Innovative city for elderly people and people with disabilities
Ban Phai Municipality

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
Ban Phai Municipality is located in Ban Phai district, Khon Kaen Province of which the area is about 16.20 square kilometers. In 2013, Ban Phai district was divided into 39 communities with the population of 29,030 people; 5,079 (17.49%) older people and 463 (1.59%) people with disabilities. In 2014, among 28,946 of the population; 5,671 (19.59%) older people and 532 (1.84%) people with disabilities. In 2015, among 28,847; 6,067 ( 21.03%) older people and 545 (1.89%) people with disabilities. In the next ten years, the number of older people regardless any gender is estimated to increase to 6,455 (22.38%) people of the whole population and has a tendency to increase every year. This can affect the population structure, particularly the Ban Phai Municipality whereof the community will become an older people’s community. The finding from the survey and visiting communities, households where there are older people and people with disabilities, the annual average income is 28,000 bahts, it’s about 2,333 bahts per month. The expense for each hospital visit can cost about 1,000 – 1,500 bahts. The survey has also found that 896 (14.77%) older people and 160 (30%) people with disabilities are very poor and disadvantaged. They have encountered so many aspects of problems like psychological problems, family problems, occupational and income problems. More importantly, the health care services are neither well directed nor provided. Their housing has been in very bad condition. These problems include their living, safety, malnutrition, problems to get into health care services as well as lacking of good government’s welfare. If these economic and social problems have been unsolved, there will be a great impact towards society at large in the future. Families and communities will become very weak and unsecured. The poverty can result economic, social and mental problems in families and communities, certainly the problems of drug addiction will be an addition.

B. Strategic Approach

 2. What was the solution?
Innovative city for older people and people with disabilities aims to enhance appropriate facilities to improve body, mind, and spiritual health of older people and people with disabilities. This innovative better life promotion has its focus on a holistic . Approach with a well strategic planning to promote good quality of life for older people and people with disabilities who have been disadvantaged for a long time.

 3. How did the initiative solve the problem and improve people’s lives?
The objectives to solve these problems are:To improve quality of lives covered all aspects – body, mind, social, and spirit - for older people and people with disabilities who have been poor and disadvantaged and To create healthy atmosphere in older people and people with disabilities’ families. The expectation are : The improvement of quality of life for older people and people with disabilities is expected to achieve at the level of 100% totally and The involvement of various organizational sectors like government, private organizations, or even family members is expected to mostly participate and cooperate.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
In the past, Ban Phai Municipality had temporarily provided onsite basic health services to disadvantaged older people and people with disabilities. Their problems, particularly each individual household’s problems had not yet been discovered. Each visit was only aimed for their basic health problems and the length of visiting time was quite limited. Consequently, there was neither solution to their problems nor a plan to provide sustainable solution. Subsequently, Ban Phai Municipality has realized these unsolved problems, an idea to create an innovative city to improve older people and people with disabilities’ quality of life was established to provide proactive health in all dimensions of healthy living. All organizational sectors have been encouraged to take part and cooperate through thinking, decision making, planning, and evaluating together. This also included fund raising from various organizations and activities to stimulate the awareness and work together to help fulfill the objectives of the project.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
This initiative has had good cooperation from 3 organizational sectors; government, private institutions, and community people. Ban Phai hospital, charity organizations, community’s leaders, public health volunteers who have been caregivers for older people and people with disabilities have helped this project driven to achieve its goal. Each institution has been responsible for the following: Ban Phai Municipality was the main sector to lead the whole process and plans as well as being a medium for cooperation. It also evaluated and provided any kind of supports such as funding, equipments, transportation, and EMS cars to take and deliver these disadvantaged people to the hospital. Moreover, fund raising called “Ban Phai people will not be abandoned” was set up to help these particular disadvantaged people. Ban Phai hospital has been responsible for going out to visit patients, older people, people with disabilities, or bed ridden patients by a medical team consisting of medical doctors, nurses, public health officers, physical therapists and those who have been involved in providing treatment to these needed people. Four public health service centers have sent together occupational nurses and public health officers to visit older people who couldn’t help themselves, bed ridden patients or even handicapped people to examine these people’s health and follow up patients with chronic diseases. Charity and private organizations have provided good cooperation by donating money and supplying essential things to assist the disadvantaged people. Community leaders such as the chiefs of the communities who have acted as a cooperator between the town Municipality and hospitals or the other offices to provide assistance to these disadvantaged people. Village health volunteers or any volunteers have acted as representatives for the town municipality because of their close relationship to the villagers. These volunteers would help screen the patients as well as providing consultation regarding basic health care treatment. The following groups of people have been beneficial from the project: The group of older people consisted of 6,067 (86.7% ) older people who were subdivided into 4,348 socialized people, 844 people who stay at home, 52 bedridden and The group of disabled people consisted of 545 people. 532 (97.61%) people with disabilities have participated in the project. It was almost the whole population of disabled people.
 6. How was the strategy implemented and what resources were mobilized?
The following is the innovative procedure. Phase 1: In 2013, Ban Phai Municipality was the leader to cooperate with the community volunteers creating activities to care for older people and people with disability. The services have not yet covered all the aspects of health care treatment and sustainable living. Older people and people with disabilities have still encountered unsolvable problems such as each family’s income, education for children, environmental living state, no loving and caring in the families, or even lacking of generosity in the society. Phase 2: In 2014, Funding was needed. People in the communities were encouraged to cooperatively participate in helping promote and raise fund so that the activities could be carried out. Since Ban Phai municipality has good strength in solving problems, the innovative activities were systematically created. Ban Phai citizens have been encouraged to reflect with comments, meanwhile these citizens can always inspect the whole procedure of organizing these activities. Working with transparency and the information has to be publicized has been the Municipality’s purpose. Phase 3: In 2015, with the slogan “Ban Phai people will not be abandoned”, activities for fund raising were organized, for instance charity concert, a soccer match among movie star celebrities, etc. The donation came from various sources, community people and several organizations. Phase 4: In 2016, a family doctor team was established to systematically increase more health care efficiency for older people and people with disabilities. This aims for longer term caring. The budget was supported by National Health Security Fund to help solve housing and family income problems. Every week, a walking street market is arranged for local people to earn some incomes by selling their household products. Moreover, more activities were strategically created to improve better health care efficiency for older people and people with disabilities as follows: Health care proactive is aimed for further referring to public health services and those older people and people with disabilities who have had health problems for a long time.Household of older people and people with disabilities is encouraged to develop a career and increase family incomes.Establishing “Ban Phai people will not be abandoned” group to help raise fund, seek for cooperation and inspect the process of working to indicate transparency.Seeking for community leaders to help educate and pass on their understanding to their families, village health volunteers or any service-minded people to be able to provide quality caring to disadvantaged people in the communities. Resources were the following: Human resource consisted of multidisciplinary team, Ban Phai Municipality officers, Ban Phai hospital, 215 public health volunteers, 117 volunteers to help take care of older people and people with disabilities, 78 core leaders, and 20 people from older people club. Financial resource was from the budgets (68,413 bahts) set up by Ban Phai Municipality office and 60,000 bahts from “Ban Phai people will not be abandoned” group. Equipments and materials such as 20 wheel chairs, 30 walking sticks, 2 beds and consumable supplies were provided by Rehabilitation and vocational training center for disabled people, Home defender individual with autism, government sectors, private sectors and other citizens around Ban Phai Municipality.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
Ban Phai Municipality initiated the innovative means to improve quality of life for older people and people with disabilities by seeking for cooperation from various resources. Local sector: Ban Phai Municipality provided some budget to make some area available for older people and people with disabilities to participate in the activities organized by the municipality office. These activities included Songkran festival, Buddhist lent candle festival, Floating festival, establishing older people’s club, a school for older people, a center for disabled people, activities to encourage people to demonstrate their love towards the city, vocational promoting, landscaping the environment, housing readjusting, improving the office atmosphere and channel services to provide as convenient as possible, arranging an EMS transportation for older people to health care centers. Government sector: Ban Phai hospital and all four public health centers have cooperated to improve their health systems regarding health checking up, educate how to prevent various diseases, how to use primary medication, promoting physical fitness exercises, how to take good care for their health, health care treatment, and rehabilitation of people with disabilities. Population sector: Community leaders and volunteers have taken their role to help take care and promote quality of live for elderly and people with disabilities by encouraging healthy people to accept their limitation and be able to live with them in harmony. Meanwhile, they were taught to prepare themselves to understand the tendency of physical and psychological changes once they reach elderly age or become handicapped. Private sector: Business companies and shops have supported both finance and materials to help older people and people with disabilities through “Ban Phai people will not be abandoned” group’s funding.

 8. What were the most successful outputs and why was the initiative effective?
Innovative City project has aimed to make services equally available for all ages, any gender, particularly to improve the quality of life of older people and people with disabilities at the level of 100 percent. The target group has been secured with housing, education for children, vocational training to increase family’s income, and eliminate poverty. The families have become loving and caring. The communities have been strong, peaceful and have mercy to each other. This innovative project has achieved the following:Volunteer networking to care for 332 older people and people with disabilities. A service center with an EMS transportation to give services systematically. A service center for people with disabilities and orthotic equipment. Develop stronger houses and a housing co-operation was established. Funding raising by “Ban Phai people will not be abandoned” group has reached 963,493.80 bahts.

 9. What were the main obstacles encountered and how were they overcome?
Problems and barriers to proceed this project as follows: Lack of expertise for health care services, especially, those who are specialized in rehabilitation or caring for final stage patients. Networking with public health centers around Ban Phai area, Ban Phai hospital, local public health centers, and giving volunteers training can temporarily help solve this problem. Lack of budget to maintain older people’s housing, to pay for health care and orthotic equipment cost, a good transportation to transfer patients to the hospital. Therefore, an EMS was set up, the donation of money and essential things were collected to help solve this problem. Houses for older people and people with disabilities have been in terrible conditions, very unstable, or even safe. The municipality has solved this problem by seeking for cooperation from the Government Housing Bank and Community Organization Development Institutes. This included the establishment of Ban Phai Housing Cooperation to cooperatively improve more stable housing and the coverage of building, maintenance, and adjusting the environment to properly facilitate these people.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
Older people and people with disabilities from 39 communities have been beneficial by this innovative project for the following: 100 percent of Older people and people with disabilities who have been very poor and disadvantaged could have access to health care services. The cost for each visit to the hospital has been reduced from 1500 bahts. Each of these people needs to go to the hospital at least one a month and 18,000 bahts per year. This cost is about 64.28% of their incomes. Older people and people with disabilities have equally been treated. No discrimination has been performed. 25.7% of older people and people with disabilities have received good assistance to have their house adjusted and more secured. The family could feel the warmness, the society has become stronger, the families have well educated of how to provide good caring. Family members who have been very poor become well educated and known how to develop quality of life. To solve poverty of these people, 100% of them have occupation and financial support from financial resources.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
Yes, the accountability from this project has obviously reformed honesty, responsibility and services of the government sector. There is more awareness of putting rules of law relating to professional ethics into a real practice. It initially started by searching for a target group and defining criteria to organize services accordingly to the prior sequence. The committee was from several sectors such as Ban Phai Municipality, Ban Phai hospital, and Public health centers. Older people and people with disabilities would be the first priority to be serviced. This could reduce inequity and provide more effective services. This innovative project has helped solve a lot of problems. For instance, establishing “Ban Phai people will not be abandoned” group of which the committee helped set up a plan to raise fund and audit the expense account as well as considering whom should be the priority to help. Every disadvantaged person would be prioritized to health and quick services. The evaluation and following up have been regularly practiced. Multimedia for public relations have been organized through newspaper, Voice of Ban Phai, wireless internet has been set up around the city, people can easily access to http://www.banphaicity.go.th , Social Media (Line , Facebook), digital advertisement board, community advertisement notice board and mobile advertisement around the city.

 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)
The accessible approach for health services for older people and people with disabilities has been carried out without any discrimination. Delivering proactive health services right to the house door has been going on in the communities without any cost. As a result, the older people and people with disabilities have accessed to the services easily and efficiently. Patients and their families have been educated with basic self-health care, how to keep good health, and learning how to prevent themselves from having chronic diseases. There have had a procedure of following up planned for the whole year to control the quality and evaluate the action plan. Every movement has to meet the criteria and be ethically carried out.

Contact Information

Institution Name:   Ban Phai Municipality
Institution Type:   Government Department  
Contact Person:   DAWAN POOHERN
Title:   Division of public health and environment  
Telephone/ Fax:   + (66) 8 6976 9662 / + (66) 4 327 2762
Institution's / Project's Website:  
E-mail:   tanayuth.kot@gmail.com  
Address:   905 Moo3 , Janjobtit Road, tumbol naimuang
Postal Code:   40110
City:   banphai
State/Province:   Khonkean
Country:  

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