Kauffman K S, Myers D H
Department of Psychiatric, University of Maryland at Baltimore, School of Nursing 21201-1545, USA.
Int J Nurs Stud. 1997 Aug;34(4):249-55. doi: 10.1016/s0020-7489(97)00012-6.
The system of Primary Health care (PHC) in Thailand is one of the oldest in the world and is known worldwide for its success. Supporting the concept of community involvement, the Village Health Volunteer (VHV) is the backbone of this health care delivery system. In December 1994, an ethnographic field study was conducted in a village in Northeast Thailand to explore the implementation and acceptance of the role of the VHV. The VHVs displayed appropriate knowledge of their role but reported decreased use of their services by residents due to the close proximity of the village to a major urban area where health services were readily available. The majority of the villagers who were interviewed did not know the VHVs in their community and few had used their services. They relied on self-treatment and self-referral for their health care concerns. With increasing urbanization of this once rural village, the VHV no longer serves as the point of entry into the health care system. While still a vital part of the PCH system, the role of the VHV will need to adapt to the changing needs of the community it serves.
泰国的初级卫生保健（PHC）系统是世界上最古老的系统之一，并且以其成功而闻名于世。支持社区参与理念的乡村卫生志愿者（VHV）是这个医疗服务提供系统的支柱。1994年12月，在泰国东北部的一个村庄进行了一项人种学实地研究，以探索VHV角色的实施情况和接受程度。VHV对自己的角色表现出了适当的了解，但报告称由于村庄距离一个可方便获得卫生服务的主要城市地区很近，居民对其服务的使用减少了。大多数接受采访的村民不认识他们社区里的VHV，很少有人使用过他们的服务。他们在医疗保健问题上依靠自我治疗和自我转诊。随着这个曾经的乡村日益城市化，VHV不再是进入医疗保健系统的切入点。虽然VHV仍然是初级卫生保健系统的重要组成部分，但其角色将需要适应其所服务社区不断变化的需求。
