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Engaging local governments in health promotion and chronic disease prevention activities: the case of Local Health Security Funds in Thailand


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Figure 1

Percentage of LHSFs with activities according to the Ottawa Charter. 2a, Facility development, 2b. Creating community space. 3a, Community action plans. 3b, Community strengthening development 3c, Community networking. 5a, Type of activities. 5b, Methods of implementation. 5c, Integration health promotion activities into home visits.
Percentage of LHSFs with activities according to the Ottawa Charter. 2a, Facility development, 2b. Creating community space. 3a, Community action plans. 3b, Community strengthening development 3c, Community networking. 5a, Type of activities. 5b, Methods of implementation. 5c, Integration health promotion activities into home visits.

Comparison of the collected data with the national data

DataParticipants study populationProportion ofNational dataProportion of Thailand
Classified by area
 Urban municipality80.71552.0
 Sub-district municipality20819.41,90024.5
 Sub-district administration organization85679.95,75373.5
 Total1,072100.07,808100.0
Classified by region
 Northern19418.11,61220.6
 Southern716.61,24616.0
 Northeastern50447.02,94537.7
 Central30328.32,00525.7
 Total1,0721007,808100.0

Health promotion and disease prevention activities for diabetes and high blood pressure in community

Type of activitiesNumber (n = 1,072)Percentage (%)
Build healthy public policy
Creating community policies & regulations to support health35833.4
promotion
 Identification of community role models24769.0
 Awards for successful guideline follower14640.8
 Punishment for violation of rules5314.8
Environment improvement to facilitate health promoting
behavior
Facility development or improvement87481.5
 Sports or exercise areas77588.7
 Public parks28732.8
 Learning centers27431.4
 Community areas for herb gardens22125.3
 Healthy markets687.8
 Swimmingpools50.5
Creating community space or areas for health62858.6
 Designation of smoke-free areas43669.4
 Designation of alcohol-free areas25140.0
 Requirement of public places such as temples and schools to be equipped with health risk assessment tools24238.5
 Requirements of restaurants in the community to have a healthy menu10316.4
Strengthen community actions through group or network formation
Community action plans104997.9
Community strengthening development103296.3
Community networking97490.9
Types of groups
 Exercise groups69471.3
 Women’s groups63865.5
 Youth groups41442.5
 Alcohol drinking cessation group15115.5
 Smoking cessation group858.7
Types of support
 Budget89088.9
 Supplies53052.9
 Study visits35935.9
 Personnel28628.6
 Organizing contests28128.1
 Monitoring, evaluation, and support22122.1
 Search and promotion of role models12012.0
Develop personal skills through health education81475.9
Target population
 General population67482.8
 Elderly persons45455.8
 Overweight persons28234.6
 Alcohol drinkers18322.5
 Smokers17119.8
Channels of health education
Workshops/seminars/lectures49846.5
Leaflets/brochures48644.3
Counselling37334.8
Community news broadcast31329.2
Billboards in the community25123.4
Training camps14213.2
Contents of health education in relation to NCDs
General knowledge82977.3
Risk factors79874.4
Severity and complications of diseases72867.9
Behavior and practice
 Diet84278.5
 Exercise82977.3
 Alcohol drinking cessation81776.2
 Smoking cessation81576.0
 Stress management77071.8
Self-care practice during illness74769.7
Self-monitoring or screening
 Blood glucose screening73168.2
 Monthly blood pressure monitoring70565.8
 Monthly waist measurement63659.3
 Weekly weight measurement60256.2
Reorient health services to facilitate health promotion activities against NCDs
Type of activities or support to health facilities or health staff88782.7
 Provision of financial support to carry out health promotion activities
 Provide data on vulnerable groups e.g. people with66274.6
 diabetes and hypertension60668.3
 Provision of supplies for use in health promotion activities42447.8
 Registration of vulnerable groups36140.7
 Hiring more staff to work at the healthcare settings16818.9
Methods of implementation66762.2
 Health promoting activities while waiting for services at the hospital59589.2
 Relaxation activities while waiting for services at the hospital19128.6
Integration of health promotion activities into home visits84578.8
 Blood sugar screening71484.5
 Blood pressure screening75188.9
 Weight measurement64876.7
 Waist circumference measurement53162.8

Diversity of 5 main categories of health promotion activities

LHSF characteristicsTotal number of LHSFs (n = 1,072)LHSFs with all 5 categories (n=223)% complete within each group
Regions

P < 0.05 by chi-square or Fisher exact tests

 Northern1943819.6
 Southern711216.9
 Northeastern50412023.8
 Central3035317.5
Size of area
 Urban municipality8225.0
 Rural municipality2084220.2
 SAOs85617920.9
Existence of public health office in the local government

P < 0.05 by chi-square or Fisher exact tests

 Yes3388525.1
 No73017918.8
Educational level of local government knowledge
 Bachelor’s degree or lower4088019.6
 Higher than Bachelor’s degree65714321.8
Work experience of local government chiefs
 More than one term in office4017619
 First term in office65710319.5
Relationship between head of local government and public health officers

P < 0.05 by chi-square or Fisher exact tests

 Excellent1864423.7
 Good71815922.1
 Fair1421510.6
 Poor19315.8
eISSN:
1875-855X
Language:
English
Publication timeframe:
6 times per year
Journal Subjects:
Medicine, Assistive Professions, Nursing, Basic Medical Science, other, Clinical Medicine