prevention in children from birth to five years were not much different. However the services recommended in the United Kingdom and the United States included family history; genetic history; vision and heaving testing; mother-child interaction; details for parental advice for child in each age group concerning food, oral care, accident prevention and developmental promotion; and empowering parents in child care. The recommended activities were consistent with the recommendations by the Royal College for Pediatricians and experts. 3. Children’s health service behavior or parents’ behavior in coming for HP-DP service. Mothers were found to be the ones who brought the child to the well baby clinic more than other persons. Most mothers were workers, housewives and public servants. They selected to receive the HP-DP service at the hospitals because their children were born there and they were rear home or office. Most received services were weight and height measurement, and vaccination. Developmental assessment and advice on child rearing and developmental promotion were limited. The health service behavior of children both before and after the universal health coverage policy was not different. About 53.3 percent of parents felt the same level of satisfaction with the service provided. The services on height measurement, vaccination, developmental promotion, health assessment and advice treatment when the child was ill were found to differ statistically significantly at p <.001
