Health Promotion For The Marginalized Thai People In The North
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Chiang Mai Health Promotion Project 2544-2545
Uthaiwan Kanchanakamol DDS,CDPH,MPH Chiang Mai University,THAILAND
Increasing Community Capacity and Empowering Community Members to Improve the Health and WellBeing of Chiang Mai Hill-Tribes and Low-income Groups in
Type of Research
Participatory Action Research
Overall Goal 1. To determine how to improve implementation and effectiveness in promoting the integral development of youth, seniors and women in Hilltribes
And….. low income communities while increasing community cohesion and collaboration through cultural, political, social and artistic activities
Overall Goal
2. To determine how to improve implementation and effectiveness in promoting development of skills among sub-district administration/organization and municipality personnel in the area of community development.
STRIVING>COPING
Overall goal
3 To determine how to improve implementation and effectiveness in promoting creation of community partnerships by local actors for health promotion
STRIVING>COPING
Project Significance and Health Issues Involved
The local area health-care has been planned. The programs were implemented under the authority of provincial board consisting of representatives from the local government, communities, and the Ministry of Health.
This is especially crucial for disadvantaged groups like the Chiang Mai Hill-Tribesand other low-income communities.
This involves providing incentives, skills and strategies to community members to enable their effective participation in designing and implementing new autonomous health care and social service systems that meet local needs.
unity
Consensus Community Development
Needs Based
Strength s Based
vs
Conflict
Strategies
Social Action (Alinsky Mod
Grassroots Oganizing Professionally Driven Oganizing 1 Coalitions Lay Health Workers Collaboration Building Community Identity Political/Legisletive Action Culturally Relevant Practice Community Building & Capacity Building (“power with”)
2 Advocacy
Empowerment-Oriented Social Action (challenging “power over”)
Community Competence Leadership Development Critical Awareness
Organizing & Community
Building Ty
ere is an urgent need to prepare the communit d their representatives to effectively participa his new system.
• Specifically, it is proposed that proven, effective participatory action techniques are utilized to educate, empower, and involve members of these
Increasing Community Capacity includes ■
■Participatory
planning
■Needs
assessment methods (with emphasis on “asset-based" methods ) ■Participatory
program evaluation techniques
Community Empowerment These included: ■ Appreciative Inquiry ■ Asset Based Community Development ■ Training in the use of focus groups ■ Delphi methods ■ Participatory rural appraisal (PRA) ■ Community Walking Mapping
Community Empowerment from….
realizing
starts
the benefits of projects
that result in improved living conditions
Community Empowerment
starts from….
crystalizing their own ideas
Community Empowerment
starts
from…. building communities from the inside out
Participatory Rural Appraisal, (PRA) The amazing tool in positively, approaching marginalized people in health
Future search conference n the youth network
Future search conference in community leaders
Focus Group Discussion in an old age group
Local-local dialogue
Future search conference in the youth
Community Mind Mapping
Participatory planning & evaluation
through community action particularly through groups organized by women&youth
through community action particularly through groups organized by women&youth
Participatory evaluation on empowerment
CIVIC AWARENESS BUILDING CBO NETWORK
BY AND
ESTABLISHING CBO
STRENGTHENING COMMUNITY ACTION CREATING SUPPORTIVE ENVIRONMENT
The New Role in Health Promotion Teamwork • • • • • •
THE THE THE THE THE THE
HP-CATALYST HP-FACILITATOR HP-PROMOTER HP-DEVELOPMENT ENABLER The HP-MEDIATOR New HP- ADVOCATE Role in Of The Healthy Community Program Health The Caries Free Village ProgramProfessionals The Vital , Creative Health in Promotion Program, etc . the
21 st Century
Civil Society
A D V O Optimal Health C A C Y
ENABLE
M ED IA TE
Quality of Life
Kanchanakamol U.,1998 Dev. from Ottawa
Community Organizations Area hospitals, NGOs, Local governmental groups were enlisted as collaborators in this learning process.
•
Their involvements have the additional advantages of identifying issues early-on for discussion and resolution, enabling coalition-building and increasing trust between the three partner groups.
Central Governmen t
Local Authorities
Private Sector
NGOs
Donor
CBOs
Local - Local Dialogue Helps Local Actors Create
Partnerships
NGO Autonomous Network
Central Government Sectors
NCCCBO PASED CCLA
Funders & Private Sectors
ICE
Coordinated Actions LAO5 by CBO1 Local Administration Organizations Multiple Actors/Sectors CBO21 MUNICIPALITY2 Community Based
Organizations
Healthy Community Good Governance
Concerned communities hold the key to successful advocacy for healthy public policy. Without community involvement, a truly public policy cannot evolve. Therefore … Advocacy for community support should arouse public interest and community action that will generate pressure for
Poverty and illiteracy do not prevent people from recognizing their needs and calling for action
Type of Research
Type of Research
Local - Local Dialogue
Type of Research
Type of Research
Local - Local Dialogue
Type of Research
Local - Local Dialogue
Type of Research
Local - Local Dialogue
Type of Research
Type of Research
Type of Research
Type of Research
Type of Research
Poverty and illiteracy do not prevent people from recognizing their needs and calling for action
Community Empowerment Starts From…. ■
Building people’s capacity to formulate and implement local development initiatives ■
analyzing & choose
among alternative approaches
Who is being empowered ? See them in
■
...
..........community participation process
1. Local initiative communication,art,media
Though drama,song,community dialogue,music therapy,internet
6. LOCAL WISDOM
2. HEALTHY CONSUMER
Traditional healing, herbal medicine biotic,vegetarian,etc.
5. PHYSICAL EXERCISE HEALTH Aerobic,Yoka,cycling, jocking
Macro-
3. RELIGION AND
Meditation network Tichi,Traditional exercise PROMOTION Interreligious activities Northern Thai boxing dance INITIATIVES Tribal culture HEALTH
4 LIBERATED LIFE STYLE
Holistic self-care, alternative medicine, self body massage HEALTHY COMMUNITY
HEALTHY CITY
The Evolution of Oral Health Care Teamwork
Community Empowerment Local Decision Making is the Key
The achievement of local autonomy through the development and use of life skills
Citizen control Delegated power
Degrees of citizen power
Partnership Placation Consultation Informing Therapy Manipulation
Degrees of tokenism Non participation
The Ladder of Citizen Participatio n in Community Health Program Kanchanakamol, U 2000 developed from Arnstein,1971:70
Holistic Health Negative Health Positive Health Death/ Deformity/Disability/Symptom/Sign Growth & Social Self
Self Development/acceptance/esteem / fulfilme
Rehabilitation /Early Diagnosis/ Eradicating/ Raising Individual / Effective Enduring & Prompt Rx Health Risks QOL Social Change
1
3
2
o
o
Disease Prevention
o
1o 3o Health Promotion
discernable point
2o
• Developing one’s creativity & potentiality
Masl ow’s Hierc Need hy of s
• Making maximum use of one’s ability • Self-esteem Esteem of others
•Love Belonging Closeness
Safety
Security
Food Air Water
Shelter
Rest
Exercise
Sex
OPTIMAL HEALTH
Health - oriented (health model)
1
Disease Prevention 2 o Disease Prevention 3 o Disease Prevention o
Effective enduring Social change
Raising individual QOL Eradicating Health Risks Early Diagnosis Prompt Rx Rehabilitation
MINIMAL DISEASE
3
o
Health
Promotion 2
o
Health
Promotion 1 o Health Promotion Disease-oriented (Bio-medical model
Kanchanakamol U. Dev. from Brown V., 1985
CRISIS in THAI SOCIETY
Civic Mind
Civic Organization Civic Network Emergence and Movement in Local & Global Civil Society
Community Empowerment…
Born men are we all Brown black by the sun Knowledge can be ones Only the heart differs
but one Cultured alike from man to man Thai-old saying
GO TO THE PEOPLE LIVE WITH THEM PLAN WITH THEM WORK WITH THEM LEARN FROM THEM BUILD FROM WHAT THEY HAVE START FROM WHAT THEY KNOW
PEOPLE DON’T CARE HOW MUCH YOU KNOW UNTIL THEY KNOW HOW MUCH YOU CARE
Sawaddee (Goodbye)
Uthaiwan Kanchanakamol DDS,CDPH,MPH Chiang Mai University,THAILAND
Increasing Community Capacity and Empowering Community Members to Improve the Health and WellBeing of Chiang Mai Hill-Tribes and Low-income Groups in
Type of Research
Participatory Action Research
Overall Goal 1. To determine how to improve implementation and effectiveness in promoting the integral development of youth, seniors and women in Hilltribes
And….. low income communities while increasing community cohesion and collaboration through cultural, political, social and artistic activities
Overall Goal
2. To determine how to improve implementation and effectiveness in promoting development of skills among sub-district administration/organization and municipality personnel in the area of community development.
STRIVING>COPING
Overall goal
3 To determine how to improve implementation and effectiveness in promoting creation of community partnerships by local actors for health promotion
STRIVING>COPING
Project Significance and Health Issues Involved
The local area health-care has been planned. The programs were implemented under the authority of provincial board consisting of representatives from the local government, communities, and the Ministry of Health.
This is especially crucial for disadvantaged groups like the Chiang Mai Hill-Tribesand other low-income communities.
This involves providing incentives, skills and strategies to community members to enable their effective participation in designing and implementing new autonomous health care and social service systems that meet local needs.
unity
Consensus Community Development
Needs Based
Strength s Based
vs
Conflict
Strategies
Social Action (Alinsky Mod
Grassroots Oganizing Professionally Driven Oganizing 1 Coalitions Lay Health Workers Collaboration Building Community Identity Political/Legisletive Action Culturally Relevant Practice Community Building & Capacity Building (“power with”)
2 Advocacy
Empowerment-Oriented Social Action (challenging “power over”)
Community Competence Leadership Development Critical Awareness
Organizing & Community
Building Ty
ere is an urgent need to prepare the communit d their representatives to effectively participa his new system.
• Specifically, it is proposed that proven, effective participatory action techniques are utilized to educate, empower, and involve members of these
Increasing Community Capacity includes ■
■Participatory
planning
■Needs
assessment methods (with emphasis on “asset-based" methods ) ■Participatory
program evaluation techniques
Community Empowerment These included: ■ Appreciative Inquiry ■ Asset Based Community Development ■ Training in the use of focus groups ■ Delphi methods ■ Participatory rural appraisal (PRA) ■ Community Walking Mapping
Community Empowerment from….
realizing
starts
the benefits of projects
that result in improved living conditions
Community Empowerment
starts from….
crystalizing their own ideas
Community Empowerment
starts
from…. building communities from the inside out
Participatory Rural Appraisal, (PRA) The amazing tool in positively, approaching marginalized people in health
Future search conference n the youth network
Future search conference in community leaders
Focus Group Discussion in an old age group
Local-local dialogue
Future search conference in the youth
Community Mind Mapping
Participatory planning & evaluation
through community action particularly through groups organized by women&youth
through community action particularly through groups organized by women&youth
Participatory evaluation on empowerment
CIVIC AWARENESS BUILDING CBO NETWORK
BY AND
ESTABLISHING CBO
STRENGTHENING COMMUNITY ACTION CREATING SUPPORTIVE ENVIRONMENT
The New Role in Health Promotion Teamwork • • • • • •
THE THE THE THE THE THE
HP-CATALYST HP-FACILITATOR HP-PROMOTER HP-DEVELOPMENT ENABLER The HP-MEDIATOR New HP- ADVOCATE Role in Of The Healthy Community Program Health The Caries Free Village ProgramProfessionals The Vital , Creative Health in Promotion Program, etc . the
21 st Century
Civil Society
A D V O Optimal Health C A C Y
ENABLE
M ED IA TE
Quality of Life
Kanchanakamol U.,1998 Dev. from Ottawa
Community Organizations Area hospitals, NGOs, Local governmental groups were enlisted as collaborators in this learning process.
•
Their involvements have the additional advantages of identifying issues early-on for discussion and resolution, enabling coalition-building and increasing trust between the three partner groups.
Central Governmen t
Local Authorities
Private Sector
NGOs
Donor
CBOs
Local - Local Dialogue Helps Local Actors Create
Partnerships
NGO Autonomous Network
Central Government Sectors
NCCCBO PASED CCLA
Funders & Private Sectors
ICE
Coordinated Actions LAO5 by CBO1 Local Administration Organizations Multiple Actors/Sectors CBO21 MUNICIPALITY2 Community Based
Organizations
Healthy Community Good Governance
Concerned communities hold the key to successful advocacy for healthy public policy. Without community involvement, a truly public policy cannot evolve. Therefore … Advocacy for community support should arouse public interest and community action that will generate pressure for
Poverty and illiteracy do not prevent people from recognizing their needs and calling for action
Type of Research
Type of Research
Local - Local Dialogue
Type of Research
Type of Research
Local - Local Dialogue
Type of Research
Local - Local Dialogue
Type of Research
Local - Local Dialogue
Type of Research
Type of Research
Type of Research
Type of Research
Type of Research
Poverty and illiteracy do not prevent people from recognizing their needs and calling for action
Community Empowerment Starts From…. ■
Building people’s capacity to formulate and implement local development initiatives ■
analyzing & choose
among alternative approaches
Who is being empowered ? See them in
■
...
..........community participation process
1. Local initiative communication,art,media
Though drama,song,community dialogue,music therapy,internet
6. LOCAL WISDOM
2. HEALTHY CONSUMER
Traditional healing, herbal medicine biotic,vegetarian,etc.
5. PHYSICAL EXERCISE HEALTH Aerobic,Yoka,cycling, jocking
Macro-
3. RELIGION AND
Meditation network Tichi,Traditional exercise PROMOTION Interreligious activities Northern Thai boxing dance INITIATIVES Tribal culture HEALTH
4 LIBERATED LIFE STYLE
Holistic self-care, alternative medicine, self body massage HEALTHY COMMUNITY
HEALTHY CITY
The Evolution of Oral Health Care Teamwork
Community Empowerment Local Decision Making is the Key
The achievement of local autonomy through the development and use of life skills
Citizen control Delegated power
Degrees of citizen power
Partnership Placation Consultation Informing Therapy Manipulation
Degrees of tokenism Non participation
The Ladder of Citizen Participatio n in Community Health Program Kanchanakamol, U 2000 developed from Arnstein,1971:70
Holistic Health Negative Health Positive Health Death/ Deformity/Disability/Symptom/Sign Growth & Social Self
Self Development/acceptance/esteem / fulfilme
Rehabilitation /Early Diagnosis/ Eradicating/ Raising Individual / Effective Enduring & Prompt Rx Health Risks QOL Social Change
1
3
2
o
o
Disease Prevention
o
1o 3o Health Promotion
discernable point
2o
• Developing one’s creativity & potentiality
Masl ow’s Hierc Need hy of s
• Making maximum use of one’s ability • Self-esteem Esteem of others
•Love Belonging Closeness
Safety
Security
Food Air Water
Shelter
Rest
Exercise
Sex
OPTIMAL HEALTH
Health - oriented (health model)
1
Disease Prevention 2 o Disease Prevention 3 o Disease Prevention o
Effective enduring Social change
Raising individual QOL Eradicating Health Risks Early Diagnosis Prompt Rx Rehabilitation
MINIMAL DISEASE
3
o
Health
Promotion 2
o
Health
Promotion 1 o Health Promotion Disease-oriented (Bio-medical model
Kanchanakamol U. Dev. from Brown V., 1985
CRISIS in THAI SOCIETY
Civic Mind
Civic Organization Civic Network Emergence and Movement in Local & Global Civil Society
Community Empowerment…
Born men are we all Brown black by the sun Knowledge can be ones Only the heart differs
but one Cultured alike from man to man Thai-old saying
GO TO THE PEOPLE LIVE WITH THEM PLAN WITH THEM WORK WITH THEM LEARN FROM THEM BUILD FROM WHAT THEY HAVE START FROM WHAT THEY KNOW
PEOPLE DON’T CARE HOW MUCH YOU KNOW UNTIL THEY KNOW HOW MUCH YOU CARE
Sawaddee (Goodbye)
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