Community Health Navigator

2018-08-27 11:59:26 healthandshare

click here for ppt. presentation :  community health navigator.eng

“Community Health Navigator”

Developing Strategic Mechanism at District Level in Providing Lao Migrant Female Sexuality and Reproductive Health (SRH) care and services in the border of Thai-Lao Khemmarat district, Ubon Ratchathani province, Thailand

 

Miss Ladda Waiyawan , Health and Share Foundation (HSF.)  /  IFP Alumni Thailand Association.

Email address: laddawaiyawan@hotmail.com 

Background

Health and Share Foundation (HSF) is an organization working on health and society in border area of Thai-Lao Khemmarat district, Ubon Ratchathani where Mae Khong River is 40 kilometer border line between Thailand and Lao PDR.  Some Lao migrants cross their country to live in the site, Khemmarat district, both daily and regularly. Based on Khemmarat Registration database (2016), the number of non-registered migrants is 520: 334 females and 186 males.  Most of the migrants are in Na Wang sub-district, Khemmarat, Ubon Ratchathani province.  The foundation, associated with the Center of Excellence in Research on Gender, Sexuality and Health (GSH), Mahidol University and the Provincial Public Health Office, Ubon Ratchathani, conducts a project Developing Strategic Mechanism at District Level in Providing Lao Migrant Female Sexuality and Reproductive Health (SRH) care and services in the border of Thai-Lao, Ubonratchathani province, Thailand during January 2017-March 2018”.  “Lao Migrant Female” is pushed to be “the minority group” in Thai society.  Living in a long distance limits the migrant to approach to basic health care and services; they cannot approach to health information, rights, and have less opportunity to improve quality of life than others. Lao Migrant Females were encounter difficulties for living. In 2017, a survey of 100 Lao Migrant Female in 3 sub-districts (Khemmarat, Na Wang, and Hua Na) revealed that most of the Lao migrant females were 31-40 years old, living in Thailand for a lone time.  They worked in farms and as employees.  The Lao migrant females were worried about health services in terms of expense, waiting list, wasting time, transportation, lack of human right information, incomprehension of hospital health service processes.  They did not realize that sexual reproductive health e.g. leucorrhea, hypogastrium pain, and dysuria indicated infection in reproductive system. Some of the labors experienced oppression from husbands, others, family members; this decreased their self-esteem, negotiation power, and self-control. In particular, the labors were willing to have health services from family members, health volunteers, and staff in the health promotion hospital.

Objectives and method:  The project aims to build up machinery to work in district level for advocating policy and implementation on sexual reproductive health and sexual wellbeing of Lao Migrant Female, with collaborations of organizations through field workers like ‘Community Health Navigator or Health Buddy’, peers who take care of health and sexual reproductive health.  Community health navigator originally started when Thai and Lao health volunteers attended empowering and driving community activities with coaching system.  The coaches are sub-district health promotion hospital staff, municipal, and civil society.  The community health navigator are key workers driving in the community e.g. survey information about Lao female labors, home visit, conducting meeting for case solutions, organizing group health activities, building up information center in community, and encouraging Lao female labors to check up for cervical cancer at the sub-district health promotion hospital.      

Results: The project establish network implementation in community level consisting of staff from public health, administration, community organizations, and civil society.  The Community health navigator interrelate Lao Migrant Female and health services; also, they are important people approaching the target due to their contextual, cultural, and ethical understanding with great complicated working skills to deal with sexual wellbeing among Lao female labors.  They are working as the insider; they are reliable for the targets considering the Community health navigator as friends and counselors.  In addition, they could suggest the targets to access hospital health services, to accommodate e.g. taking care of documentation, taking patients/cases to health service processes, decreasing gap between government officers and the labors since the migrant labors feel uncomfortable to deal with the officers.  These make multi-dimension of work: sexual reproductive health, violence agent women, and labor rights. They were building power of negotiation among the labors to take care and protect themselves.  Moreover, the Community health navigators are able to give health information and knowledge through activities to the Lao Migrant Females so that they can take care of their health wellbeing and sustainability.

Conclusion: Although the “Community Health Navigators” are able to relate issues of migrant labors in the project site and the implementation is clear at community, sub-district, and district levels with machinery and system built up together. However, some Lao Migrant Females are illegal migrants. The illegal migrants feel worried about expense, transportation to Thailand, accessibility to government health services; this makes them unable to access health services. Previously, the project could support only some cases; therefore, policy support at sub-district, district, provincial, national, and international levels should be advocated so that the health volunteers and staffs will be able to ethically and equally serve, coordinate, refer the migrant labors in the area both legal and illegal migrants.   

Key world: Community Health Navigator, Community networking, Machinery, Integrated, Lao Migrant Female, Sexual and Reproductive Health, Thai-Lao border

 

 

 

 

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Buddy home care Project

2018-04-24 15:03:33 healthandshare

 

 

  1. Background

Health And Share Foundation (HSF.) is working in rural area on primary health care and HIV/AIDS along the border Thai-Laos, Ubon Ratchathani Province. In the rural area the family structure has been changing, many families moved to the big city for working. They have left children at home with aging people. Those aging people sometimes don’t know how to raise and communicate with the children who would rather favor of playing internet and phone. They would just blame it. The absence of fostering circumstance has affected children’s behavior both in physical and mental health. Moreover, children are facing with many problems. In the year 2015, the HSF surveyed and identified 344 disadvantaged children in Khemarat and Huana Sub-district who are in difficult situations such as, 1) homeless 2) orphan 3) live in risky situations (drug, domestic violence, sexual violence, etc) 4) poor family (family income less than US$45 per month, 5) health problem 6) parent in prison 7) sing parent due to divorce, 8) disable children 9) discrimination and injustice problem, and 10) stateless or No ID number/non Thai.

  1. Stakeholders

Recently, the Family Care Team (FCT) has been set up for taking care of households which have health problems in the whole country under the policy of Ministry of Public Health. The FCT works at three different levels, namely district, sub3district and community. The HSF has already experienced to work with the health staff at the sub-district level and with the village Health Volunteers (VHVs) in our project area. Some of the VHVs have been trained as a community caregiver and they visited home of the aging persons along with the health center staff. Because the FCT has not focused on capacity building of those disadvantaged children, HSF came up with an idea to work with them to join the home care project. The buddy is pairing a Village Health Volunteer or VHV and a disadvantaged child. They make home visits to the aging people. Through the activities of Buddy Home Care, VHVs play a key role in observing and supporting the disadvantaged children and their families. VHVs share information on how to access to social welfare and health services with the children’s family. 

Apart from VHVs, we are also working on the project in collaboration with the Community Action Group (CAG) who represented five sectors in the community such as the 1) local government, 2) school 3) hospital and health promoting hospital or health center, 4) community based organizations and 5) administration. CAG have worked for the disadvantaged children in the community.

  1. Working Process

Meetings were held by the VHVs and CAG to study the problems of the disadvantaged children and

screen them as project participants. We selected 20 children out of the target group (aged 10-15 years old), who are living in the community and available to join the project. Then, coordination among these children was initiated for them to attend the Buddy Home Care activity together with CAG. Meetings and capability building activities for children and VHVs are organized such as:

  • Self-empowerment workshop. The purpose of which is to know each other and raise their self-confidence in order to be more capable in facing other people in their own community.
  • Community analysis. At this point, children and VHVs analyze community health problems through community mapping and screening cases. They also learn about their roles as buddy home care. For instance, what they should do when they work as buddies for home care in the community
  • Basic health skills training. They learn the concepts and acquire skills on basic health care and home care during the training. They are trained how to sponge bath the body to reduce the patient’s temperature, to turn over the body position, to change fresh clothes, and to do exercise and rehabilitation.
  1. Plan and Prepare Materials for Home Visits

The Buddy team has to perform two main activities as follows:

  • The Buddy team of a disadvantaged child and a VHV carry out home visits for the aging people in their community together with the hospital staff and CAG members;
  • The Buddy team summarizes their activity and refers information to the hospital staff or to the social welfare office staff when they find a serious case that needs financial support, medical equipment and the likes.

 5.Achievements

Most of the aging people stay in bed all the time. Children’s visits made them smile and eased their stress caused by loneliness at home. The disadvantaged children raised their self-confidence and self-esteem as a result of doing home visits. They felt proud of themselves that they could work for others in the community.

The VHVs could directly support the disadvantaged children. They taught other children some life skills such as negotiation and bargaining skills, self-protection skills (to prevent them from being in a risky situation), problem solving skills (scenario making to draw concrete solutions in response to problems identified), and referral skills (for health and/or social welfare), and so on.

  1. Lesson Learned and Next Steps
  2. There are some challenges related to sustainability of the project. Some of the disadvantaged children cannot join the activities continuously because of family problems. Others have to take care of other family members while the parents work outdoor. VHVs want to invite other community people to understand the situation of the disadvantaged children and join the activity. They especially aimed for the village chief, hospital staff and others who are interested on volunteer work so that the project would take root in the community.
  3. Screening the aging persons as the subject for home visit was mostly decided by the VHVs. They tell the children what to do, when they both do home visits. Because the VHVs mostly chose severe cases like dying, it affected the children’s mind. Some children were scared and did not know what to do while they were visiting. The children as they reflected realized that they want to join the succeeding home visits but doing something more appropriate for their young age. For instance, demonstrating how to exercise, helping to clean the rooms of the aging people, and other lighter tasks. The buddies need to be more motivated to stimulate discussion and decision making on whatever activities they have to do. In this leaning, each of the buddies might value their team even more.
  4. For the home visits, environmental cleanliness and hygiene management is a big challenge. These include room cleaning, safe environment, and rehabilitation. It may also entail rail support for stand and walk signals.
  5. The VHVs and the disadvantaged children still lack the skills of taking care aging people. In response to this discrepancy, we plan to prepare the handout on the basic health care and the typical diseases such as diabetes, hypertension and stroke. They are more prevalent among the aging people.
  6. The aging people themselves or caretakers cannot manage to dose and /or administer medicine. The buddy team discusses with the aging people and the caretaker to prepare some medicine boxes. These boxes are more efficient for the aging people to get their medicine easily following the right dose, and the right time regularly.
  7. For food, the children and the VHVs could give suggestions on what food is appropriate to eat for each patient at home.
  8. Regarding exercise and rehabilitation, children could help to show how to exercise at home or encourage the patient and caretaker by teaching them how to do it with the help of a physical therapist.

 

Ms.Siriwan Arsasri

Health And Share Foundation (HSF.)

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Punmoo

2013-11-21 14:01:26 admin

“Pun Moo” is E-Saan Language. “Pun ” means share, and “Moo” means friend.  Therefore “Pun Moo” means share to friend. We would like to promote our representative as “Pun Moo” to do Fund Raising for doing good with our target groups at project site areas, border Thai-Laos.

We gave the name ” Pun Moo” as a name of a humble buffalo. Pun Moo is as sincere, patient, and ready to struggle as the peaceful Health and Share Foundation aiming to distribute happiness and to relieve suffers by providing comfort zones for empowering the outreach to be healthy and within equal rights as the others.

Pun Moo, the observer who loves to utilize existing resources for appropriate ways of life and to promote community participation in terms of planning, taking action, and applying local wisdom for developing the community, youth groups, the outreach children and people in six districts (Khemmarat, Natan, Pho Sai, Kudkaopoon, Warin Chamrab, and Kuang Nai), Ubon Ratchathani province, Thailand

Pun Moo empowers people with sex diversities and Karaoke sex workers to be within equal rights and to live happily together with the others in communities as well as to be socially accepted for accessing equal health services in Thai-Lao boarder, Ubon Ratchathani province.

Pun Moo promotes happy living among people by promoting health care among family members, community people, and people with HIV/AIDS in Khemmarat and Natan districts, Ubon Ratchathani.

 

Thank you for kindly supporting us

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Announcement of Study Tour

2012-06-19 22:44:05 admin

Are you interested in community based health NGO work?

HEALTH and SHARE Foundation (HSF) currently has been working on HIV/AIDS care and a prevention project at Thai-Lao border area in Ubon Ratchathani province, Thailand.

There have been about 500,000 HIV positive people existing in Thailand nowadays. After Thai government provides free Antiretroviral (ARV) drugs, new cases of HIV positive have been decreased in total. However, there have been still issues left to be overcome since some HIV positive cases taking ARV stop drugs by themselves after they realize that they become healthier.

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The memorable day of Independence for SHARE Thailand

2012-06-01 12:19:10 admin

by Fumiko Kudo, Health Project Consultant for SHARE

[gallery link="file"] On May 5, Health and Share Foundation (HSF), outgrown from SHARE Thailand, established itself as an independent, indigenous Thai NGO. Way back in May 1990, SHARE launched its first, independent overseas health project in Yasothon Province, Isan (North-east Region of the country) just after it started to stand on its own in Japan. I, Fumiko Kudo, under the auspices and cooperation of Dr. Samroon Yangratoke, the then director of CDC 7 (Communicable Disease Control office, Zone 7), entered Ubon Rachathani Province where the CDC head office was situated and I participated in the joint Diarrhea Control Project between CDC 7 and Yasothon Provincial Public Health Office. At that time the Isan region was suffering greatly from diarrheal endemic and Yasothon used to be the epicenter.
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