jumroon ldfw summary report 2

8/6/2019 Jumroon Ldfw Summary Report 2

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SUMMARY REPORTThe Integrated Planning and Strengthening Partnership Approach for

Community-based Quality of Life Development for the Thai ElderlyProject

by Jumroon Mikhanorn*

1. Background

The Thai National Family Planning Program has, over the past 35 years, beenextremely successful in reducing population growth rates. This initiative, however,has indirectly facilitated a number of previously unforeseen health and social welfarerelated problems. A growing concern, in Thailand, is the dramatic increase in thenumber of elderly people living in all geographic areas of the country. A rapidlyincreasing aging population, complicated by new socio-economic forces that havetransformed traditional societies into integral members of the global community, is animmediate concern for many countries in Asia. The negative consequence of this so-called unplanned development has already affected the quality of life for manyelderly people living in both urban and rural areas of Thailand. As such an importantpriority for Thailand, over the next decade, will be to help strengthen and developappropriate quality of life strategies and programmes for its senior citizens or itselderly population. The Royal Thai Government has already begun to explore severalinterventions aimed at successfully addressing this issue.

A review of existing health data seems to indicate that in every province in thecountry all basic health service facilities [i.e. general hospitals, community hospitals,and health centres in urban and/or rural areas] have established at least oneCommunity-based Organization for the Elderly (CBOE). These CBOEs, or Healthand Welfare Clubs for the Elderly are responsible for the health and welfare of the

local elderly population. The CBOEs are known in Thai as Chomrom Phoo SoongAyu. The majority of these CBOEs, however, are not well organized, and they lackthe necessary technical and financial support needed to function as designed eventhough they have been set-up as part of the Primary Health Care strategy of thenational health care delivery system.

The Foundation for Life Development, which is an NGO established under thePatronage of HRH Princess Galyani Vadhana Krom Luang NarathiwasRajanagarindra, in junction with the ASEAN Institute for Health Development(AHID/Mahidol University), and the Department of Medical Services (Ministry ofPublic Health) conducted the Centres first workshop on 7 September 2005. TheIntegrated Planning and Strengthening Partnership Approach for Community-Based

Quality of Life Development for the Thai Elderly Projectwas formulated as a result ofthis workshop.

According to the Project Planning Phase all concerned parties supported a fundraising proposal made by The Foundation for Life Development. This proposal wassubsequently submitted to the National Lottery Office of the Ministry of Finance,requesting that a 10-million Baht grant be made available to establish a Quality ofLife Development Centre for the Elderly in Kanchanaburi province. The proposalalso contained a request for an additional 10 million Baht grant to establish a secondQuality of Life Development Centre for the Elderly in Mae Hong Sorn province.These 2 grants were approved in February 2007.

* MD, MPA (Hons), DPH (RCP London&RCS England)

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In 2007 the AIHD/Mahidol University and The Foundation for Life Development, inclose cooperation with various departments from the MOPH [i.e. the Department ofMedical Services, the Department of Health, & the Department of Health ServicesSupport] implemented The Integrated Planning and Strengthening PartnershipApproach for Quality of Life Development for the Thai Elderly Project to supportCBOEs operating in Kanchanaburi Province. The initiative was designed tostrengthen the CBOEs by creating well-organized and competent Elderly VolunteerTeams who could subsequently assess the needs as well as implement specificactivities for the elderly using a Participatory Action Research approach model. Thisapproach was expected to serve as an appropriate model for future Projectreplication in Mae Hong Sorn and other provinces in Thailand.

2. Objectives:

2.1 General Objectives: To support community-based quality-of-lifedevelopment programmes for Thailands elderly population in order to comply

with an acceptable WHO standard, through existing Health and WelfareClubs or Community-based Organizations for the Elderly (CBOEs) within theProvincial Health System [which is based upon a Primary Health Careapproach].

2.2 Specific Objectives:(1) Obtain adequate financial resources, through NGO donations, to support

the construction and establishment of a provincial Elderly Quality of LifeCentre in Kanchanaburi Province, to serve as a multi-sectoralcommunity-based headquarters for a provincial CBOE support network,

(2) Mobilize elderly individuals, retired from appropriate organizations withsuitable health status and social background, to participate as members

of the Elderly Volunteer Group (EVG). The members of the EVG areexpected to become key team members of the Participatory ActionResearch (PAR) Team,

(3) Support human capacity building of the EVG through appropriateorientation and PAR processes to form an effective EVG Network. Thisalso includes the formulation of an Action Plan for the Provincial Quality ofLife Development Centre, as well as the construction and establishmentof this centre [physically adjacent to the Provincial Hospital] which will besupported by the Governor of Kanchanaburi province. The EVG willcontinue to work on the PAR process for the Action Plan in order toestablish an organization called, The Association of KanachanburiCommunity-based Organizations (CBOEs) for the Elderly. Thisassociation will be based at the Kanchanburi Quality of Life DevelopmentCentre, of which all CBOEs located in province will be members,

(4) Establish Mobile Elderly Volunteer Teams (MEVTs) to be responsible forimplementing the various outreach programmes of the Quality of LifeDevelopment Centre, and/or as requested by the member CBOEs,

(5) Review and modify the model so that it can shortly be replicated to MaeHong Sorn as well as eventually to other provinces in Thailand.

3. Methodology:The Projects primary methodology was a Participatory Action Research(PAR) approach. The following diagram illustrates the overall Projectconceptual framework:

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Social Preparation for Community

Leadership and Elderly Volunteer

Development

PAR Workshop

Strengthening

of CBOEs

Replication of the

Project key features

Conducting a National Seminar on Strengthening of the

CBOEs as a Key Feature of Healthy Communities Based

on PHC in Thailand

Data Collection andDocumentary Research

Establishment of The Provincial QoL Development Centre for the Elderly

The Life Development Foundation

Kanchanaburi Province

MOIAIHD/Mahidol University

MOPH

Highlighting

Lessons Learned

MSDHS

The Elderly Volunteer

Group (EVG)

The Community- based

Organization for the Elderly

(CBOE)

Establishment of the Association for CBOEs in the Province

PAR Team Building

The Project Conceptual Framework

Report Publishing and Distribution

*N.B MOPH : Ministry of Public HealthMOI : Ministry of InteriorMSDHS : Ministry of Social Development and Human

Security

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4. Major Activities Undertaken

A Participatory Action Research (PAR) approach was the primarymethodology used by the Project. Some of the key Project inputs andactivities were as follows:

10 January 2007 Joint Integrated Project SteeringCommittee and Project ManagementCommittee Meeting held atthe Kanchanaburi Provincial Health Office

19 January 2007 The 1st

Conference for the ElderlyVolunteer Group Development initiated inPhanom Tuan District

8 February 2007 Orientation Meeting on Elderly Volunteer

Members conducted at the KanchanaburiProvincial Health Office

14 February 2007 Approval of the Government LotteryOffice Grant for funding the establishmentof the QOL Development Centres inKanchanaburi and Mae Hong Sorn

1 March 2007 The First Joint Committee OrientationWorkshop conducted at the KanchanaburiProvincial Health Office

4 April 2007 Workshop for 71 Elderly VolunteerMembers ofThe Life DevelopmentFoundationconducted in Bangkok

7 June 2007 PAR Team Workshop conducted at AIHD,Mahidol University, Salaya Campus

8-9 June 2007 The First PAR Workshop for 54participants at the Pavilion

Rimkwai Resort, Kanchanaburi

6 September 2007 PAR Team Meeting at AIHD

18-19 September 2007 The Second PAR Workshop for 106participants at the Wang SinghaResort, Kanachaburi

23-24 November 2007 The Third PAR Workshop conducted for117 participants at Raj Supthamitr Hotel ,Kanchanaburi, on Programmes of the

Quality of Life Development Centre

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January - April 2008 Establishment of the Association ofKanchanaburi CBOEs, who will takecare of the Kanchanaburi QOLDevelopment Centre for the Elderly

May - December 2008 Implementation of the AssociationsProgrammes in sustainable developmentof the Kanchanaburi CBOE Associationand its CBOE network

January - September 2010 Establishment of the Association of MaeHong Sorn CBOE and its provincialCBOE Network

5. Achievement of Project Objectives

The First Participatory Action Research (PAR) Workshop took place inKanchanaburi Province from 8-9 June 2007. Participants included 49members of different elderly volunteer groups located in the 13 districts ofKanchanaburi, 5 members from The Life Development Foundation inBangkok, local authorities and community leaders, as well as professionalstaff from AIHD and the MOPH. The workshop expected outcomes includedthe following: (1) identify needs of the community-based elderly groups, (2)develop a strategic intervention plan and action plan, and (3) shareexperiences between the elderly volunteers from the Foundations Centre inBangkok and the elderly volunteers in Kanchanaburi Province.

The Second PAR Workshop for 106 participants, dealing with ElderlyVolunteers Development, was conducted at the Wang Sing Resort, SaiyokeDistrict, Kanchanaburi province. The workshop was organized to help identifyempowerment needs assessment tools for Community Based Organizationsfor the Elderly (i.e. the Chomrom Phoo Soong Ayu) operating inKanchanaburi Province.

The sharing of ideas and experiences helped participants formulate theoperation plan and the functions of six working groups in support of CBOEs inthe Project intervention areas.

The Action Plan designated that the 10 million baht, donated by theGovernment Lottery Office through The Life Development Foundation, beused to construct and establish a Quality of Development Centre within thepremises of the Kanchanaburi Governors Office, located adjacent to theprovincial hospital. The centres building was also envisioned to serve as thehome office of the newly established Association of the Community-BasedOrganizations for the Elderly (CBOEs) for Kanchanaburi province.

6. Project Outcomes

The PAR Workshops, for volunteer-team participants, held at Muang District,

Kanchanaburi Province on 23-24 November 2007 were very productive. Thepurpose of these workshops was to facilitate the PAR process to helphighlight the lessons learned among Elderly Volunteer Groups. This included

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a review of the planning, monitoring, and evaluation of the Quality of LifeCentre established in Kanchanaburi, whose main role was to improvesupport for all CBOEs in the province.

The workshop also identified ways to recruit Elderly Volunteers to work asthe Founding Committees of the Provincial Association for CBOEs, whichwill eventually be legally incorporated to serve as the owner of the newlydeveloped Quality of Life Development Centre.

At the present time the replication of the new Kanchanaburi Model Quality ofLife Development Centre in Mae Horng Sorn is progressing according toplan. The facility has successfully been constructed as well as appropriatelyfurnished to serve as a provincial Quality of Life Development Centre. Thetwo centres in Kanachanaburi and Mae Hong Sorn are used toaccommodate their respective associations for Community-basedOrganizations for the Elderly (CBOEs). In summary the Community-basedQuality of Life Development for the Thai Elderly Project, in both

Kanachanaburi and Mae Hong Sorn, have been integrated within theirprovincial health care delivery systems, based upon a PHC approach, andthis process is ready for further replication to other provinces in Thailand.

7.Lessons Learned

It is evident, from observations and anecdotal reports, that healthy senior citizens inKanachanaburi, many of whom have a wealth of professional and personalexperience, are finding it difficult to identify constructive activities or things to do withrespect to earning their living as well as enjoying a productive and rewarding sociallife that includes serving their friends and neighbors. Whenever they are encouragedand supported to do so, however, the results are very impressive. These individuals

are eager to share their knowledge and experiences to improve the quality of life forthemselves and their neighbors.

At the present time a group of approximately 60 Elderly Volunteers are activelyenrolled in participating in a wide array of activities aimed at supporting the newlyestablished Quality of Life Centre for the Elderly in Kanchanaburi province. Many ofthese individuals are highly competent in various fields related to the activities thathave been recently undertaken by the CBOEs. They have expressed theirwillingness to share their knowledge and experiences with other Elderly Volunteers inKanchanaburi province as well as with elderly members of the Foundations Centre inBangkok. The approach implemented by the present Project can serve as anexcellent model for new social movements in the context of community-based qualityof life development for the elderly living in Kanchanaburi as well as in other provincesof Thailand. A group of elderly volunteers have formally agreed to be trained to servein the following Elderly Volunteer Teams (EVTs):

1. Management Team2. Elderly Services Programme on Health and Social Welfare Team3. Social Assistance for the Disabled, Sick, and Under-served Elderly Team4. Fund Raising and Community Empowerment Team

The volunteer teams have been organized to work as mobile outreach teams tosupport all accessible CBOEs throughout the province in order to strengthen and

empower all CBOEs to ensure sustainability as well as to replicate the appropriatecomponents of this model.

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The lessons learned in both Kanchanaburi and Mae Hong Sorn will be reviewed andutilized by the Project for further development and replication to other provinces. Themodel has already been replicated to Mae Hong Sorn in 2008, and it will hopefully beexpanded to other geographic areas in the coming years ahead. The GovernmentLottery Office has already approved 20 million baht to cover the costs of constructing2 Quality of Life Development Centres, and it is expected that similar grants will beavailable to other provinces in the future. Through a process of integrated planningand partnership development, an appropriate model for a Community-based Qualityof Life Development Programme for the Thai Elderly can be successfullyincorporated within the existing provincial health care delivery system that is basedupon a Primary Health Care approach.

jumroon ldfw summary report 2

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