The document discusses District Health Systems (DHS) in Thailand. It outlines the structure and components of DHS, including establishing primary healthcare centers (PHCs) as health hubs that provide essential care services. The goals of DHS include strengthening community and home-based care through resource sharing between PHCs, hospitals, and other partners using a bottom-up approach. Metrics are presented on service expansion and quality improvements across several DHS pilot sites from 2554-2557, including increased access to care, personnel, and community participation. The document advocates for people-centered, age-friendly primary healthcare through DHS that enables active aging in the community.

1. District Health System (DHS)
chuchai.sn@gmail.com
13
2557

2. District Health System DHS
+

3. District Health System Network
•
•
health system
–
–
–
–
Down VS Bottom Up
district
Top

4. PHC as Health Hub
4
Self care management)
World Health Report 2008
:

5. 1.
2.
3.
4.
P &P
MCH
EMS
Acute Minor
Diseases
5. Dental
Health
6. Chronic
Diseases
7. Psychiatric
Diseases &
Mental
Health
8. Disabilities
9. End of life
care
10.High risk
groups (Preschool, Adol
escent, Elder
ly)
•Concept &
Policy
•Structure &
Organization
•Resources
Allocation &
Sharing
•Manpower
Development
•Information
System
•Supportive
mechanism
•New
Management
(Partnership &
Networking)
:

6. DHS :
UCARE
U : Unity
of DHS
Team
E : Essential
care / ODOP
R:
Resource
sharing
C:
Community
Participation
A :
Appreciation

7. UCARE
 Unity – teamwork
(Unity District Health Team)
 Community
participation
 Appreciation
 Resource
– process
sharing
 Essential
care
comprehensive health
–
care

8. 2557
2556
2554-2555
2552-2554
50% DHS
25% DHS
21 DHS +4
+25 buddy
Core team project DHS

9. DHS
- Service plan 10
-
-
)
-
(4
[QOF]
)
(2
(3
)

10. DHS
PP 20
OP 32
PC
4
QOF
DHS+PCA
3
• DHS
•
•
•
•
•
• PCA

11. 3.3:
CUP/PCU
[4
1
PC
]
PP, TTM, Rehab.
•
-
Priority
DHS
• Mapping Grading
255
•
-
>7.7 MB)
•
•
•
- DHS
-
PP
ODOP ,DHSA ,PCA
Convenience Care
1.
1
CUP
2 /CUP
1
/CUP
2.
FM
1:10,000
FPL/FM 1
CUP
RNNP 1:5,000
1:1,250
3.
CUP
,

DHS
Leader/Manager
4.
PCU
5.
PCU
FM&PC
(Context
Base Learning) 255
6.
FM&PC
1

12. & DHS :
Essential care
&
•
CUP /
DHML
•
FM /
FPL
• NP /
DHS
-
CBL
•
•
•
•
•
-
PCA
-
CBL
Day care
PCA
-
-
Day care
CBL
CBL
/
/NGOs
DMHT
Self Care
Home HC
•
•
-
Care giver / CBR
&
( Context Based Learning )
• System
based
learning
• Research

13. 1
26
System
District Health
2556 -2557
2-
( 217 -
,
3 - 15
27
4 -15
,
6
(14
2
22 12 -
21
85
7
/ FPL 5
558
/CBL 7
PCA 6
/
10 -
(925
5 23
-
- ( 2111 -
8-
(
( 25
CUP
/NP
/
84
/ FPL 2
/CBL 7
CUP 10
/ NP 694
/ PCA 5
/

14. Internal
Review
DHS 2556 - 2559
Core team
5
-
Core team
External
Review
/Award
+
Exter
nal
Unity District Health Team
PEER
REVIEW
+
-
Expert
-
+
-
+
+
People
audit
SE
+
+
CUP & Community
+
People
audit

15. Primary Care Innovation

17. ACTIVE AGEING: TOWARDS AGEFRIENDLY PRIMARY HEALTH CARE
17

18. 1.
-
/
/
2.
:
/
1.
-
/
/
/
2.
3.
4.
:
/
/
-
1.
-
2.
/

19. (Home
services)
(Home
care)
(Home nursing
services)
(Home
modification):
(Day care)
(Home-based &
Community Health
services)
(Respite care)
(Hospital day care)
(Intermediate care)
:
(Residential home)
(Nursing
home)
(Long-stay ward)