International Journal of Educational Science and Research (IJESR) ISSN(P): 2249-6947; ISSN(E): 2249-8052 Vol. 6, Issue 3, Jun 2016, 69-74 © TJPRC Pvt. Ltd.

THE PATTERN OF HEALTH MANAGEMENT WITH SELF-RELIANCE

BASED ON MPI PEOPLE LOCAL WISDOM, PHRAE PROVINCE,

SIRIPORN PHUNTULEE 1, WATTANA WANITCHANONT 2, NIROTE SINNARONG 3 & CHANTHANA SUSAWAENGSUP 4 1, 2, 4 Department of General Education, Maejo University-Phrae Campus, Phrae, Thailand 3Department of Economics, Maejo University-Phrae Campus, Phrae, Thailand ABSTRACT

Community based local health management toward Mpi culture and local wisdom is the main point in this research. It is conducted through Mpi people participation to solve their health communication problem for sustainability. This research aimed to 1) create the pattern of health management with self-reliance based on Mpi local wisdom to promote Mpi people as the caring partners for their health care management; and 2) evaluate the knowledge and understanding of potential development implemented from the pattern of health management with self-reliance based on Mpi local wisdom. A participatory action research process (PAR) was used as a tool through the learning process in Mpi community that led to quality of life improvement as well. Moreover, this study used the purposive

sampling selected from 80 stakeholders including local government officers, local villagers, career leaders, village Original Article health volunteers as well as the director of Suan-Kheun district health promotion hospital, and the interested Mpi residents. Data collection tools were as follows: 1) focus group discussion for the needs of health management with self-reliance pattern based on Mpi local wisdom; and 2) self appraisal to evaluate the knowledge and understand the health communication through broadcast tower and board presentation for health promotion created by the volunteers for health communication of Mpi people. The research result revealed that there were 2 patterns of health management

with self-reliance based on Mpi local wisdom as follows: 1) the health communication through broadcast tower and 2) the health communication through board presentation for health promotion by using as a media for health communication. 30 people joined the workshops and trainings which comprised of both lecture section and practice section to develop the health communication potential of volunteers by using Mpi local wisdom. The results of the potential development implementation showed that knowledge and understanding in health communication through broadcast tower, and board presentation for health promotion created by the volunteers for health communication of Mpi people increased significantly after the workshops and trainings (P>0.01).

KEYWORDS: The Pattern of Health Management, Self- Reliance and MPI Local Wisdom

Received: Apr 28, 2016; Accepted: May 11, 2016; Published: May 23, 2016; Paper Id.: IJESRJUN20168

INTRODUCTION Background/ Objectives and Goals In the past, Mpi people was an ethnic tribe which migrated from region, , and had settled down in Phrae province, Thailand more than 300 years. As Mpi people used their local language for communication, they had a problem in understanding health care media communicated from public health sector which usually used academic and technical terms. Then, it was quite difficult to understand for Mpi people who used only Mpi local language. So, this research tried to enlarge the strength and limit the weakness to solve the

www.tjprc.org [email protected] 70 Siriporn Phuntulee, Wattana Wanitchanont, Nirote Sinnarong & Chanthana Susawaengsup problem. There were two objectives which aimed to create the pattern of health management with self-reliance based on Mpi local wisdom to promote Mpi people as the caring partners for their health care management; and to evaluate the knowledge and understanding of potential development implemented from the pattern of health management with self- reliance based on Mpi local wisdom. Two research questions were undertaken below:

• What/How did the pattern of health management with self-reliance based on Mpi local wisdom promote the health care of Mpi people ?

• What/How was the result of the knowledge and understanding of potential development implemented between pre-test and post-test from the pattern of health management with self-reliance based on Mpi local wisdom ?

At the present, Mpi local language nearly dissapears and also there is no conservation to the next generation. Thus, this study attempted to keep Mpi culture, and also conserve Mpi local wisdom by using Mpi language through the pattern of health management with self-reliance to promote the health care of Mpi people. Therefore, it is necessary to be aware of the importance of learning process construction in Mpi community to increase thoroughly knowledge and understanding in health care communication to Mpi people. Thus, this research was conducted under the project title: "The Pattern of Health Management with Self-Reliance Based on Mpi People Local Wisdom, Phrae Province, Thailand ".

(Source: Thailand Maps (2016) Figure 1: Research Area in Phrae Province, Thailand

METHODS

A participatory action research process (PAR) was used as a tool. It was a process for knowledge production in which participants have a role in setting the agenda for the research, participating in the data gathering and analysis and

Impact Factor (JCC): 4.3912 NAAS Rating: 2.72 The Pattern of Health Management with Self-Reliance Based 71 on Mpi People Local Wisdom, Phrae Province, Thailand controlling the use of outcomes (Phuntulee et al., 2011; Phuntulee et al., 2010; Reason, 1994). The PAR process not only emphasized the collaborative and the co-construction of knowledge to improve the lives of those who have participated in research and society as a whole, but also led to participatory empower in community development with thinking, doing, solving, developing and evaluating of the people in community together since the beginning until the end (Cassano, 2005). Furthermore, for the research method, both of qualitative research and quantitative research were used to promote Mpi people as the caring partners for their health care management with self-reliance based on Mpi culture and local wisdom. The example groups of research areas were 2 villages in Ban Dong village, Suan-Kheun sub-district, Muang district, Phrae province, Thailand. Moreover, this study used the purposive sampling selected from 80 stakeholders including local government officers, local villagers, career leaders, children and youths, occupational group network, village folk philosopher, assistant village headman of community leaders, village health care volunteers as well.

Data Collection

The data are collected through 2 parts as follow s; qualitative collection tool and quantitative collection tool, which passed the research ethic to protect human rights. Firstly, the qualitative data were collected through an in-depth interview, a focus group discussion, a participatory observation for health care communication problem of Mpi people and the needs of capacity development for health management with self-reliance pattern based on Mpi local wisdom. Secondly, the quantitative data were collected through the self appraisal for the evaluation of knowledge and understanding in health management with self-reliance pattern based on Mpi local wisdom as local health communication through broadcast tower and board presentation for health promotion created by the volunteers for health communication of Mpi people. They participated in thinking, doing, solving, developing and evaluating with the researchers in every step. There were 8 stages as follows:

• Making understanding with the key informants and studying the community context such as social capital, cultural and local wisdom capital of Mpi people.

• Stakeholders meeting to gain understanding about the objectives and the process of research.

• Exploring about the historical background of Mpi people, community context such as social capital, cultural and local wisdom capital of Mpi people.

• Searching the willingly volunteers in Mpi community as health care communicators (HCCs) to promote health care of Mpi people with the pattern of health management with self-reliance based on Mpi local wisdom.

• Need surveying analysis of Mpi's HCCs to build their capacity for promoting health care of Mpi people.

• Workshop training for capacity development to Mpi's HCCs about health care communication based on Mpi local wisdom according to the need analysis of them.

• Evaluating Mpi's HCCs capacity about the health care communication with self-reliance based on Mpi local wisdom.

• Arranging lessons stage to share, learn and to participate the health management together in Mpi community with self-reliance based on Mpi local wisdom.

www.tjprc.org [email protected] 72 Siriporn Phuntulee, Wattana Wanitchanont, Nirote Sinnarong & Chanthana Susawaengsup

Sources of Information

There were two sources of information; 1) the primary data collected from the preliminary information interview and focus group discussion with the related stakeholders in Mpi community towards the population example above. Moreover, 2) the secondary data were collected from the study of government documents, publications and project report.

Data Analysis

In the qualitative data, content analysis from each activity was used to recognize and classify as a category towards objectives and activities. Then, they were analyzed in parallel contexts and arranged learning exchange stage for summarizing in each step of research. The community and the research team participated to analyze, define the indicators and evaluate together. Moreover, for the quantitative data, dependent t-test statistic method was used for analysis the Mpi's HCC capacity before and after training with one group pretest - posttest design.

RESULTS

This study aimed to create the pattern of health management with self-reliance based on Mpi local wisdom to promote Mpi people as the caring partners for their health care management; and evaluate the knowledge and understanding of potential development implemented from the pattern of health management with self-reliance based on Mpi local wisdom. There were two key findings which have emerged as follows:

The Patterns of Health Management with Self-Reliance Based on Mpi Local Wisdom

In the figure 2-3, the patterns of health management with self-reliance based on Mpi local wisdom was shown. There were two patterns as follows; 1)the health communication through broadcast tower, and 2) the health communication through board presentation for health promotion by using Mpi language as a media for health care communication. At the end, these patterns decreased the limitation of knowledge & understanding in the health care media communicated from public health sector which usually used academic and technical terms. Moreover, it was also led to conserve Mpi local language for the next generation as well.

Figure 2: The Pattern of Health Communication through Broadcast Tower for Health Promotion by Using Mpi Language

Impact Factor (JCC): 4.3912 NAAS Rating: 2.72 The Pattern of Health Management with Self-Reliance Based 73 on Mpi People Local Wisdom, Phrae Province, Thailand

Figure 3: The Pattern of Health Communication through Board Presentation for Health Promotion by Using Mpi Language

The Evaluation of the Mpi's HCCs Capacity Development

The intervention for Mpi's HCCs capacity development included the workshop training by giving the knowledge, and practical action both of the principle of communication through broadcast tower and board presentation for health promotion. In consequence, 30 Mpi's willingly volunteers as health care communicators (HCCs) joined the workshops and trainings which comprised of both lecture section and practice section to develop the health communication potential of volunteers by using Mpi local wisdom.

In the overall, as shown in Table 1, the compare mean result showed that, after workshop training, Mpi's HCCs correctly understood their own health care in two communication channels to promote health care of Mpi people. The result of first channel implied that there is a statistically significant difference between before and after training at the 99% confidence level (P<0.01). Furthermore, the comparison of knowledge and understanding via board presentation for health promotion also found that there is a statistically significant difference between before and after training at the 99% confidence level (P<0.01).

Table 1: The Comparison of the Difference between the Knowledge and Understanding via Communication Channels Before and After Training

Pre-Test Post-Test Communication Channels X S.D. X S.D. t Sig. Principle of broadcast tower 4.70 1.02 8.50 0.57 -15.42** 0.00 Principle of board presentation 3.93 1.11 8.60 1.10 -15.72** 0.00 total 4.31 0.60 8.55 0.81 -20.85** 0.00 Note ** p < 0.01; * p < 0.05

Summarily, in this modern age in which we live, changes are occurring with accelerating rapidity and escalating unpredictability, while society itself is becoming increasingly competitive (Samantrakul, 2012). Hence, in the direction of globalization, it had an effect on people in every level in Thailand, not only the socio-economic systems but also the public health care systems. More competitions led to social problems and various health problems ensue. That's why it's time to be aware the immunity creating in the health care management with self-reliance and sustainability not only in country and community level, but also in family level.

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In addition, the case of Mpi community illustrated how to apply Mpi local wisdom as a media for the self -health care management according to Mpi community context and community needs with self-reliance to Mpi people, by Mpi people and for Mpi people. The two patterns of health care communication included the health communication through broadcast tower, and the health communication through board presentation for health promotion. They were the proactive way which led to increase the capacity in the health management both health care knowledge and practical action in health care management for Mpi people.

CONCLUSIONS

Importantly, for the key of success in the health management with the efficiency and the effectiveness, the stakeholders in Mpi community should participate together to think, to do, to solve the health problem in community and to develop the concrete pattern of health care continuously according to health problem situation. Besides, there were two main implications in this research as follows; 1) the managerial implication, the leader in Mpi community, like the mayor, should promote the pattern of health communication through broadcast tower and board presentation for health promotion by using Mpi language and contain as master plan in five years and should develop local curriculum on health care communication to the next generation; and 2)for the research implication, the researcher should conduct a research and develop the network of local health care communicator volunteer both in community level and family level to promote the holistic health through the participatory process in health management with self-reliance and sustainability.

ACKNOWLEDGMENTS AND LEGAL RESPONSIBILITY

The authors would like to acknowledge the National Research Council of Thailand (NRCT) for the financial support granted in 2014. Authors are grateful for the Mpi people for their cooperation and information providing during data collection for this paper which are also much appreciated.

REFERENCES

1. Cassano, R. & Dunlop, J.M. (2005). Participatory action research with South Asian immigrant women: A Canadian example, Critical Social Work,6 (1), 2.

2. Phuntulee, S.& Wanitchanont. W. (2011). The promotion process of sufficiency economy lifestyle value by using knowledge management process in Mae-Lai community, Proceedings in the International conference on Advancement of Development Administration 2011, 1-19.

3. Phuntulee, S. & Wanitchanont. W. (2010). Pattern of local health communication to promote holistic health of elderly people in Maesai community with participatory action research, Proceedings in the 2 nd International Conference on Sustainable Ways of Living based on a Sufficiency Economy, 858-864.

4. Reason, P. (1994). Three approaches to participative inquiry. In N.K. Denzin & Y.S. Lincoln (eds.), Handbook of Qualitative Research, Thousand Oaks: Sage Publications, 324-339.

5. Thailand Maps. [Online]. Available http://www.thailandmaps.net/index.html (13 January 2016).

6. Samantrakul, S. (2012). Sufficiency economy:How to live sufficient lives, Handout in International Conference on Advancement of Development Administration.

Impact Factor (JCC): 4.3912 NAAS Rating: 2.72