รูปแบบการจัดการปัญหาการเข้าถึงบริการสุขภาพช่องปากในพื้นที่ห่างไกลโดยการมีส่วนร่วมของท้องถิ่นและชุมชน กรณีศึกษาบ้านเกาะโคบ ตำบลเกาะหมาก อำเภอปากพะยูน จังหวัดพัทลุง

Abstract

The purpose of this descriptive study was to study the model for managing problems of access to oral health services in remote areas through local and community participation. This study was conducted in Ban Ko Kob, Ko Mak subdistrict, Pak Phayun district, Phatthalung. The data was collected quantitatively from the 255 local people by checking their oral health and answering the questionnaire on factors of access to oral health services in remote areas. The qualitative data were collected by 3 subgroup discussions; 12 officials from the community group, 6 officers from the local government organization group, 7 authorities from the public health unit, and 12 personnels from the organized workshop. The results showed that the management model should start from raising awareness among communities and localities by surveying the situation, size, severity of the problems and causes and factors affecting access to oral health services. The surveyed information should be brought into three small group discussions and workshop in order for community, local, and public health agencies to share the goals and methods for reducing the size of the problem with an emphasis on the local community to increase promotion on the behavior of oral health protection of the locals in the community and to make the service more proactive. Plans and projects can be classified according to health determinants namely: individuals should develop the capacity of health officials, village health volunteers and people in the community to have knowledge on oral health care, oral diseases, awareness of oral health and beliefs in receiving oral health services. In terms of the environment, there should have an increase of access to oral health information, information on the right to treat dentistry and shuttle buses to access the dental care units with support from the local government organization. There should have community measures in the grocery stores and sweet shops. The local administrative organization mechanism should support scholarships for students in the area to study dental public health and return to work in the health promoting hospitals in the area and reinforce dental equipments and materials. Public health agencies should increase the issuance of mobile oral health services. The hospital should open a special appointment channel for patients in remote areas and an online appointment system to receive services at the community hospital by making appointments through the subdistrict health promoting hospital. Dental personnels should visit homes with a multidisciplinary team. There should have an integrated budget from the public health network and health insurance fund budget at the local or area level (NHSO), dental fund and the budget from the allocation within the school. In addition, there should be a joint monitoring and evaluation mechanism of communities, localities, and public health agencies. To implement the management model of access to oral health services in remote areas into practice, the executives of each concerned department should have a clear policy and working plan of each agency should be included as a routine.