Questions/Answers

From the analysis of the situation of chronic non-communicable diseases in Su-ngai Kolok District, Narathiwat Province in 2016, found 5,744 hypertension patients, 2,149 diabetes mellitus and 359 stroke patients. Statistics of stroke patients in 2014 - 2016, found that 217, 242 and 359 persons respectively. In the Pohong Yamoo community, it was found that the incidence and prevalence of patients with stroke is as high as 1 in 3 of Su-ngai Kolok District. Taking care of oneself who are sick still use local knowledge and black magic practitioners. There is a culture of eating on sugary, greasy and salty foods and not exercise. People in the community are not aware of the symptoms, warnings and prevention. Therefore, we have established a Living Stroke Project in order to reduce mortality, disability caused by stroke. Providing people with knowledge about the disease, symptoms and prevention. Also change the risk group and the sick group to the correct health behavior, increase vegetable intake by growing organic vegetables, having physical activity in the community and be able to control blood pressure and blood sugar levels. So the risk group decreased, the sick group have a better quality of life. With the cooperation of network partners in the public, private and public sectors allow the public to share opinions, make decisions, participate in actions, monitoring and evaluation with a process for developing awareness, warning and prevention of stroke in the community. There is a health screening activity, Badan Sehat, and an assessment of health status with 7 colors ping pong innovation and 3 languages Stroke public relations media. Health Volunteers are leaders, public health officers are mentors and the project has been extended to other communities and has driven with the District Quality of Life Development Committee to create sustainable development in the future.

The operating results are consistent with 2nd branch, promoting policy integration mechanisms for sustainable development. Since the project has developed the health system of the community and provides opportunities for all to participate in the development which government agencies play an important role in initiating the survey, establishing a community forum, support budget, planning of activities, monitoring and evaluation Including creating sustainability with the District Quality of Life Development Committee that allow people to be self-reliant, promote the potential of the community to be a strong community, be able to manage health problems of themself and family sustainably.

The multicultural stroke reduction community is consistent with the UN's Sustainable Development Goals (SDGs) of the article item 3.4 on health and well-being of people. By disease prevention and control, focus on the participation of network partners in order to be consistent with the problems in the area and promoting awareness of warning symptoms and prevention of strokes. 110 people are aware of the warning symptoms and 93 people know to prevent of stroke and no new cases of stroke patients. Communities can be role models and sustainable self-management.

In social dimension : Establish a community forum to make an integrated project. Set a clearly operating period, define the person responsible for, and plan the implementation and evaluation of the project with the District Quality of Life Development Committee. In economic dimension : Establishing a community fund management committee and use the funds to finance community activities. In environment dimension : There are public areas of the community, villagers and municipality areas to support the area through the community committee to improve and maintain the location of the activities.

From the project, it can reduce the problem of supervision with network partners participating in the management of health problems by creating a stroke leader in the community, divide responsibilities into various zones of the community, starting with educating the stroke leaders in the community and educating about diseases. Basic symptoms, warning and prevention of diseases. It helps to reduce the severity of the disease, the problem of medical services from the government sector by strengthening good relations and reducing the gap between service providers and people. New stroke patients think of Su-ngai Kolok Hospital as the first service place and be able to access the service in a timely. Reduce medical expenses not a burden to the family and the community. The patient can manage health conditions which resulting in better quality of life for people.

In implementing the project, health information is transmitted in the community and join the community to find the true size of the health problem. A representative is chosen by a community member. Therefore, representatives in the community have the right and freedom of expression on an equal basis, regardless of gender, age, or religion. Also establishing a women's club in the Pohong Yamoo community. Muslim women can fully play a role, such as being a community leader, health leader, be able to screen health, to organize various activities without violating religious principles and is accepted by the community.

Target group: A total of target group are 110 people. Stroke risk group are 65 people and stroke group are 6 people. After participating in the project, the public are aware of the warning symptoms and the prevention of stroke from a total of 76 people increased to 93 people with health behavior risk of chronic non-communicable diseases decreased from 88 people reduced to 39 people. The number of 71 people are able to control blood pressure and blood sugar levels to be in the criteria normally decreased to 35 people. The risk group decrease and the sick group have better quality of life. Tracking found no new stroke patients in the community yet and the satisfaction level in participating in the project is very satisfied.

Statistics of stroke patients in 2014 - 2016, found that 217, 242 and 359 persons respectively. In the Pohong Yamoo community, found that the incidence and prevalence of patients with stroke is as high as 1 in 3 of Su-ngai Kolok District. Therefore, we have established the Living Stroke Project focusing on the participation of network partners driven by working with the District Quality Development Committee and adopted the policy of Su-ngai Kolok Hospital. Starting by investigating the problem, establishing a community forum, requesting a budget, support planning, monitor and assess health conditions. Resulting in a total of 110 target groups, 65 people at risk of stroke and 6 patients with stroke after participating in the project. The public are aware of the warning symptoms and the prevention of stroke from a total of 76 people increased to 93 people. Health behavior risk of chronic non-communicable diseases decreased from 88 people reduced to 39 people. 71 people be able to control blood pressure and blood sugar levels decreased to 35 people so the risk group to decrease, the sick group have better quality of life. Tracking found no new stroke patients in the community yet. And the level of satisfaction in participating in the project is very satisfied. In 2018, the community health leaders and the public health staff has a process to develop awareness, warning, and prevention of stroke every month. With health volunteers in the community, the project has been extended to other communities in Su-ngai Kolok District and Pohong Yamoo Community received the award winning stroke prevention community. In the year 2019, the Stroke Living Project has been extended to the Saithong Community, Ban Bango Primeng Community and Pasemas Village in Su-ngai Kolok District.

Problems and obstacles : Taking care of oneself with a little illness still uses local wisdom before going to receive services at government facilities and private clinics. Promoting health and disease prevention in communities are less practical. Patients have an attitude belief in treatment with local doctors, masseurs and black magic. Solutions for problems : Promoting knowledge and conduct surveillance and prevention of complications at risk and stroke by a multidisciplinary team and network partners and adjusting the right attitude. Including providing accurate knowledge of the disease, warning symptoms and prevention of stroke to community leaders, radio and television publicity.

- Make public relations for stroke in 3 languages (Thai, Malay, Jawi) due to the context of the area therefore people understand and access more information. - Technique for screening with7-colors ping pong to tell the severity of the disease and proper behavior. - Fitness innovations, Ronggeng dance aerobic exercise and loincloth aerobic. Therefore they are applied to design the physical exercise together with the loincloth. - Innovation of using water pipes in the exercise due to the limited space context and lack of exercise equipment. Therefore, using waste materials as an innovation in exercise.

- Public relations media for stroke in 3 languages (Thai, Malay and Jawi) is a further development from the existing 2 languages (Malay and Jawi) and7-colors ping pong screening is a further development from the health surveillance system of the Ministry of Public Health which applied to the context of the folk way. Both innovations have received the concept of health believe model in assessing one's own health status and is an incentive to improve health behaviors. - Ronggeng dance aerobic exercise is a combination of exercise and folk play of the community.

From making a living project to a distant stroke has released a short film media. "The turning point…at the river side" in the academic forum in Narathiwat Province and the Health Zone 12. There were 2,000 participants and was broadcast on the digital page of Su-ngai Kolok Hospital. There were 1,500 participants in the audience as a means of public relations. And the project has been expanded to Saithong Community and there were 70 participants in this project. There were 70 participants from Bango Primeng Community in the project and 50 participants from Pasemas Village to promote disease prevention and control by focusing on the participation of network partners in accordance with the problems in the area for sustainable development in the future.

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People: Personnel from Su-ngai Kolok Hospital, Chief of Su-ngai kolok District Agricultural Extension Office, Su-ngai Kolok District Community developer, Public health volunteers, Village leaders, Community leaders, Elderly and the military medical unit has a role as a knowledge speaker on each side. Fund: Received a budget of 67,850 from the Su-ngai Kolok Municipality Health Security Fund to support project activities. Materials: Blood pressure monitors, Sugar-finger punching machine, 7 colors Ping Pong Vinyl, food model, health record, fitness equipment and fitness center. Other resources: Database information systems provide basic information for analyzing disease severity situations.

From the project activities, the community realizes the importance of organizing health promotion projects. There is ongoing community planning which is supported by the budget of Su-ngai Kolok Municipality Health Fund and communities funding from other agencies. There are also community funds established by the community.

Yes

The work has been officially evaluated from outside, namely the Narathiwat Provincial Public Health Office, assessing the prototype community to reduce stroke at the provincial level. By using criteria to assess the stroke reduction community. Using random sampling methods to survey and interview the villagers in the community about awareness of diseases, warning signs and prevention of multicultural stroke and the District Quality of Life Development Committee assess the project's performance by using the health behavior questionnaire according to the principles of 3 E 2 S.

Assessment from the Provincial Health Office by using a community assessment tool to reduce stroke. And with 80 percent rate indicators, people in the community have a level of knowledge and understanding of stroke, warning symptoms and disease prevention. And evaluated from the District Health Board by using the Health Behavior Questionnaire based on the 3E 2S and there are indicators of 50 percent. And the blood pressure and blood sugar levels of risk groups and sick groups were reduced to normal levels by 50%.

From the assessment from the Narathiwat Provincial Health Office received a prize in the prototype community to reduce stroke at the provincial level and responsibilities are divided into various zones in the community for the provision of resources sufficiently. Patients still lack awareness of correct behavior such as lack of medication, lack of follow-up appointment. Public health officers have guidelines to follow from every 3 months to every 1 month so that patients cannot have complications from the disease and have a better quality of life. As assessed by the District Quality of Life Development Committee, the results showed that 72% increased risk of chronic non-communicable diseases and be able to control blood pressure and blood sugar levels to normal levels by more than 54% resulting in lower risk groups. The sick group had better quality of life. Eating sweet, greasy and salty foods and exercising are still not continuous. The health leaders in the community participated in proactive planning with friends and friend’s activities to have activities to reduce sweet, greasy and salty foods and exercise continuously and sustainably.

Establishing a community forum with network partners driven by the district quality of life development committee consisting of hospital, district public health hospital, municipality health division, Agricultural, Social Welfare Division, Community Development District, Health Volunteers, doctors, nurses, public health academics, nutritionist and military medical unit including private sector agencies, people and leaders in the community to select health problems. Su-ngai Kolok Hospital supports staff to provide knowledge about non-communicable diseases, warning and management, or awareness of prevention of risk factors and access to Stroke fast track services. Nurses and volunteers jointly screening for normal groups, risk groups and chronic non-communicable diseases. The nutritionist is a lecturer on self-management in sugary, greasy and salty foods. District Agriculture give knowledge to grow organic herbs. The leaders exercise with the elderly club of Su-ngai Kolok District. Women groups and religious leaders is a lecturer teaching exercise by using loincloth and pole dance. Local cable news communicated to the public in health promotion and reducing risk factors for chronic non-communicable diseases continuously. Establishing health literacy and health literacy tools, increasing communication channels by setting standards for health media for dissemination to the public health, knowledge library and clear public relations campaigns.

The public is aware of health problems. Be able to manage health problems and assess their own primary health, family and community. With community leaders establish community committees and religious leaders in the community are the ones who combine knowledge related to health care on the day of religious practice resulting in quick access to health services timely and can reduce the severity of the disease. And the health service units proactively provide services. There are local agencies that support the budget to succeed in promoting disease prevention and control at the personal level, families and communities. And schools can also be the backbone of knowledge dissemination in the family.

Proactive work and community access by using local language communication processes in the context of communities, causing the community to gain understanding, access data and the trust. Which is received the cooperation of the community and network partners will lead to solving health problems that meet the needs. Which working in the community based on the principle of "inform, demonstrate, be a viewer, do yourself without watching", thus allowing the public to be able to take care of multicultural health by themselves. And working as network partners both the government, private sector, and the public. With the District Quality of Life Development Committee as the driving force in operations, monitoring and evaluation, resulting in sustainability until it can be extended to other communities.