?????????? ???????????????????????????????????????????????????????????????????????????????????????????????????????? ??????????????????????(Strategy Map)???????????????????????????????????????????????????? (Track 4 )

1
PHC4D
???????? ??????????????? ??????????? 4
PRIMARY HEALTH CARE IN THE 4 DECADE
??????????????????????????????????????????????????
????????????
???????????????????????
2
PHC4D
???????? ??????????????? ??????????? 4
PRIMARY HEALTH CARE IN THE 4th DECADE
?????????????????????????????????????? ???????????
????????????????? ??? ????????? ???????????
?????? ??? ??? 23 ?? 2551 ????????????????????????
?????
???????????????????????
3
PHC4D
???????
PRIMARY HEALTH CARE IN THE 4th DECADE
???? 2551-2560 ????????? ???????????????????????
???????????? ??? ???????????????
?????????????????? ??????????? 4 (PRIMARY
HEALTH CARE IN THE 4th DECADE 2008-2017
?????????? PHC4D)
I am committed to integrated primary health care
as a strategy for strengthening health
systems. Dr. Margaret Chan,
DG of WHO, 4 Jan 2007
???????????????????????
4
PHC4D
??????????????????????? ??????????? 1-3
(2521-2550)
????????? 1 ??????????????? ???-??? ????????? 2
?????????-??????????????? ????????? 3
????????????????-UNIVERSAL COVERAGE
????????? 4 EMPOWERING COM FOR Health
???????????????? ???????? ????????????????
??????? ???? ??????? EQUITY-EQUALITY ?
???????????????????????
5
????????? ??????????? ??? ???????????????????????
????????????? ?????????? ?????????????????
??????????????????????????????????????????????????
????
??.?????? ????????????? 17 ?? 2550 ??.????????

• ????????????????????? PHC4D
• ?????????????????? ????????????????????????????
  ???????????????????????????????????????
  ?????????????????? ???????????????????????????????
  ???????????????

• ????? SCAMPER ??????????????????????
• S Substitute ??????????????????????????
• C Combine ??????????????????????????
• A Adapt ??????????????????????????
• P Put to other Purposes
• ????????????????????????????????????????
• E Eliminate ??????????????????
• R Rearrange ??????????????????????

???????????????????????
6
??????????????????? ???????????????? ????????
7
What is Primary Health Care?
?????????? ???
WHO - Declaration of Alma-Ata, 1978

• "Primary health care is essential health care
  based on practical, scientifically sound and
  socially acceptable methods and technology made
  universally accessible to individuals and
  families in the community through their full
  participation and at a cost that the community
  and country can afford to maintain at every stage
  of their development in the spirit of self
  reliance and self-determination.

8
PHCintegral part
?????????? ???

• It forms an integral part both of the country's
  health system, of which it is the central
  function and main focus, and of the overall
  social and economic development of the community.
  

WHO - Declaration of Alma-Ata, 1978
9
PHC-first level of contact
?????????? ???

• It is the first level of contact of individuals,
  the family and community with the national health
  system bringing health care as close as possible
  to where people live and work, and constitutes
  the first element of a continuing health care
  process."

WHO - Declaration of Alma-Ata, 1978
10
In the current contexts.
?????????? ???

• I am committed to integrated primary health care
  as a strategy for strengthening health systems.
  Of all my initial commitments, this one has
  provoked the most discussion within and outside
  the Organization. As you know, we have made the
  primary health care approach a focus for wide
  consultation.
• In the broader context of development, we can see
  the importance of the value system that is part
  of this approach the focus on equity, universal
  access according to need, the provision of
  comprehensive and affordable care, local
  ownership, and sustainability. With health now
  directly linked to poverty alleviation, and with
  our commitment to the Millennium Development
  Goals, we can see the core importance of these
  values in todays international development
  agenda.
• 
  (Dr. Margaret Chan, DG of WHO, 4
  Jan 2007)

11
Group work Meeting on Revisiting CBHW and CHVs,
Chiang Mai, 3-5 Oct 2007

• Suggested 3 country priorities (immediate
  actionwithin December 2007)
• Apply strategy map to be implemented at local
  level
• Forums among partners at national level
• Roles functions
• Review training capacity for all partners at all
  levels
• Universities and educational institutes
• Review financing and administrative framework to
  facilitate implementation of strategy map
• Appointed committee under NHSO Board(s1-2)
• Suggested WHO contributions
• Training strategy map
• Establish learning centers for in-countries and
  inter countries
• Networking VHV, CBHW
• Monitor and evaluate outcomes

12
Future directions of PHC -TAO
????? ??? ???? ??????????????/ PREVISION

• Decentralize PHC management and implementation
  through local authority organization TAO
• Building capacity of local administration(s1)
• Seeking political commitment(s4-1)
• Revising existing law and regulations to be in
  line with current situation and future
  development(s4-2)
• Establishment of WHO CC on PHC(s3-1)
• Reconsidering specific roles of volunteers(s3-2)

13
????????? PHC 4D ????????????
?????????? ?????????????? ??????????????????
???? ?????? ??????? ????????????????????
??????????????????/ ????????????????????? ????????
?????????????
??.????. ??? NGO
????????? ???????? ??????? ?????
??????????????? ???????????
???????????????? ??????????????
??pp
?????????????????????????
??????????????????????????
????????????
???????????

• ??? /???????????????
• ???./????????/?????????????? ??????

???????
?? ???10000
????????????? ?????????????
?????/??????
????????
????? ?????????? ???
????????-????? ??????????
???????????????????????
????????????/?????????????????/?????????/ ????????
??????????? ??????????????????
???????????/???????
???????? ????? ???????? ?????????????

• ???????????????-?????????????-?????????????

14
???????????????????? PHC 4D
?????????? ?????????????? ??????????????????
???? ?????? ??????? ????????????????????
??.????. ??? NGO
???????????????? ??????????????
????????? ???????? ??????? ?????
??????????????? ???????????
???????????????? ????????????????
??pp 37.50??????
???????????????? ????????????????????? ???????????
???(TCDA)
??????????????????????????
?????????????????? ??????????????
???????????

• ??? /???????????????
• ???./????????/????????/??????/???????? ??????

???????
?? ???10000
????????????
????????????? ?????????????
?????/??????
????????
????????
????????-????? ??????????
???????????????????????
????????????/?????????????????/?????????/ ????????
??????????? ??????????????????
????????????????/?????????
????????????? ??????????? ????????????
?????????????

• ???????????????-?????????????-?????????????

15
??? ????? (PHC TAO)
??????????????1

• ????????????????????????????????????????????
  ???????? ??????? ??? (???????????????????)
  ??????????????????????????????????????????????????
  ??????????????????????????? ?????????????????????
  ?(Strategy Map)???????????????????????????????????
  ?????????????????
• D1 ??? ?? 51-52 ?????????????????(? ???)
• D2 ????? PHC ????????????? ???? ???
  ????????????????????
• D3 ?????/?? ?????????????????????????? ???????
  ????-????????
• D4 ??????????????????????? DEM0NSTRATION

???????????????????????
16
???????????????????????????
??????????????2
PRIMARY HEALTH CARE KNOWLEDGE MANAGEMENT PHC -KM

• K1 ????????????????????????????????????????
• K2 ??????????? ??????????????????????? ??????????
  ??????????????? ???????????????????
• K3 ???????????????????????????????????????????????
  ???????????????? ?????????????????????????????????
  ????????????????????????
• K4 ????????? ?????????????????????????????????????
  ? ??? ?????????????

???????????????????????
17
????????????????? PHC TC
?????????????? 3
PHC TRAINING CENTERS

• T1 ????????????????????????????????? RTC /PTC/
  DTC/ TCT ??????????????????????(Strategy
  Map)??????????????????????? ???????? ??????
  ???????????????????? ??? ??????????????????
• T2 PHC COLLABOLATING CENTER FOR TRAINING
  (international development agenda)
• T3 TCDA-TCDV

???????????????????????
18
??????????????/????????/??????????
?????????????? 4
??????????????????????????????/????????? PHC -M
PRIORITY7
PRIORITY3
??. ????. ??? NGO
?????????? ?????????????? ??????????????????
PRIORITY6
???? ?????? ??????? ????????????????????
?????????? ????????????????????????????
PRIORITY4
????????? ???????? ??????? ?????
??????????????? ???????????
PRIORITY 1
PRIORITY5
????????????
PRIORITY2
????? ??? ???????? ?? ???
???????????????????????
19
????? ???? VHV-CBVHV- CAPACITY(CAPABILITY)
BUILDING
??????????????5
????????

• ????????????????? ??????????......
• ?????????????????????????-??? ???5?

????????????????????????? ??????????/?????????
????????????? ????? ??? 20 ???. ?????
??? ???????
??????? ??????? ????????? ??? ????????? ???
???????????????????????
20
???????????? ??? ???????? ??????????-??? ??? 5
?

• ??????? ??????????????????? ??? ????????????
  ????????????/????/???? ????????????? ?????? ???
  5?
• ?1 ???? ???????????????????? ???????
  ????????????????
• ?2 ??????? ????????????????????
  ??????????????????
• ?3 ?????? ???????????(??????????????????????)
  
• ?4 ?????? ?????????????????????????????????
• ?5 ????? ???????? ????????????????????????????
  
• ??????????????????? ?????????????????????????
• ??? ??????????/??????????????????????
  
• ????? ??? 20 ???. ?????

???????????????????????
21
???????????????????? village self managed
????????????? ??? ????????????????? ????? /??? 5?
P5 ????????
???????????????? ???????????????? 5?
P4 ????-??????????
????????????????????????? 5?
??? ?????????? ??????????????????? ???????????????
????????? ??????????????????????
P3 ????????

• ????????????????????
• ?????????(?.??./
• ????.??. ???
• ?????????????
• ??????????????????????

???????????????????? RTC /PTC/ DTC/
TCT ?????????????????????????()
P2 ?????????
?????????????????????????????-????????
?????? ??? ??????????????
P1 ???
???????????????????????
22
??????????????????????????????????? PHC-I
???????????????????????
23
??????????????????????????????????????????????????
???
??????????
???????????
??????????? ???????????? ????????? ????? ???????
????????? ??????? ?????????? /????????? ???./????
?
???? ????????? ?????????/ ?????

• ????????????????????
• ?????????(?.??./
• ????.??. ???
• ?????????????
• ??????????????????????

?????????
?????????
?????????
???????????
??????????????/???????
??????????????????????????????????????????????????
?????????????????????????????????????
????????????????? ????????????? ???????????
?????????? ???????????? ????????????????
????????????????????????
??????????????????? ???????? ????????? ???????????
????????????????????????? ?????????????????
????????????????????
??????????????????????? ?????????
???????????? ?????????????? ?????
?????????????????????????
24
?????????????????????????????????????????????
??????????????????????????????????????????????????
?????????????????????? 4
??????????????????????????????? ???.
???????????????/??????????????????????????????????
????? ???. (??????? 1 ?????????????????????
(Consolidation Phase))
?????????????????????
??????????????? ???.???????
???????? Benchmark ???????????????????????????????
??????? (??????? 2 ??????????????? (Transition
Phase))
????????????/?????????(??????? 3 ???????????
(Expansion Phase))
25
P2
P2
P3
P3
P2
P1
P1
P1
P3
P3
26
??????????????????????????????? ??? ????????
??????????????????????????
?????????? ???????? ?????????? ???
???????? 1?????-??????????????????? PHC
?????????????????/?????????/??????/?????
??????????????/????????????????
????????????????/?????????/?????
???????? 2 ????????????????????????????????????
PHC
????????????????????????
???????? 3???????????????/???????????????????????
?????????????????????/?????
??????????????????????? PHC????????
????????/ ???????????? ??????? PHC
????????4??????? ????????????????????????????????
??/??????? PHC
????????/????????????????????/????????????????????
???????????????????????/?????????????
????????????????? ??????????PHCID
27
??????? ?????????????????? ??? PHCIDPHC-INNOVATIO
N DECADE 2008-2017

• ?????????? ???????? ??? PHCID ???????? 1-5 ????
  2008 ???????? 1-3 ?????????? 12-19-27 ??
  2551 ???????? 4-5 ?????????? 11 ??? 19 ??????
  2551
• ?????? ????????????????????????
  ???(???????????????????????? /?????????????????
  PHCID) ???? ??????? 51
• ????????? PHCID ??? ??? ??? ?? 51??????? WHO ????
  ??? ?? (INTERNATIONAL MEETING)
• ????? ???? ??????????????????? PHCID ????????

???? WWW. ?????????????????????????????? ??????
???????????