Village Health Volunteers Research Articles

A Comparative Study of the Service Quality between the Sub-District Health Promotion Hospital Transferred to the Provincial Administrative Organization and the Sub-District Health Promotion Hospital under the Ministry of Public Health in the Tha Sala District, Nakhon Si Thammarat Province

Background and Aim: A comparative study of the service quality of subdistrict health promotion hospitals transferred to the Provincial Administrative Organization. And subdistrict health-promoting hospitals under the Ministry of Public Health in ​​Tha Sala District Nakhon Si Thammarat Province. It occurred due to the setting and driving of the policy to transfer Subdistrict Health Promoting Hospitals (Subdistrict Health Promoting Hospitals) to the Provincial Administrative Organization. The research objectives are to (1) study and compare the quality of services of Subdistrict Health Promotion Hospitals transferred to the Provincial Administrative Organization and Subdistrict Health Promotion Hospitals under the Ministry of Public Health, (2) determine guidelines for developing service quality. Of Subdistrict Health Promoting Hospital in Tha Sala District Nakhon Si Thammarat Province Materials and Methods: This research uses a qualitative research method, using data collection tools, which are questions for in-depth interviews, to collect information from key informants. Consisting of (1) a group of officials from Subdistrict Health Promoting Hospital in Tha Sala District, four people, (2) a group of directors from Health Promoting Hospital in Tha Sala District, four people, and (3) a group of village health volunteers, which is a group receiving services from Subdistrict Health Promotion Hospital transferred to the Provincial Administrative Organization and Subdistrict Health Promotion Hospital under the Ministry of Public Health, totaling four people. Results and Conclusion: The results of the study found that (1) the concreteness of the Subdistrict Health Promotion Hospital services transferred to the Provincial Administrative Organization; There is the concreteness of service by providing services based on the standards of primary care units, 2024 edition, with clean, proportionate, and appropriate service locations. (2) Reliability of service providers. Subdistrict Health Promoting Hospitals transferred to Provincial Administrative Organizations There is a thorough check on the accuracy of dispensing medicines to patients. There is training to provide knowledge on various matters (3) in responding to the needs of Subdistrict Health Promotion Hospital service recipients transferred to the Provincial Administrative Organization. Service information is publicized through village health volunteers and Subdistrict Health Promoting Hospitals under the Ministry of Public Health. (4) in the aspect of providing confidence to Subdistrict Health Promotion Hospital service recipients who are transferred to the Provincial Administrative Organization. As for the Subdistrict Health Promotion Hospital under the Ministry of Public Health, bathrooms are designed with safety in mind. While working, staff wear uniforms and gloves and strictly follow procedures. (5) Understanding and knowing service recipients. Subdistrict Health Promoting Hospitals transferred to Provincial Administrative Organizations Staff provide services with convenience and speed and take care of patients with professional ethics. Pay attention to taking care of patients very well. As for the Subdistrict Health Promotion Hospital under the Ministry of Public Health Staff provide service with a cheerful smile, speak sweetly, and take care of patients closely.

Potential Development in Knowledge, Chest Compression Skill, Automated External Defibrillator Skill and Basic Life Support for Thai Village Health Volunteer

Background and objectives: Currently, emergencies from complications, congenital disease, or physical pathology, such as out-of-hospital cardiac arrest (OHCA), are important causes of death and hospital admission, and sudden cardiac arrest occurs until the heart stops working immediately. This study aims to To examine the results of repeated measurements with Qualitative Confirmation of results, knowledge, understanding, chest compression skills, use of AEDs, and basic life support for village health volunteers (VHV). Methods: This mixed-method. Phase 1 quasi-experimental research. The sample group consisted of 30 Village Health Volunteers (VHV) selected using a simple random sampling method. The tool used in this research was the basic life support program that seduces a group process. Knowledge assessment form and basic life support skills. Data collection was performed by repeated measurement six times; Phase 2, qualitative research by discussing Basic life support program of Village Health Volunteers (VHV) that participated in the quantitative research program. After the 6th follow-up repeat measurement for one month, the sample was selected randomly from 10 participants in the program in phase 1. Quantitative data were analyzed using descriptive statistics, one-way analysis ANOVA with repeated measures, and statistical data. Qualitative data were analyzed using content analysis. Results: The findings of the quantitative study showed that Village Health Volunteer (VHV) had knowledge scores on patient assessment and environment, chest compression, use of AED, and basic life support. From each measurement, there was a better direction statistically significant at the qualitative level of 0.01. Conclusion: Basic life support program using group processes can develop potential and increase confidence in knowledge and understanding, skills in patient assessment and environment, chest compression, use of AED, and basic life support. Therefore, knowledge, understanding, and basic life support skills should be regularly and continuously reviewed to ensure resuscitation efficiency. Word count: 5,578 words, excluding references. Funding Statement: The study was supported by a grant from Non Sung Hospital, Nakhon Ratchasima Province, Thailand. Conflict of Interest declaration: The authors declare that they have NO affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript. Author Contributions: AV and PC contributed to the design and implementation of the research, JK and KV to the analysis of the results, and TB and TP to the writing of the manuscript.

Developing web-based interventions for alcohol use screening and alcohol education administered by village health volunteers in the community setting

BackgroundGiven technology’s rising importance in addressing alcohol issues, this study aimed to compare the effectiveness of web-based interventions and that of traditional paper-based methods for alcohol use screening and education administered by village health volunteers (VHVs) in Thailand. MethodsThis cluster randomised controlled trial was conducted in two Thai villages with similar demographics and alcohol-use patterns. The villages were randomly assigned to either a web-based or a paper-based intervention group. The web-based group accessed screenings and interventions through a digital platform designed to facilitate user interaction and data collection, whereas the paper-based group used conventional face-to-face screenings, paper questionnaires, and printed educational materials. ResultsOf the 1,396 participants, those in the web-based group (n = 421) demonstrated a significantly higher likelihood of abstaining from or discontinuing alcohol use by the third session compared to those in the paper group (n = 975) (adjusted odds ratio 1.88 to 8.11). Additionally, satisfaction among VHVs regarding the ease of use and data accuracy was notably higher in the web-based group, with scores averaging 20% higher than those in the control group. ConclusionWeb-based interventions are more effective and efficient than traditional methods and provide a promising tool for expanding alcohol use disorder screening and education. This approach not only enhances participation rates but also improves the accuracy and reliability of health data collection.

Health Literacy in Preventing and Controlling Dengue Hemorrhagic Fever Among Village Health Volunteer, Pattani Province, Thailand

Background: Dengue Haemorrhagic Fever (DHF) is a mosquito-borne viral infection caused by the dengue virus (DENV). The situation of the DHF prevalence rate was still high in the community. One reason for this high rate involves community members, who had less participated in the prevention and control measures of DHF. Objectives: This descriptive study aimed to study factors associated with preventing and controlling DHF among village health volunteer, Pattani Province. Methods: Population consisted of 6,841 village health volunteers registered in Pattani Province, Thailand, in fiscal year 2020, and the sample size was calculated using Daniel formula for 215 cases, and systematic random sampling was carried out for collecting data. Data were collected by questionnaires composed of 3 parts, including characteristics, health literacy factors, and preventing and controlling DHF. In addition to check questionnaire standardization, validity was checked by three experts and try out testing reliability by Cronbach’s coefficient alpha about 0.87. Data were analysed using statistical as Pearson product moment correlation coefficient and Stepwise Multiple Regression Analysis. Results: The analysis found that health literacy factors were associated with preventing and controlling DHF among village health volunteer, Pattani Province such as access skill (r=0.310, p-value<0.001) communication skill (r=0.201, p-value=0.003) media literacy skill (r=0.386, p-value<0.001) decision skill (r=0.349, p-value<0.001) self-management skill (r=0.480, p-value<0.001), respectively. Conversely, cognitive skill had no association (r=0.117, p-value=0.086). Conclusion: The finding showed that health literacy of village health volunteer was associated with the preventing and controlling DHF. Therefore, health workers should encourage the village health volunteers to participate in sustainable prevention and control of DHF.

Effect of a multidisciplinary program with seven color balls on non-communicable diseases prevention in a Muslim community: A real-world study

Prevalence of diabetes and hypertension are increasing. Health promotion is needed for the diseases prevention. The objective of this study was to determine the impact of a multidisciplinary program and a seven-color balls on fasting blood glucose and blood pressure in a Muslim community. A one-group pre-post test of participatory action research was employed. The screening test was administered and assigned a color to each of seven health statuses. All participants made a commitment to improve their weekly performance. They were instructed and practiced for three weeks on six health information topics. Then, each village health volunteer reminded the participants of health information, and a religious leader declared (Kutbah) during Friday prayer that tobacco and alcohol are contrary to Islam. Utilizing frequency and percentage, the study outcome at the end of the program was compared to that at baseline. The results revealed that the mean age of the participants was 33.92 years, with a range of 15 to 82 years. Six months after program finish, 87.5% of those at risk and 93.3% of high risk for hypertension returned to normal blood pressure levels. For FBS level, risk for diabetes participants improved to a normal level by 57.6%, participants who were possibly for diabetes improved to better level by 50%, and third level illness decreased to a lower level by 50%. The program could improve participants’ health status and encourage their self-esteem for health prevention. Prevention of hypertension, and diabetes is essential for promoting individual and community health.

Factors influencing the organizational engagement of village health volunteers, after the COVID-19 Outbreak in Phayao Province

Village health volunteers (VHVs) play a crucial role in promoting health advancements and enhancing community well-being. This cross-sectional descriptive study explores the factors that influence organizational engagement among VHVs in Phayao Province. Data were gathered from 400 volunteers using Krejcie and Morgan’s formula and analyzed through a questionnaire. Analytical methods included descriptive statistics, Pearson’s product-moment correlation, and multiple linear regression. The findings revealed that the majority of volunteers were female (77%), aged between 41-60 years (62.3%), married (81.3%), with over ten years of experience (61%), and had educational levels of high school or vocational certificate (46.8%). Most were agriculturists (63.5%), with incomes below 5,000 baht (54%), and served as general members (74.5%) in a single role (78.8%), primarily under the provincial administrative organization (54%). The scores for motivational factors, quality of life, and organizational engagement were high. Responsibility, the nature of work, and respect were identified as significant predictors of organizational engagement, accounting for 51.1% of the variance. These findings were statistically significant (R = 0.715, R Square = 0.511, P-value < 0.001). Based on these results, organizations are encouraged to ensure appropriate working conditions and respect to enhance engagement among village health volunteers.

Beliefs, taboos, usages, health perceptions, and practices toward wildlife among different ethnicities in Tak and Mae Hong Son Provinces, Thailand

This concurrent qualitative study was carried out with the main objective to determine wildlife beliefs, taboos, usages, health perceptions, and practices among ten ethnic groups in four communities in Tak and Mae Hong Son provinces of Thailand from November 2020 to January 2021. We also gathered comprehensive information on study respondents’ knowledge related to potential risk behaviors that could lead to zoonotic disease transmission and infection. Furthermore, we intended to use the study’s findings to develop communication strategies and health literacy improvement interventions for mitigating risky behaviors, with a focus on ethnic groups and particular individuals who live in close proximity to forests and wildlife, to prevent future pandemics. Sixty-five respondents were purposively selected based on their extensive knowledge, active participation in local cultural contexts, beliefs, and exposure to wildlife contact or consuming game animals. Twenty (30.8%) participated in in-depth interviews (IDIs), while 45 (69.2%) participated in eight focused group discussions (FGDs). The results revealed that the characteristics of wildlife contact are similar and distinct based on their beliefs and taboos among various ethnic groups and study locations, which are influenced by cultural backgrounds and traditions. Although some ethnic groups do not have explicit restrictions on the consumption of wildlife, others adhere to specific beliefs and taboos that forbid the consumption or killing of specific wild animals. These beliefs frequently correspond with conservation initiatives, thereby facilitating the preservation of threatened species. The study also revealed a lack of appropriate health knowledge, perceptions, and practices regarding wildlife contact and consumption. As a result, it is recommended that public health officials and local governments develop and execute communication and education initiatives. These campaigns should aim to increase health literacy and promote safe handling, preparation, and cooking practices to reduce the risk of zoonotic disease transmission and infection effectively. Moreover, it is necessary to design and implement wildlife conservation education and outreach activities. The programs should promote environmental stewardship while considering the cultural contexts, beliefs, and practices of various ethnic groups. The activities should involve diverse stakeholders, including local leaders, religious influencers, community members, schoolteachers, students, health professionals, village health volunteers, and civil society organizations.

Health literacy development using a short drama programme for dengue fever control in Thailand

Background: Dengue is a viral infection that spreads from mosquitoes to people. It is especially prevalent in tropical and subtropical regions of the world. To address the challenges posed by dengue in countries such as Thailand, effective prevention and control to strengthen health literacy at the community level is needed. One way of achieving this goal is to work with village health volunteers (VHVs). This article documents the use of VHVs for dengue fever prevention in Mueang district, Khon Kaen province, northeast Thailand. Method: A quasi-experimental study was conducted. The experimental group comprised 45 people who received a programme that aimed to enhance health literacy through the provision of knowledge and social support by community-based volunteers accompanied by a short drama programme. A group of 45 people receiving health services without the drama programme comprised the comparison group. The duration of the activity was 12 weeks. Data were collected by means of a pre- and post-test survey and were analysed using descriptive statistics and a comparison of mean health literacy and practice scores before and after the intervention. Results: Following programme delivery, the experimental group had a mean health literacy score which was significantly higher than that of the comparison group, while the mean practice score of the experimental group was also higher than that of the comparison group. Conclusion: The results suggest that a health literacy programme which includes a short drama programme could be effective in bringing about desired changes with respect to dengue fever prevention. The programme provided in this study was effective and easy to understand. The model developed here could also be useful in other villages in epidemic areas.

Effectiveness, Safety, and Acceptability of Primaquine Mass Drug Administration in Low-Endemicity Areas in Southern Thailand: Proof-of-Concept Study.

A challenge in achieving the malaria-elimination target in the Greater Mekong Subregion, including Thailand, is the predominance of Plasmodium vivax malaria, which has shown extreme resilience to control measures. This proof-of-concept study aimed to provide evidence for implementing primaquine mass drug administration (pMDA) as a strategy for P. vivax elimination in low-endemicity settings. The study employed a mixed-methods trial to thoroughly evaluate the effectiveness, safety, acceptability, and community engagement of pMDA. The quantitative part was designed as a 2-period cluster-crossover randomized controlled trial. The intervention was pMDA augmented to the national prevention and control standards with directly observed treatment (DOT) by village health volunteers. The qualitative part employed in-depth interviews and brainstorming discussions. The study involved 7 clusters in 2 districts of 2 southern provinces in Thailand with persistently low P. vivax transmission. In the quantitative part, 5 cross-sectional blood surveys were conducted in both the pMDA and control groups before and 3 months after pMDA. The effectiveness of pMDA was determined by comparing the proportions of P. vivax infections per 1000 population between the 2 groups, with a multilevel zero-inflated negative binomial model adjusted for cluster and time as covariates and the interaction. The safety data comprised adverse events after drug administration. Thematic content analysis was used to assess the acceptability and engagement of stakeholders. In the pre-pMDA period, the proportions of P. vivax infections in the pMDA (n=1536) and control (n=1577) groups were 13.0 (95% CI 8.2-20.4) and 12.0 (95% CI 7.5-19.1), respectively. At month 3 post-pMDA, these proportions in the pMDA (n=1430) and control (n=1420) groups were 8.4 (95% CI 4.6-15.1) and 5.6 (95% CI 2.6-11.5), respectively. No statistically significant differences were found between the groups. The number of malaria cases reduced in all clusters in both groups, and thus, the impact of pMDA was inconclusive. There were no major safety concerns. Acceptance among the study participants and public health care providers at local and national levels was high, and they believed that pMDA had boosted awareness in the community. pMDA was associated with high adherence, safety, and tolerability, but it may not significantly impact P. vivax transmission. As this was a proof-of-concept study, we decided not to scale up the intervention with larger clusters and samples. An alternative approach involving a targeted primaquine treatment strategy with primaquine and DOT is currently being implemented. We experienced success regarding effective health care workforces at point-of-care centers, effective collaborations in the community, and commitment from authorities at local and national levels. Our efforts boosted the acceptability of the malaria-elimination initiative. Community engagement is recommended to achieve elimination targets. Thai Clinical Trials Registry TCTR20190806004; https://www.thaiclinicaltrials.org/show/TCTR20190806004.

Geospatial joint modeling of vector and parasite serology to microstratify malaria transmission

The World Health Organization identifies a strong surveillance system for malaria and its mosquito vector as an essential pillar of the malaria elimination agenda. Anopheles salivary antibodies are emerging biomarkers of exposure to mosquito bites that potentially overcome sensitivity and logistical constraints of traditional entomological surveys. Using samples collected by a village health volunteer network in 104 villages in Southeast Myanmar during routine surveillance, the present study employs a Bayesian geostatistical modeling framework, incorporating climatic and environmental variables together with Anopheles salivary antigen serology, to generate spatially continuous predictive maps of Anopheles biting exposure. Our maps quantify fine-scale spatial and temporal heterogeneity in Anopheles salivary antibody seroprevalence (ranging from 9 to 99%) that serves as a proxy of exposure to Anopheles bites and advances current static maps of only Anopheles occurrence. We also developed an innovative framework to perform surveillance of malaria transmission. By incorporating antibodies against the vector and the transmissible form of malaria (sporozoite) in a joint Bayesian geostatistical model, we predict several foci of ongoing transmission. In our study, we demonstrate that antibodies specific for Anopheles salivary and sporozoite antigens are a logistically feasible metric with which to quantify and characterize heterogeneity in exposure to vector bites and malaria transmission. These approaches could readily be scaled up into existing village health volunteer surveillance networks to identify foci of residual malaria transmission, which could be targeted with supplementary interventions to accelerate progress toward elimination.

Understanding perspective on community health literacy for promoting the health of older adults with hypertension: a qualitative descriptive study

Introduction: This study aimed to understand the community people’s experience of access, understanding, evaluation, and application of health information for self-care of hypertensive older adults, and explore the community's perspective on promoting community health literacy (CHL) on caring for hypertensive older adults. Methods: This was a qualitative descriptive study. Data were collected through focus groups and in-depth interviews in one sub-district municipality in Mahasarakham, Thailand. A total of 37 participants from older adults with hypertension, families of older adults with hypertension, and community committees were recruited based on inclusion criteria using purposive sampling. Data were then analyzed using a five-step thematic analysis. Results: Four main themes of community people’s experience emerged 1) access to health information limited by the healthcare personnel at the primary care unit (PCU), 2) understanding the health information because it is clear and familiar, and can ask the medical personnel directly, 3) do not evaluate the health information received from healthcare personnel because they trust them, and 4) applied health information to practice only taking medicine and doctor’s appointments. Three main themes to promote CHL are 1) usual healthcare activities, 2) community action, and 3) nurses at PCU, village health volunteers, and community committees should be involved in playing a key role in promoting CHL. Conclusions: Cooperation with community leaders is important to promote CHL by using active learning education and creating a supportive environment focusing on encouraging older adults to perform self-care to control their health conditions.

Factor analysis of the village health volunteers’ core competencies in Thailand

This survey research aimed to study the VHVs’ core competencies, in particular by analyzing the VHVs’ Competency Standards developed in 2007 in Thailand. The research used multistage probability random sampling. A total of 500 samples were collected from four regions in country through administering a questionnaire. The IOC was 0.70 –1, the CVI was 1, and the Cronbach’s alpha coefficient was 0.98. Exploratory factor analysis was deployed with principal component analysis and the Promax method for factor extraction and rotation. The sampling adequacy was verified with appropriate values (KMO = 0.96 and MSA values for each item ranging from 0.94 - 0.98 and Bartlett’s Test of Sphericity (p < 0.001)). The results demonstrated that there are seven core competencies for VHVs as follows: 1) Empowering children and youth to engage in community healthcare development, 2) Health promotion, 3) Disease prevention, 4) Basic medical care, 5) Policy implementation, 6) Fostering self-care awareness, and 7) Health risk monitoring and precaution. All competencies explained 70.02% of the variance. The results could serve as guidelines for developing VHVs’ competencies to deliver high-quality healthcare services in the community.

Paradigm Conflict: Village Health Volunteers and Public Health in Thailand

Reformist doctors in Thailand have combined to create a primary health care system in rural areas in which village health volunteers play a major role. Consistent with the WHO whole-of-society approach, these doctors have envisaged a decentralised system that emphasises volunteers as community oriented, self-reliant agents of change. Our ethnographic research in Chiang Mai, Thailand, reveals that these ideals of village health volunteer empowerment have not been realised. Rather, village health volunteers have become entrapped in a hierarchical, top-down health bureaucracy that affords them limited deliberative agency. We argue that this predicament reveals a conflict of paradigms between, on the one hand, an idealised holistic, spiritual dimension of health with village health volunteers as dedicated, self-sacrificing agents of local communities and, on the other hand, the imperatives of state authoritarian interventions in the avian influenza and COVID-19 pandemics, including rigorous public health protocols and epidemiological methods.

#1381 Economic evaluation of an integrated care program versus conventional care for chronic kidney disease patients in rural communities of Thailand

Abstract Background and Aims This study evaluates an integrated care program for chronic kidney disease (CKD), which has demonstrated effectiveness in delaying kidney function decline in the rural population of Thailand. Efficacy of the program was initially established through the ESCORT-1 study, a cluster-randomized controlled trial (doi: 10.1186/s12882-016-0414-4), and further demonstrated the effectiveness by the larger-scale prospective cohort study, ESCORT-2 (doi: 10.1111/nep.13849). The aim of this study is to assess the cost-effectiveness of incorporating this program into Thailand's public health benefit package, with the goal of establishing it as a model for similar rural areas in resource-limited settings. Method Following the Thailand's guideline for health technology assessment, a cost-utility analysis utilizing data from the ESCORT studies, local databases, and literatures. The integrated care program was tailored to primary healthcare system by using preexisting workforces. It involved a collaboration between Multi-Disciplinary Care Teams (MDCT) at district hospitals and Community Care Network (CCN) teams at Sub-District Health Centers (SDHC). The MDCT, comprising general practitioners, CKD nurse managers, pharmacists, a nutritionist, and a physical therapist, provided key patient education on diet, medication adherence, exercise, and avoiding certain medications and herbal remedies. The CCN teams, including community nurses and village health volunteers, conducted home visits for health monitoring and lifestyle guidance. Both MDCT and CCN personnel received training in CKD care based on the NKF-K/DOQI and KDIGO Clinical Practice Guidelines. A decision-analytic Markov model and Monte-Carlo simulation were applied to quantify and compare the lifetime costs and quality-adjusted life years (QALY) outcomes of the intervention and conventional-care from a societal perspective considering both direct and indirect costs. The analysis included extensive sensitivity analyses, incorporating a probabilistic model and scenario-analyses based on patient ages, CKD stages, and varying program efficacy. Additionally, a budget impact analysis from the payer's perspective assessed the financial impact and affordability over a five-year period. Results The integrated care program was found to dominate conventional care. The results indicated an incremental cost-effectiveness of (-)278,000 Thai Baht (∼7,267 EUR) per QALY for the base case analysis. Probabilistic analysis demonstrated consistent outcomes, with the integrated care program being cost-effective at almost 100% of the time during analysis at the 160,000 Thai Baht (∼4,182 EUR) willingness-to-pay threshold (Fig. 1). These results are driven by significant cost savings due to reduced time and overall costs in dialysis before death. The program is most cost-effective when provided early to patients, in terms of both age and CKD stages (Fig. 2). The budget impact analysis showed that introducing the intervention could save the payer 184 billion Thai Baht (4.76 billion EUR) over five years. (The exchange rate; 1 Thai Baht = 38.26 EUR) Conclusion The integrated care program for patients with stage 3-4 CKD is cost-effective and suitable for inclusion in Thailand's health benefit package, mainly due to its significant cost savings and enhanced health outcomes. The program's design, focusing on sustainability and feasibility by utilizing existing workforces, positions it as a viable model for similar economic and healthcare contexts, especially in resource-limited countries.

One-dose intradermal rabies booster enhances rabies antibody production and avidity maturation

The incidence of rabies in Thailand reached its peak in 2018 with 18 human deaths. Preexposure prophylaxis (PrEP) vaccination is thus recommended for high-risk populations. WHO has recently recommended that patients who are exposed to a suspected rabid animal and have already been immunized against rabies should receive a 1-site intradermal (ID) injection of 0.1 mL on days 0 and 3 as postexposure prophylaxis (PEP). In Thailand, village health and livestock volunteers tasked with annual dog vaccination typically receive only a single lifetime PrEP dose and subsequent boosters solely upon confirmed animal bites. However, the adequacy of a single PrEP dose for priming and maintaining immunity in this high-risk group has not been evaluated. Therefore, our study was designed to address two key questions: (1) sufficiency of single-dose PrEP—to determine whether a single ID PrEP dose provides adequate long-term immune protection for high-risk individuals exposed to numerous dogs during their vaccination duties. (2) Booster efficacy for immune maturation—to investigate whether one or two additional ID booster doses effectively stimulate a mature and sustained antibody response in this population. The level and persistence of the rabies antibody were determined by comparing the immunogenicity and booster efficacy among the vaccination groups. Our study demonstrated that rabies antibodies persisted for more than 180 days after cost-effective ID PrEP or the 1st or the 2nd single ID booster dose, and adequate antibody levels were detected in more than 95% of participants by CEE-cELISA and 100% by indirect ELISA. Moreover, the avidity maturation of rabies-specific antibodies occurred after the 1st single ID booster dose. This smaller ID booster regimen was sufficient for producing a sufficient immune response and enhancing the maturation of anti-rabies antibodies. This safe and effective PrEP regimen and a single visit involving a one-dose ID booster are recommended, and at least one one-dose ID booster regimen could be equitably implemented in at-risk people in Thailand and other developing countries. However, an adequate antibody level should be monitored before the booster is administered.

Community rehabilitation by the trained village health volunteers on activities of daily living and quality of life in stroke survivors

Background: The number of people with disabilities resulting from strokes is increasing in Thailand. The major sequela of the disease was weakness in one side of the body that causes difficulty in activities of daily living (ADL) and poor quality of life (QOL) for stroke survivors. Community-based rehabilitation could be one of the strategies that enhances functional performance and improves QOL in these individuals. There were many disabled people in Mae Ka subdistrict, San Pa Tong District, Chiang Mai Province, where health care providers and local people were enthusiastic to take care of each other’s health in the community. Objective: The present study aimed to investigate rehabilitation outcomes in ADL and QOL of stroke participants who received rehabilitation services from trained village health volunteers (VHVs). Materials and methods: This study was a quasi-experimental research design. Subjects were recruited using purposive sampling, including 10 stroke survivors. Instruments used were 1) ADL Assessment for Occupational Therapy Clients; and 2) World Health Organization Quality of Life Assessment, Short Form-Thai version. The statistics used were descriptive, as well as the Wilcoxon Signed Ranks Test. Results: Results demonstrated that scores of basic activities of daily living (BADL) in the participants increased significantly (p<0.05) except for sexual expression. The score in the instrumental activities of daily living (IADL) was also significantly higher at post-rehabilitation than pre-intervention (p<0.05), as was the total ADL score. Stroke patients had significantly higher QOL scores after intervention than the pretest (p<0.05). Conclusion: These indicated that the community rehabilitation center at Mae Ka Subdistrict Administrative Organization, San Pa Tong District, Chiang Mai Province, run by the trained VHVs could promote ability in daily activities and improve QOL in stroke participants who come for their services.

Social Return on Investment (SROI) from the Community Waste Bank Implementation under the Learning Center of Systematic Waste Management Innovation According to the Circular Economy Concept

This article presents the results of social return on investment (SROI) evaluation in the community’s waste bank program implemented in the Moo 7 and Moo 8 Villages of Tan Diao Subdistrict, Kaeng Khoi District, Saraburi Province during 2020–2022, which is a part of the Learning Centre of Systematic Waste Management Innovation According to the Concept of Circular Economy project. This research employed participatory action research to collect data on total cost for investment and income from selling recyclable waste through in-depth interviews and focus groups with a total of 40 stakeholders including: 25 community members, 5 community leaders, 3 representatives from Tan Diao Subdistrict Administrative Organization, 5 village health volunteers, and 2 private waste buyers. The SROI analysis of the Moo 7 and Moo 8 waste banks (2020–2022) by using the discount rate based on the government bond yield at 3% shows the total net present value at 106,166.60 Thai Baht (2,941.76 USD), a ratio of cost-benefit analysis at 12.74 times, the payback period at 4.7 months, and the SROI result is 2.65 Thai Baht (0.073 USD). In other words, for every 1 Thai Baht invested in the community waste banks during this period, the benefits generated were equivalent to 2.65 Thai Baht (0.073 USD). This translates to a positive return on investment. The contribution of community waste bank under the project, can significantly change in 1) community relations with an intensive engagement in community waste management, 2) economic perspective as it generates employment and income, and reduces transportation costs for landfilling, and 3) environment term, as it reduces household waste and waste disposal. The suggestions have been developed in terms of policies and action plans for community waste management together with local administrative organizations to develop Tan Diao Subdistrict as a model of waste management.

Predictive factors for resilience quotient among village health volunteers in Northern Thailand post-COVID-19

Village Health Volunteers (VHVs) played an important role during the COVID-19 virus outbreak by coordinating with the public health team and closely engaging with community members. This study aimed to assess the resilience quotient levels of VHVs in Northern Thailand post-COVID-19. The research involved a random sample of 416 VHVs and utilized various tools such as questionnaires. Data analysis employed descriptive statistics and stepwise multiple regression. The study revealed that most of the sample group were women (81.3%), with an average age of 55.03 years (X̅ = 55.03, SD = 10.44). Most were in a relationship (79.3%), and 49.0% had completed primary education. Additionally, 47.8% were employed in agriculture, and 54.3% reported having sufficient income. A significant portion of them, 70.7%, had no history of chronic illnesses, whereas 53.1% had previously tested positive for COVID-19. The overall resilience quotient level of VHVs was high (X̅ = 61.88, SD = 9.14). The study identified the following four significant predictor variables: mental health, anxiety, depression, and mental health literacy, accounting for 40.30% of the variance. These findings were statistically significant at 0.05 (R = 0.639, Adjusted R2 = 0.403, F = 71.071, P-value < 0.001). In conclusion, this study provides valuable insights for developing targeted interventions and support systems to enhance the resilience quotient of VHVs, particularly in the post-COVID-19 landscape and similar situations.

Health Literacy and eHealth Literacy in the Prevention and Control of COVID-19 Among Village Health Volunteers in Area Health Region Number 7 of Thailand

Health Literacy and eHealth Literacy in the Prevention and Control of COVID-19 Among Village Health Volunteers in Area Health Region Number 7 of Thailand

Elderly care by village health volunteers during COVID-19 pandemic in Thailand

Purpose: This study aimed to understand how village health volunteers (VHV) perform their duties and look after older adults during the COVID-19 pandemic health crisis.
 Methods: We used in-depth interviews, group interviews, and observation to collect the data. This study was carried out in Wat Rong Lot, Chiang Rai, Thailand. Eleven people were involved in this research including one Public Health Department officer, Master of the Temple, five VHVs, one nurse, and three older adults in the community. We used content analysis to analyze our data.
 Results: Before the pandemic, VHV’s duties included health screening and monitoring, reporting the results to the primary health center, and health education to the older adults in the community. During the pandemic, they perform these duties by making a monthly visit to conduct ADL and living arrangement assessment and drug delivery. Since the lockdown, many VHV duties must be shifted which resulted in pausing regular care plans for the elderly. However, VHVs keep delivering health services to the elderly by making home visits in case of an emergency, drug delivery, and donating masks and medical supplies. They were burdened with additional responsibilities related to COVID-19 prevention, detection, and surveillance. They admitted to facing some challenges such as being unconfident when performing their work and distrust from the community.
 Conclusion: The additional responsibilities and lockdown hinder regular treatment. Further research is needed regarding the impact of care plan cessation for the elderly.