Chulalongkorn University Theses and Dissertations (Chula ETD)

Process evaluation of implementation in accordance with the model for diabetes mellitus prevention and control in Yasothon province

Year (A.D.)

2000

Document Type

Thesis

First Advisor

Sathirakorn Pongpanich

Faculty/College

College of Public Health Sciences (วิทยาลัยวิทยาศาสตร์สาธารณสุข)

Degree Name

Master of Public Health

Degree Level

Master's Degree

Degree Discipline

Health Systems Development

DOI

10.58837/CHULA.THE.2000.1682

Abstract

The purpose of this study was to evaluate the process of implementation in accordance with the model for diabetes mellitus (DM) prevention and control in Yasothon province. The system theory was used for conceptual framework; focusing especially on the process of implementation and comparison with this model. The DM patients service system consisted of 1) Screening system in the villages and treatment system in the hospitals and health centers and 2) Support system namely; drug supply and medical equipment service, development of health personnel and VHVs potential, development of DM information system, and supervision. Besides, this research studied problems and obstacles from implementation This research was qualitative research. Data collection used in-depth techniques for responsible persons in the hospitals, district health offices and health centers; this group consisted of 25 persons and focus group discussion technique was used for the village health volunteers (VHVs); these consisted of six groups in Korwang, Kudchum and Loengnokta districts. Triangulation was used to check for validity and reliability of data. The qualitative data was used for content analysis and the quantitative data was used for descriptive statistical analysis namely, frequency and percentage. The results of the evaluation were as follows: 1. DM Service Svstem 1.1 It was found that the screening system in the village covered every activity and the following up of the urine abnormal group was relevant to the flow chart of this model except health education was not clear. Besides, the target determination and the public relations for target group preparation weren’t specific to them. So it might affect the screening and not find the real target group. 1.2 It was found that the treatment system in the health centers and the hospitals covered every activity, but the health center level personnel in every tambon couldn’t perform according to referral criteria from the health center to the hospital. The main causes were that the DM patients didn’t assent to be treated at the hospital and some of the responsible persons in the health centers couldn’t remember these criteria. And the DM patient referral from the hospital to health centers in one district wasn’t under the same criteria because there were managerial problems in that district. 2. Support system It was found that every support system activity followed provincial directions except the development of DM information system, which could not be calculated and checked about data reiteration. The main problems from implementation were management and DM patient referral. The researcher suggested the related health personnel revised the model clearly and adapt to different conditions, especially the responsible persons and consider the policy of working. The agencies of Yasothon Provincial Health Office have had to proceed according the new model since December 2000.

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