The Development of Sub-district Administration organization to be Health Promoting organization

Assoc. Prof. Dr. Chulaporn SotaFaculty of Public HealthKhon Kaen University,Thailand

Back ground

Disease Pattern is changed from communicable disease to be non communicable disease. (HT,DM,CA,HD)

Health Promotion is the process of enabling people to increase control over, and to improve their own health.

OTTAWA Charter

BuildingPolicy

Environment

Community strengthen

Skill Health service

Sub-district administration organization (SDAO)Thailand has delegation the powerful to local as

top down since the year 1994 until now by SDAO take action as the main organization for development appropriate their need and problem.

But Health promotion was not enough concern from SDAOM although the government try to alert and motivation.

Thailand has already conducted HPH, HPS, Healthy work place, but no have HPSDAO although SDAO is very important organization to improve people’s health and quality of life.

Health Promoting Sub-

district Administration Organization

Objectives

Research Design

This participatory action research (PAR)Aimed to “”””””””””””””””””sub-district

administration organization member (SDAOM) to be health promoting sub-district administration organization

Study area : 2 SDAOs Nongbua sub district , Nong kungsee

district, Kalasin Province Kao Suan Kuang sub-district , Kao Suan

Kuang district, Khon Kaen Province, Thailand.

Sample The samples were 56 leaderships. People :””””””””””””””” There were 3 phases study. Phase 1 study context and situation

analysis Phase 2 potential development of Sub-

district administration organization Phase 3 SDAOM conducted health

promoting activities for people in communities.

Data CollectionThe data were collected by questionnaires

both pretest and posttest and AIC technique (Appreciate Influence Control)

Data analyzed by SPSS program for quantitative data. The statistics were analyzed for descriptive data : percentage, distribution, arithmetic mean and standard deviation and comparative internal group were used paired Sample t-test.

Qualitative data was analyzed by content analysis.

Research ToolQuestionnaire and Observation form

AIC (Appreciate Influence Control) for qualitative data

Empowerment1. Academic support2. Motivation : Emotional support3. Knowledge management or caring and Sharing 4. Health Promoting activities consultation5. Equipment support 6. Competition : health promotion village, Local

song (Sarapanya) 7. Health Promoting Handbook

Health Promoting SDAO1. Health Promoting Plan and Project, Policy2. Various Health Promoting Activities3. Increasing concern about health promotion4. Increasing stakeholders participation5. Health promotion committee 6. SDAO allowance budget for health

promotion.7. Continuing development.

Sport support

Good Participation : school, community, temple

AIC

Results1. After implementation, the subjects had

mean score of Knowledge, attitude , enabling, and reinforcing factor of SDAOM higher than before implementation significantly at p<0.001.

No significant of practice and role of health promotion support.

Results : Situation1. SDAOM almost had experiences for

health promotion training however no policy and no health promotion activities were arranged.

After implementation there were many health promotion activities appear including plan and policy were focused .

Good Community participation

AIC Technique at Nongbua sub-district, Kalasin Province

Research Results

1 .General data

1 .Sample (56 Persons)

2 .Sex (Female 51.8%)

3 .Age 6 -45 yr 39.28%)

5.Education (Primary school

26.8%)6 .Body

weight (51-60 กKg. 50.0%)

7 .High (151-160 Cm. 53.57%)

4 .Marital status

(Married 85.7%)

8. BMI (19-25 75.0%)

1 .1 .General data

9 .Sickness (No 67.9%)

Member 10. Family

Illess(NO67.9%)

11 .Agriculture

( 58.9%)

13 .Exercise training (83.93%)

14 .Nutrition training

( 69.64%) 15 .Alcohol and Tobacco

Training (58.93%)

12 .Income Per month (<5000 Bt 81.78%)

16 .Stress management

(45.64%)

1 .1 .General data

17 .AIDS Training (48.21

%)

19 .Sanitation and

Environment ( 58.93%)

18 .Traffic accident

Prevention Training

( 69.64%)

22.8324.64

3.593.93

0

5

10

15

20

25

30

pretest posttest

kn

ow

led

ge

sco

re

average score

S.D.

2. Comparison of knowledge for health promotion between pretest and post test.

Significantly Difference (p<0.001; 95% CI: 2.98 to 0.61)

Competition of Local song for health promotion

Health Promotion Training for Senior people

72.2878.6

7.76 5.09

0

10

20

30

40

50

60

70

80

90

pretest posttest

Att

itu

de

sco

re

average score

S.D.

3. Comparison of Attitude toward health promotion between pretest and post test.

Significantly Difference p<0.001; 95% CI: 8.89 ถึ�ง 3.75)

1.66

2.53

1.71 1.53

0

0.5

1

1.5

2

2.5

3

pretest posttest

En

abli

ng

Fac

tore

average score

S.D.

3. Comparison of Perception of Enabling factor of health promotion between pretest and post test.

Significantly Difference (p<0.000; 95% CI : 8.89 ถึ�ง 3.75)

Health promotion training for adolescent

1.68

3.32

2.08

1.6

0

0.5

1

1.5

2

2.5

3

3.5

pretest posttest

Rei

nfo

rcin

g

fac

tor

average score

S.D.

4. Comparison of reinforcing factor on health promotion between pretest and post test.

Significantly Difference (p<0.001; 95% CI : 2.36 To 0.92)

101.66 100.04

13.24 11.57

0

20

40

60

80

100

120

pretest posttest

คะแน

นด้�าน

พฤติ

�กรรม

average score

S.D.

5. Comparison of practice on health promotion between pretest and post test.

No Significantly different (p<0.447; 95% CI : -2.63 To 5.88)

33.51 34.32

7.257.36

0

5

10

15

20

25

30

35

40

pretest posttest

Su

pp

ort

ive

role

average score

S.D.

6. Comparison of supportive role for health promotion between pretest and post test.

No significantly Difference(p<0.527; 95% CI : -1.72 To 3.33)

People Characteristic

Recommendation from research

1. Human relationship among stake holders is very important including researcher and community leader.

2. Mobilization among other supportive organizations should concern.

3. Knowledge management for caring and sharing should be conducted.

Recommendation from research

4. Motivation relevance with community context made the leader alert to join health promotion activities

5. Re- planning is very important for increasing sustainable development.

6. Researcher should be facilitator and help the local authority take action and increasing their proud.

Recommendation from research

7. Enhancing Local Authority has opportunity to present the activity an increasing self of belonging.

1. It should be R&D (Research and Development) for sustainable and creative activities.

2. It should integrate culture for health development.

3. Integrate health promotion among all of element is interesting such as physical activities, nutrition , mental health, tobacco and alcohol abuse, AIDS , accident prevention and environmental health.

Recommend for further research

Recommend for further research

4. Comparative study between difference local authority.

5. Study and Develop KPI for local Authority.6. Study outcome and impact of

preventative disease decreasing. Relative health promotion implementation.

7. Study applying for health Promotion in various dimension of health promotion.

ConclusionHealth promotion activities was very

important behavior, especially decreasing preventable

diseases. , The SDAOM should more concentration and support including motivation and

encourage the people for more concerning and participation about health promotion .

AcknowledgementThanks the National Health Security OfficeThank Khon Kaen UniversityThank sub-district Administration

Organization : Both Nong bua Sub-district , Nongkungsri District, Kalasin Province and Kaosuankuang Sub-district ,

Kaosuankuang Sub-district,Khon Kaen Thailand.

Thanks for all valuable supportive.

Thank you for your Attention