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Abstract

Background: The growing burden of NCDs in Thailand highlights the need for effective community management by Village Health Volunteers (VHVs). This study investigated factors associated with health literacy and chronic disease service performance among VHVs in Chiang Rai Province, Thailand.

Methods: A cross-sectional survey was conducted among 325 VHVs via two-stage cluster sampling between June and July 2023. Data were collected using a validated five-part questionnaire (Cronbach’s alpha = 0.93–0.98). Data analysis included descriptive statistics, content analysis, Chi-square tests, and Spearman's rank correlation coefficient.

Results:VHVs demonstrated good health literacy (41.8%) and a high level of chronic disease service performance (65.5%). Health literacy was significantly associated with education level, occupation, and prior NCD training (p < 0.05). It was positively correlated with work motivation (r = 0.587, p < 0.001) and social support (r = 0.497, p < 0.001). Service performance was significantly associated with education level, residence in health-behavior modification villages, and specialized training (p< 0.05). Performance showed positive correlations with work motivation (r ¼ 0.464), social support (r ¼ 0.484), and health literacy (r ¼ 0.701, p < 0.001). Key barriers include patient non-cooperation, elderly abandonment by families, and insufficient medical equipment.

Conclusion: Work motivation and health literacy are critical determinants of VHV performance. Public health agencies should prioritize competency-based training and strengthen social support systems. Addressing systemic barriers through equipment provision and family-community linkages is essential for sustainable health outcomes.

Keyword: Health literacy, Chronic disease services, Village Health Volunteers, Work motivation, Social support

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