The changing role of village health volunteers in northeast Thailand: an ethnographic field study.

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.