Questions/Answers

The objectives include increasing access to public health services and raising the standard of living of people in the provinces in Thailand, especially in areas where there are conflicts and armed violence. These are termed “red areas” as opposed to the more secure “green areas”. The conflicts and violence undermine the people’s trust in government officials, and exacerbate the problem of access to basic health services. So it is necessary to help build trust, to create a public service network, reduce paperwork, and facilitate workflow to increase accessibility to comprehensive public health services. It is also necessary to solve problems, reduce obstacles, raise incomes, improve society, the economy, and community security. In order not to leave anyone behind, it is important to build a network of people in the community and enhance access to quality services in areas where there is conflict and fighting. This is especially true for underprivileged and vulnerable groups affected in the red areas where public officials feel insecure about access, compared to the safer government controlled green areas

The intent is to help people who live in conflict areas. There are obstacles to trust between the government and the people to the extent that government officials are unable to access the area. The goal is to increase access to basic health services and to develop effective, efficient, proactive service processes in red areas. It is important to develop a “keyman” network. Key men, such as religious leaders, village headmen, and other talented people, are recognized by villagers and should be involved to promote trust so the government can proactively bring equal and inclusive services to the underprivileged.

It is necessary to reduce inequality of access to service systems in red areas and green areas in the lower southern border provinces. The accessibility rate to health services in the red areas is one-third of that for people in the green areas. In order to create equal accessibility, it is important to create security and increase trust so people can receive government basic health services again. This is related to the country's sustainable development goals consistent with SDGs category 3, number 3.8 which is to achieve access to quality basic public health services.

Nong Chik District is located in Pattani Province, a southern border province of Thailand. It is a region with armed conflict, divided between red and green areas (unsecure and secure). As a result, groups in the red area formerly did not receive basic health services, especially when fighting occurred. The impact included loss of life, especially loss of family leaders, people becoming disabled, loss of income, and many other problems. Nong Chik Hospital tried to help, but the people did not trust government officials. For this reason, health care providers have worked at building trust and showing commitment to equalize accessibility to the services by developing and working with key men in the area. This helps build networking collaboration and demonstrates sincerity in solving problems proactively. This effort has continued for 15 years, listening to both sides with impartiality and creating understanding and trust in government officials. Finally, public health services are being delivered to people in red areas and people who live there are being treated and have had increased accessibility at the same level as people in green areas. This effort can be a model for other government agencies to learn how to increase access to restricted areas.

Violence in the lower southern border provinces of Thailand reduced confidence in government services and trust between government officials and people. This resulted in a decline of necessary public services. It has taken more than 15 years to re-build trust in accessing basic public health services in the red (violent) areas. There is an innovative database system for accessing public health services in NongChik District. This is a basic system for collecting data, to help increase confidence in the service system, and to reduce duplication of the government services.

The innovation is a development of a database to facilitate access to integrated public health services and to representatives of affected people and key men. The database includes data about families in the district. This is to ensure staff can meet local residents and that each family truly receives care, without duplication of services. This helps communication, acknowledge the problem solving in a collaborative way, and log in information in a meaningful way. The program is developing a map of access to basic public health services using Google Maps to help government officials get to the target groups easily and promptly.

The “NongChik Model” service data base has been continuously developed. It has become a model for basic public health services for other districts, and provinces; and--after study tours--neighboring countries such as Malaysia and Indonesia have implemented similar programs. This model won the National Mental Health Award in 2018 from the Department of Mental Health; it publishes in research publications such as the Journal of the Association of Researchers; and has received community participation awards in various forums. The "NongChik Do Not Leave Each Other" program has been ranked first in the country 5 years in a row.

Resources include “4Ms”-- men, money, material, and management. Men are key men or executive who value and support personnel. Money is the budget from various organizations such as the Southern Border Provinces Administrative Center and the Pattani Provincial Social Development and Human Security Office. Materials are supplied by the Mental Health Center 15, and Pattani Primary Educational Service Area Office 1. Management is provided by the academic Deep South Coordination Center (DSCC) and all sectors are involved. The image reflects the social resources, wisdom, and economic advantages in the development of service systems.

Sustainability is supported by the following: 1) Engaging with community networks, by inviting people to receive public health services, not discriminating against the target groups, taking into account the equal value of all humans. 2) Surveying data on the needs of victims and their families through the network in order to address their problems and needs, even if they do not accept government services. 3) Increasing access to welfare services such as the provision of proactive services in the red area to those in the network. 4) Coordinating with concerned agencies to identify problems in the area in order to coordinate work efforts. Many factors have to be taken into account in order to have full and complete services and coverage. It requires the use of social resources, intellectual resources, and economic capital to benefit the development of a care system for the affected people. These arise from a base of affected people and families in the community, working to improve basic public health service in the area.

Yes

In 2006, the initiative was officially assessed in the following aspects: (1) Key man and multidisciplinary team Basic knowledge and skills in mental health and healing; (2) Health care facility in case of unrest. The service is unique. Considering privacy, security, mental security, "secrets, but not secrets"; (3) 1. Information facilitating activities to promote prevention, treatment, rehabilitation and transmission of information of the recipient; 2. Receive external evaluations, such as representing the province. From health zone 12, Thailand.

The evaluations can be used to develop proactive government services, with Key Men as public service partners to increase accessibility to public health services for people in the red area. People in the red areas are now easily serviced; the indicator is that 70 percent of those affected by the unrest in the southern border provinces have continually received care. This is a basic need for conflict victims in the region, to reduce health risks that will affect them in the long term.

Results were achieved after using a proactive approach with key network partners. 99.08 percent of people affected by the unrest in the southern border provinces have had increased access to the basic health system, and access has been continually improved. Affected households and families in the red area now dare to get basic health services through local network partners. There is more trust in the government and less feeling of being neglected and left to their own resources.

The program design to build trust and relationships with Key Men as network partners. Various individuals, such as public health officials, have clear roles and responsibilities. Key Men are responsible for ensuring safety and understanding. Government officials have access to community activities, such as religious activities. Health promotion includes increasing access to basic health services and creating new perspectives so people will have confidence in government services. The targets include the network of families affected by disasters in the area. There remain opportunities for other government agencies to participate in community development and achieve a sustainable development agenda through 2030.

It has taken 15 years with the operation to overcome obstacles to create good feelings and to build trust in the southern border provinces in Thailand. Persistence and hard work, particularly with and by the Key Men, have changed and improved people's viewpoints about accessible and basic public health services. Other supporting factors include time spent, commitment, harmony, unity in work, sustainable development, and the human heart. The principle of sincere care helps deliver impartial services at all levels.