Lafiyar jama'a a Thailand, labari mai nasara
Tailandia tana da dogon tarihi mai nasara na haɓaka lafiyar jama'a.
WHO, Hukumar Lafiya ta Duniya, 2007
Yara da yawa suna mutuwa a lokacin, kuma ba mu san dalili ba.
Phasom Yunranatbongkot, mai aikin sa kai na shekaru 30
Wadannan masu aikin sa kai sune kashin bayan tsarin kiwon lafiyar jama'a mafi nasara a duniya. Misali, sun ba da gudummawa ga raguwar cututtuka masu yaduwa kamar HIV, zazzabin cizon sauro da dengue.
WHO, 2012
Masu aikin sa kai na lafiya a kauyuka
Bari in fara da fadin wani abu game da masu aikin sa kai na kiwon lafiya a kauyuka, domin watakila su ne suka fi bayar da gudunmawa wajen inganta lafiyar al’umma, musamman a yankunan karkara, kuma abin takaici ba a san su ba.
A cikin Ingilishi ana kiran su 'Masu Agajin Lafiya na Ƙauye' kuma a cikin Thai, tare da gajarta, za,'oh ina. An kafa shi shekaru hamsin da suka gabata ta likita Amorn Nondasuta (yanzu mai shekaru 83), adadin su a halin yanzu 800.000 ne, ko daya a cikin gidaje ashirin. Ana iya samun su a kowane kauye (abin takaici ban iya gano ko suna aiki a cikin garuruwa ba, watakila akwai mai karatu wanda ya sani ko zai iya tambaya? Ina zargin ba haka ba).
Waɗannan masu aikin sa kai sun tabbatar da cewa an rarraba tsarin kula da lafiya cikin adalci. A cikin ƙasar da wutar lantarki ke haskaka arziki daga Bangkok, wannan yana ɗaya daga cikin ƴan misalan ingantaccen tsarin dogaro da kai, tushen al'umma da kuma jagorancin al'umma. Faɗin ayyukan waɗannan masu aikin sa kai sun nuna a sarari cewa da yawa suna kulawa kuma sun himmantu ga fa'idar gabaɗaya da ta gamayya ta Thailand.
Menene Kiwon Lafiyar Jama'a?
Kiwon lafiyar jama'a shine rigakafin cututtuka, tsawaita rayuwa da inganta lafiya ta hanyar shirye-shiryen al'umma. Kasance mai mahimmanci a cikin hakan rigakafi, salon rayuwa, zamantakewa da muhalli da kiwon lafiya.
Kula da lafiya a cikin kunkuntar hankali (asibitoci, likitoci, ayyuka da kwayoyi) shine mafi ƙarancin mahimmanci. A cikin karni na 19, lafiyar al'ummar Holland ta inganta ta hanyar tsalle-tsalle da iyaka ba tare da albarkar kimiyyar zamani ba, amma ta hanyar rigakafi mafi kyau, salon rayuwa mai kyau, tsabtataccen ruwan sha, ingantaccen tsabta da, musamman, ƙara ilimi a tsakanin jama'a. Waɗannan su ne ginshiƙan ingantaccen kiwon lafiyar jama'a.
Idan da za a rufe dukkan asibitocin, lafiyar jama’a ba za ta tabarbare haka ba, a wasu lokutan cikin zolaya na ce, amma akwai ’yar gaskiya a ciki.
Lambobin
Mu kira wasu busassun lambobi. Mutuwar yara ita ce mafi mahimmancin nuni ga kyakkyawar lafiyar jama'a (dukkan alkalumman UNICEF, 2011; Tailandia ta ga raguwar mace-macen yara cikin sauri tsakanin kasashe 30 da suka yi kusan daidai a kan matakan zamantakewa da tattalin arziki).
Mutuwar jarirai har zuwa shekara guda (a kowace dubun haihuwa), shekara da adadi
1990 29
2011 11
Mutuwar jarirai har zuwa shekaru biyar (kowace haihuwa dubu daya)
1970 102
1990 35
2000 19
2011 12
Tsawon rayuwa (lokacin haihuwa)
1960 55
1970 60
1990 73
2011 74
Mutuwar mata wajen haihuwa (a cikin 100.000 masu rai na haihuwa)
1990 54
2008 48 (matsakaicin yanki: 240)
Duk wasu lambobi
- Kashi 96 na al'ummar kasar suna da ruwan sha mai kyau
- Kashi 96 cikin dari suna da isassun wuraren tsafta
- Kashi 99 na dukkan yara ana yi musu allurar rigakafi
- Kashi 81 na mata masu jima'i suna amfani da maganin hana haihuwa
- Kashi 99 na duk mata suna samun kulawar haihuwa aƙalla sau ɗaya kuma kashi 80 cikin ɗari sau huɗu
- Kashi 100 na duk mata suna haihuwa tare da taimakon kwararru
- Kashi 1 cikin 7 na yara na fama da matsananciyar rashin abinci mai gina jiki, kashi XNUMX cikin XNUMX na rashin abinci mai gina jiki
- Kashi 8 bisa dari na yara suna da matsakaicin matsakaicin nauyi zuwa matsananciyar kiba
- Kashi 47 na amfani da gishiri mai dauke da aidin
HIV/AIDS da samun damar kula da lafiya
Bari in kara wasu muhimman abubuwa guda biyu. Tailandia misali ce ga duniya wajen rigakafi, sarrafawa da kuma kula da cutar kanjamau. Lokacin da na zo zama a Tailandia shekaru 14 da suka wuce, na ziyarci wurin ganawa wani matashi kowane wata, wanda abin farin ciki ya zama abin ban mamaki a yanzu.
Kwaroron roba da masu hana HIV ana samun su cikin sauƙi da rahusa. Na biyu shi ne kusan kowane mazaunin Thailand ya sami damar samun lafiya cikin sauƙi da arha a cikin 'yan shekarun nan, wanda bai kai rabin al'ummar ƙasar shekaru talatin da suka gabata ba. Iyalai da dama sun kasance suna fadawa cikin matsanancin talauci saboda yawan kudin magani, an yi sa'a waɗancan lokutan sun ƙare.
Duk wasu dalilai na wannan labarin nasara
Don haka kasar Thailand ta samu babban ci gaba ta fuskar kiwon lafiyar jama'a cikin kankanin lokaci. Hankali, kyakkyawan tsari da tsari, kayan aiki har zuwa karkara mafi nisa da tsarin masu sa kai mai ban sha'awa suna da alhakin wannan.
Ci gaban tattalin arziki na 'yan shekarun nan ba shakka kuma shi ne ke da alhakin wannan ci gaba a lafiyar jama'a. Hakanan yana da mahimmanci a gare ni girma na ilimi. Har zuwa 1976, kashi 80 cikin 100 na dukan yara sun tafi makaranta, amma matsakaicin adadin shekaru a makaranta ya kasance hudu kawai! Yanzu kusan kashi 12 cikin XNUMX na dukan yara suna zuwa makaranta kuma suna zama a can na tsawon shekaru XNUMX (ciki har da ilimi mai zurfi). Wani muhimmin bangare na shi tsarin karatun makaranta ilimi ne a mafi yawan bangarorin kiwon lafiya (ilimin jima'i abin takaici yana baya, HIV/Aids ana bi da su daidai).
Kadan akan masu aikin sa kai na lafiya
Wannan kungiya, da aka yi bayani a takaice a sama, ta bayar da muhimmiyar gudunmawa, watakila mafi mahimmanci, wajen inganta lafiyar al’umma, musamman a yankunan karkara. Kowane Thai ya san su kuma yana yaba su.
Suna samun horo na makonni biyu, suna saduwa kowane wata, ko kuma sau da yawa idan ya cancanta, kuma suna samun damar samun kulawar lafiya na yau da kullun don shawarwari da shawarwari. Suna karɓar izinin kuɗi na wata-wata na baht 700 kuma suna da damar samun kulawar lafiya kyauta. Sau da yawa ana zabar masu aikin sa kai ne don zuciyoyinsu don amfanin jama'a, kyautatawa, son taimakon mabukata, baya ga ilimin kiwon lafiya da cututtuka.
Ayyukan su suna da yawa, zan ambaci mafi mahimmanci: rigakafi, matsalolin sigina, tuntuɓar sashen na yau da kullun, bayanai da haɓaka salon rayuwa mai kyau. Suna ziyartar tsofaffi, mutanen da ke fama da rashin lafiya irin su ciwon sukari da HIV, mata masu juna biyu da mata masu jarirai.
Sun kuma taka muhimmiyar rawa a cikin annobar murar tsuntsaye a shekarar 2007-8. Kasancewar masu aikin sa kai a kusan kowane ƙauye cikin sauri sun gano tare da ba da rahoton mutuwar kaji ya sa Thailand ta zama ƙasa mafi ƙarancin cutar a Asiya.
Matsayinsu na inganta lafiyar jama'a a cikin shekaru 50 da suka gabata ya kasance ba makawa kuma masu aikin sa kai suna alfahari da hakan. Kuma Thailand za ta iya yin alfahari daidai da abin da ta samu a fannin kiwon lafiyar jama'a a cikin 'yan shekarun nan.
Sources:
Thomas Fuller, Masu Sa-kai Suna Ƙarfafa Kulawa a Ƙauyen Thailand, NYTimes, Satumba 26, 2011
Arun Boonsang et al., Sabuwar Kiwon Lafiya ta Farko a Thailand, Satumba 25, 2013
Sara Kowitt et al., Nazarin Nazari akan Ayyukan Masu Sa-kai na Lafiya a Tailandia, Jami'ar Mahidol, Satumba 25, 2012
Komatra Chuensatiansup, MD, PhD, Masu Sa kai na Lafiya a cikin Yanayin Canje-canje, Ma'aikatar Kiwon Lafiyar Jama'a, Thailand, 2009
Matsayin Masu Sa kai na Lafiya na Ƙauye a cikin Sa ido kan cutar mura a Thailand, WHO, 2007, tare da cikakken bayanin aikin waɗannan masu sa kai
http://www.unicef.org/infobycountry/Thailand_statistics.html
Dear Tina,
Dole ne in yarda cewa ni - zaune a Bangkok - ba ni da kyakkyawan ra'ayi game da ayyukan masu sa kai na karkara a cikin kula da lafiya na rigakafi. Koyaya, rabin sa'a na gogling ya haifar da bayanan masu zuwa:
– tsakanin 2000 zuwa 2011, yawan mata masu tasowa ya karu da kashi 43%;
– adadin masu cutar kanjamau kuma ya karu a ‘yan shekarun nan;
– Yawan masu tabin hankali suma suna karuwa. Dr. Surawit ya kiyasta cewa 20% na Thais (da gaske, 1 a cikin 5) suna da matsalolin lafiyar kwakwalwa (ciki har da damuwa);
– akwai matsalar barasa da ta’ammali da miyagun kwayoyi da ke karuwa a kasar nan (har ma a tsakanin ‘yan kasashen waje!);
Daya daga cikin manyan masu ba da shawara don inganta kiwon lafiya na karkara, Mista Mechai Viraviadya (wanda aka fi sani da Mr. Condom) ya yi imanin cewa daya daga cikin dalilan da ke haifar da ci gaba mai dorewa shine cewa ba a magance muguwar dabi'a ba. Kuma tushen shi ne talauci. Ana iya samun kyakkyawar hira da Kuhn Mechai game da ra'ayoyinsa a content.healthaffairs.org/content/26/6/W670.full.
Masoyi Hans.
Na fassara kalmar 'masu tabin hankali' da tabin hankali. Ban san me ke damun hakan ba. Ina ambaton madogarata kuma ba na ɗaukar abubuwa da wasa don ban san kaina ba, amma na dogara ga masana a wannan fannin. Tino ya kira rigakafi da salon rayuwa sassa na lafiyar jama'a kuma yana da gaskiya game da hakan. Bugu da kari, ya yi ikirarin cewa masu aikin sa kai sun ba da gudummawa sosai don inganta lafiyar jama'a. Ina da sharhi kan wannan idan aka zo ga adadin abubuwan rayuwa marasa mahimmanci. Kuma na yarda da Kuhn Mechai cewa za a iya samun ɗorewar lafiyar jama'a kawai idan an magance talauci da gaske, ba kawai tare da ƙarin ƙarin mafi ƙarancin albashi zuwa baht 300 a rana ba yayin da ɗimbin yawa na Thai ke aiki a cikin da'ira na yau da kullun ko na kansu kuma ba su da. biya aiki kwata-kwata.
Ba ni da nisa in yi iƙirarin cewa komai game da lafiyar jama'a a Thailand cikakke ne. Lallai Tailandia tana tafiya daga yanayin cutar 'wayewa': ƙarin ciwon daji da cututtukan zuciya. Wannan ba ya ragewa ga babban ci gaban da aka samu a cikin 'yan shekarun nan.
Wani adadi akan HIV/AIDS. A cikin 1991 an sami sabbin shari'o'i 143.000, a cikin 2011 akwai 9.700 kawai kuma waɗannan galibi suna cikin ƙungiyoyi uku masu haɗari, masu amfani da kwayoyi a cikin jini, karuwai da abokan cinikinsu, da maza masu yin jima'i da maza. Bayan haka, cutar HIV ta kusan ƙarewa. A cikin 2012, sabon shirin rigakafin cutar kanjamau wanda zai gudana har zuwa 2016, mai suna AIDS Zero, UNAIDS ne ya ba da tallafin kuma Janar Yuttasak ya kaddamar.
Hai…. daga 143.000 zuwa 9.700 .... a cikin shekaru 10. Da alama ba zai yuwu a gare ni ba. Duka alkalumman za su dogara da karfi kan hanyar kirgawa. Kuma hanyar kirgawa zai dogara ne akan abin da mutum yake son cimmawa tare da lambobi. Amfani da kwaroron roba a tsakanin Thai har yanzu yana da ɗan ƙaranci. Na san lokuta 2 na Thai waɗanda suka mutu da cutar kanjamau kuma duka biyun sun mutu da ciwon huhu a gida ba tare da kulawar likita ba. Don haka da alama ba a yi musu rajista ba a cikin kididdigar AIDS.
A cikin shekaru 20, masoyi Ivo. Wadannan alkaluma sun fito ne daga wurare daban-daban, WHO, UNAIDS da Mista Mechai (Mr. Condom). Sabbin cututtukan HIV/AIDS: 2007 a 14.000; 2010 11.000; 2012 9.000. Me yasa ba zai yuwu ba? An yi bincike da yawa; wadannan alkaluma, kuma tabbas yanayin (raguwar kashi 90 cikin 20 na sabbin lokuta a cikin shekaru 1991) daidai ne, babu shakka game da hakan. Tabbas akwai takamaiman adadin rahotannin da ba a bayyana ba, babu wanda ya san nawa, mai yiwuwa fiye da 45 fiye da yanzu. Amfani da kwaroron roba tsakanin matasan Thais shine kashi XNUMX cikin dari, yayi kadan amma ba kadan ba.