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Community Health Workers as Agents of Health Promotion: Analyzing Thailand’s Village Health Volunteer Program

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Abstract

The village health volunteers (VHVs) have been a regular part of Thailand’s health system since the 1960s. Despite widespread recognition, little research has been conducted to describe VHV activities, the settings in which VHVs provide help, how the program is administered, and how changing politics and health problems in Thailand have influenced the program. In order to understand the roles and practices of the VHVs, we conducted in-depth semi-structured interviews and focus groups with VHVs, community leaders and members, and public health officials in three semi-urban communities in central Thailand. Using the Social Ecological Framework, we mapped factors that influenced how the VHVs provided support, including governmental oversight, collaboration with public health officials, and community trust. These influences are discussed as “points of consideration,” which help to identify the strengths and tensions within the VHV program and best practices in supporting and assessing community health worker efforts.

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Acknowledgments

The authors thank Nareeman Neelapaichit, Thanyaporn Wanichritta, and Hataya Petcharoen for their help in participant recruitment, data collection, and translation. Thank you as well to Allan Steckler for his help in reviewing the manuscript and providing guidance and support throughout the study. Funding for this research is provided by the American Academy of Family Physicians Foundation (AAFP Foundation). E. Fisher has received compensation for serving as a speaker/consultant/advisory board member for the AAFP Foundation. S. Kowitt, D. Emmerling, and E. Fisher were all supported by the Eli Lilly and Company Foundation and the Bristol-Myers Squibb Foundation.

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Correspondence to C. Tanasugarn.

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Kowitt, S.D., Emmerling, D., Fisher, E.B. et al. Community Health Workers as Agents of Health Promotion: Analyzing Thailand’s Village Health Volunteer Program. J Community Health 40, 780–788 (2015). https://doi.org/10.1007/s10900-015-9999-y

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