Improvement of national security by health behavior modification Project(INSHBMP)
Fort Prachaksinlapakom Hospital

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
The Thai army is the main and the largest force which has the mission in protecting the country sovereignty and security, keeping peace, disaster relieve, and help in developing the country. Although the army has more than 250,000 personnel, the work load is still too much for them not to have enough time to rest and take care of their own health. The health of the personnel is not as good it should be such as there are more than 30% of personnel that have more Body Mass Index (BMI) than standard value. This group of personnel has become increasingly at the rate of 7% per year. This will lead to the increasing risk of Diabetes, Hypertension, Cardio-vascular Diseases, Celebro-vascular Diseases. These have been directly affected the ability in performing the duty of the army which can lead to the problems of the prevention of drug addiction, crimes and criminal, and other illegal matters that reflect the national security. Consequently, the army has assigned Fort Prachaksinlapakom Hospital, which is the main force of duties and responsibilities to give medical treatment, medical evacuation, health promoting and preventive medicine, to improve the health and well being of the army personnel and their families including population in general in the area.

B. Strategic Approach

 2. What was the solution?
Fort Prachaksinlapakom Hospital has been assigned by the Thai army to set the pilot project to solve the personnel’ health problem by working closely with the army medical department and the ministry of public health to improve the process of health promotion for the army personnel which will affect their performances. Fort Prachaksinlapakom Hospital acts as a facilitator to set up the project and activities for the personnel. We recruited the high BMI group, which are prone to health problem and diseases, to participate in the program that emphasized in health behavior modification process by creating their motivation such as giving knowledge about the benefit of having proper weight, exercise and proper nutrition that will result in efficiency of the personnel to reduce cost of medical treatment will eventually improve the national security.

 3. How did the initiative solve the problem and improve people’s lives?
National security depends not only on the budget or the equipment of the armed forces but also the efficiency of the personnel who work for the armed force. The preparedness of the personnel depends on education and training which are based on the health and well-being of these personnel. Most of them have health problems of being wellness inappropriately in health behavior and unawareness in taking care of their own health. So Fort Prachaksinlapakom Hospital found that the health behaviors of the personnel are related directly with the national security. We, therefore, plan to make an awareness and a modification of health behavior that will decrease the incident of diseases that are related to behavior (such as hypertension, diabetes Mellitus, cardiovascular diseases and celebro vascular diseases. We will not only improve the health and well-being of the personnel but also the capability of protecting the country and reducing the health care expense of the army.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
Fort Prachaksinlapakom Hospital is the pilot unit in setting up the health behavior modification program starting in 2008 in 3 steps. First, create motivation for the personnel to take care of their own health especially to have proper BMI since January 2009 we did detailed medical checkup for the personnel and found that more than 30% of personnel are overwight and increased at the rate of 7% per year. Second, in 2012 we emphasized on making awareness and concern about BMI and balancing of food intake and exercise that match with age groups. In this phase there were increasing number of personnel who joined the program. Third, Evaluation and Expansion of the program. We expanded the program to other units in the army and other health care units which aim to improve the health of the army personnel as well as the general population which will improve the capability of the national defense.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
The Implementation of behavior modification programs to enhance health starts from the associated organization. The goal of the practice is to provide the armed force to focus on their own health and ready to maintain sovereignty. Fort Prachaksinlapakom Hospital of Thai military army seeks for the corporation with the Public Health Care Unit that there are qualified personnel to provide suggestions of the health care plan, training to armed forces. Army medical Department is responsible for research, analysis development plan and technology innovation that lead to success of the project. Fort Prachaksinlapakom Hospital has enough various resources for activity to reach the target. To achieve the project-driven from the initial planning collaboration of all sectors within the Army medical department is the health of armed forces and capable to perform the duties effectively and be the model of good health to the public attention and lead to strengthened social landscape of the country as a whole.
 6. How was the strategy implemented and what resources were mobilized?
Modifying health behavior project arise from the Thai army want the soldiers to take care of their health. To be effective in maintaining sovereignty and strengthening the nation, The start by using the integration of resources and people, who have expertise. In co-operation with Department of Health, Ministry of Public Health with researchers of the Army Medical Department. Preparation of workshop activities to the target group of Army troops. The budget for the project came from the Ministry of Defense. Then the action is performed by the medical staffs of Fort Prachaksinlapakom Hospital. The expert of the Department of Health Promotion, Ministry of Health advises with co-operating with the Army Medical Research and the Department of the stored data and evaluation of the project at all stages. A piece of medical equipment budget of the Ministry of Health and the operations performed on both the vehicle and the fuel cost of Fort Prachaksinlapakom Hospital. After the co-operation found that the success of the project is satisfactory. The Army has increased the budget to provide equipment for activities. The project expanded to cover all units in the estate bending forces. Operating throughout the duration of the project is to exchange knowledge experience and technology co-operation between agencies. The results have been tangible, is to use the resources of each agency with existing resources. So the Army has sustainable development.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
Achievement of the performance of the project starting from the year 2008 to present a summary of what has been implementing the project. The project has been that the troops participating in the BMI criteria increases which are a clear example as well as recognizing the importance of health. The direct impact of the mission assigned. The integration of resource efficiency. All this makes the execution of the project with higher achievement. Moreover, when the summary information throughout the project also found that the reduction of expenditures. Army can make this part of the budget which is used to develop the training, munitions and supply with the ultimate goal of the project to be stabilized for the nation.

 8. What were the most successful outputs and why was the initiative effective?
Fort Prachaksinlapakom Hospital emphasized on sustainable solutions and require that the project be implemented continuously. In order to strengthen capacities in the operations of the army, the medical staff of Fort Prachaksinlapakom Hospital co-operating with the authorities of the project, the activities will monitor the implementation of the project. To collect data, the project was scheduled to be examined by two approaches; firstly, by monthly report. The Medical staff of Fort Prachaksinlapakom Hospital reported the event such as changes in BMI. The data is then sent to the Army, reported. The other approach is to check the reverse. Fort Prachaksinlapakom Hospital and Army Medical Department send the assessment team to confirm what had been reported.

 9. What were the main obstacles encountered and how were they overcome?
The lack of understanding of the army personnel that are seen as important in health care which is the main problem at the beginning of the project. Fort Prachaksinlapakom Hospital has examined general health. Threfore, the army personnel knew and understood the dangers of health problems such as using BMI as a parameter. After the army personnel have the correct knowledge and awareness of the issues that will affect the national security by keeping armed forces to cooperate with the authorities for participation in various styles. Public relations has performed the duty by providing information which is useful to people who are not yet participating. The current projects are struggling to meet the requirement of the needs of our troops. The projects are much interested and paid attention to the public which needs the funding to support these activities. These are much beyond the capability of the Fort Prachaksinlapakom Hospital to continue the project to be sustainable. Since most people see the benefits and the importance of possible planning of health benefits, this problem needs to be urgently solved.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
The data collected from the project has been analyzed. There were 241 armed forces personnel from 7 units participating in the pilot project. 235 personnel or 97 percent, achieved standard BMI. The hospital admission rate, risk of death, medical expenditure decreased. People pay more attention in health promotion that leads to continuous improvement. The activity following strategy shown the development process of quality of life precede the military operation is effective and suitable. The promotion of health improves resulting in a sustainable national security.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
The pilot project of healthy behavior modification is very successful is the army unit of the Udon Thani province. The Army has delivered the policy to expand this type of operations. Without any prejudice to the integration of personnel with the expertise, knowledge, technology and resources from academia and civil government agencies and the private sector effectively. By putting it into the project plans, annual performance in 2014-2015 in the army. In addition, the budget allocated to the project to the areas other targets to cover all the units in the country. To provide the funding for the development of research to achieve further implementation of the project.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
Lessons from the project implementation of healthy behavior modification, at the beginning the armed forces personnel paid no attention since they think they have exercised regularly and have medical check up every 6 months. The body showed no sign of danger or a risk of serious disorders. Fort Prachaksinlapakom Hospital is responsible for the project to take the annual health check to be revealed the risk of long-term health of the troops. In practice, as mentioned above, this method works very well in the aspect of awareness to the troops and families, even the medical staff who are prepared to do health programs as well.

Contact Information

Institution Name:   Fort Prachaksinlapakom Hospital
Institution Type:   Government Agency  
Contact Person:   Pratin Nakchuen
Title:   Dr.  
Telephone/ Fax:   06642342777
Institution's / Project's Website:  
Address:   550 Tahan Road,Makheang
Postal Code:   41000
City:   Muang
State/Province:   Udonthani

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