Review Guidelines Evaluation to Develop the Collaboration of Over A

Review Guidelines Evaluation to develop the collaboration of over a hundred organizations to improve the quality of life for people living in the southern border provinces. Thailand.

Evaluate the quality of primary or secondary care networks or CUPs that are self-assessing with various benchmarks. The indicators for project evaluation are as follows: (1) the evaluation of public participation employed the UCCARE criteria, including Unity Team; Customer Focus; Community Participation; Appreciation; Resource Sharing and Human Development; and Essential Care. The maximum score for each criterion is worth; the overall score must be at least 3.

UCCARE Rating Scale

1 Have clear guidelines and / or commence operations. (The guidelines consist of three elements: what is the purpose, what is the plan, and what is the target measure.) 2 Expansion of operations. But not covered yet. 3 Systematically and / or review, evaluate, and improve critical processes and / or processes. There are comprehensive actions. (The system can be repetitive. There are clear steps.) (The action consists of three elements: how do you cover every step of the plan, how does the person who is assigned perform each task? And do people do it or not?) 4 Review, evaluate, and improve using real data and learning to improve. (Learning consists of three components: the goal is to achieve or not, how to exchange the lessons learned? And how to improve the lesson?) 5 Integration of new developments into the core work system of the organization. Start to see better results. And respond to corporate goals / mission. (The integration consists of three elements, namely, consistency of targets, measurable action plans, compliance with other relevant processes. And consistency with the goals of the primary care network.)

UCCARE 1 Start a guideline 2. Extend the 3. Implement as a 4 Learning 5. Integration keyword and / or start operation. system. And / or And operational definition action. cover Unity There are ways to Team work on some cross functional as fully integrated Community Health Team means a team Team work together and issues. And / or with team Between the into the same sector Become a within the same agency. The to carry out the a sector partner. planning and teamwork Both team with the team with the hospital, the responsibilities. implementation. vertical and health network. hospital with the hospital Some of the parties horizontal, with On all major team. , Inter-agency team involved. sector partners. health issues (Team, hospital, hospital, 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 hospital), vertical and horizontal teams, and / or Cross team (Various sectors) Customer There are There are many There are channels To learn and Demand of The needs of the people and Focus channels to ways to recognize to recognize and develop the people and the service (Health Need) recognize and and understand the understand the needs awareness service recipients. refers to issues or issues. understand the needs of people and of individuals and channels. The It is integrated People and service needs of the service providers, at service groups. needs of each with various recipients need to be people and the least in high-risk Covering the group of people systems. It makes included in the definition of service is groups. majority of the to be consistent. people believe, felt need (eg, rehabilitation) reactive. population and And more trust, engage and and unfelt need (eg, improving the effective. participate with preventive services). system. the primary care unit. 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Commun Have a guideline Carry out the Community and partner Community and Community and Level of participation: Co- ity Partici or start a community. And the networks are involved. Co-operative partner networks consensual pation community. And Health Co-operation Implement systematic Affiliation are fully co-operation and Evaluate network partners Network. In a wide health care with Network Review integrated. As are involved in variety of tasks and primary care network. and improve the well as evaluating health operations. expanded. And the band has quite participatory and contributing extensive coverage. process. to the ownership of primary care network

UCCARE 1 Start a guideline 2. Extend the 3. Implement as a 4 Learning 5. Integration keyword and / or start operation. system. And / or And operational definition action. cover operations. 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Apprecia Have a clear Expansion of Follow the Health Network Create a culture Engagement means the tion approach or implementation of guidelines or how to is learning. network to keep person's enthusiasm for method. Or start guidelines or methods care, develop and Review the the staff happy. work, duties, and tasks. to take care. of development. And satisfy. And the process of care, Pride, With commitment to fulfill Development and increase the engagement of development, recognition, and corporate mission. satisfaction of satisfaction of personnel in and engagement engagement in the personnel. personnel in each accordance with the of personnel in work of the unit. Or at each level. mission necessary accordance with primary care systematically. the context. network. 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Resource Have a guideline or There is action. To Resource Review and There is a shared Resource refers to people's Sharing plan to share use resources And management improve resource money, knowledge as well and resources. To development of Develop and develop resource management as information. This is the Human develop human personnel in certain personnel in a management. based on the goals input of the work. Developm resources to support areas or systems. systematic and And of the health ent the development of comprehensive development of network (no community health. manner in the personnel. And barriers) and the context and need of increase use of resources the area. To support efficiency. from the the achievement of community. This the goals of the results in a health network. sustainable community health system. 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Essential Have a guideline or Contextual health Contextual health Have a review The health system Essential Care refers to the Care start implementing care system And care system of the health is integrated with essential health services for the basic health care according to the According to the care system. the people. Related the people. This is

UCCARE 1 Start a guideline 2. Extend the 3. Implement as a 4 Learning 5. Integration keyword and / or start operation. system. And / or And operational definition action. cover system needed in needs of the people needs of the And continue to parties The result is consistent with the context each group in the and the community. recipient. Each develop to healthy. of the community. It is based context of the Especially for high- individual group achieve optimal on the potential of the community. risk groups. And the community health care. primary care network. covered. Most More consistent people 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5

Self evaluation of the project demonstrates the following results:

In the region where armed attacks occur regularly, local government institutions used to work separately to merely achieve their own goals. Additionally, complicated systems of official agencies and duplication of efforts caused problems to people and had drawbacks on the development of community well-being. In order to create a sustainable system for people, all public-sector institutions have to strengthen cooperative synergies and expand the organizational network through the concept of participatory governance in responding to social problems. Such integration accords with the 2030 agenda for sustainable development in terms of Goal 3 (Good health and well-being) in section 3.8 (supporting healthcare services and better quality of life and well-being). The collaboration also corresponds to Goal 10 (Reduced inequalities) in section 10.3 (ensuring equal opportunity and eliminating inequalities of outcome). The result is that local people were encouraged to get into self-care, which achieved the goals of Thailand Healthy Lifestyle Strategy. It is undoubtedly crucial to integrate internal policies, human resources, budgets, and logistics management from each institution to support the inter-agency network to perform proactive operations. Furthermore, the reduction of conflicts among agencies results in organizational culture that helps improve and develop the quality of life for people on the basis of social and community contexts. Hence, the public integration primarily focuses on holistic approaches to promoting preventive healthcare, based on information and demands of stakeholders which have been gathered through SWOT analysis from the civil society forum, home visits and morning talks. The impacts of the project which complies with the concept of “area-based, people-centered approach” are as follows: (1) There is no conflict of interest within government institutions as they avoid duplication of efforts in collaborative operations. In 2018, Thailand conducts a self-evaluation of public-sector integration, and scores 4.75 out of 5 following the UCCARE criteria; (2) Prior to the project, Nong Chik people had suffered from low quality of life in some aspects while they had high quality of life in all aspects after joining the project; (3) 56.70 percent of the local people are happier than people in general. The evaluation of the project demonstrates the following results: (1) According to feedback conversations with local people, it was found that they felt happier and more secured when government officials paid them home visits. Overall, local people were satisfied with

more accessible healthcare from government institutions; (2) Self-evaluation questionnaires were distributed to assess and develop the level of public participation; (3) NongChik Hospital was selected to be an exemplary model for other government agencies at the international level; (4) NongChik District Health Board was awarded with various prizes, such as the National Award for the Best DHB; (5) It has become a model for basic public health services for other districts, and provinces; and--after study tours--neighboring countries such as Malaysia and Indonesia have implemented similar programs. This model won the National Mental Health Award in 2018 from the Department of Mental Health; it publishes in research publications such as the Journal of the Association of Researchers; and has received community participation awards in various forums. And (6) R2R Award for Outstanding 5 years in a row.

The results of driving the project

"The Collaboration of Hundreds of Organizations for the Quality of Life

in the Southern border provinces”

Nong Chik Hospital, Nong Chik District, Pattani Province, Thailand.

Abstract

The project occurs with the collaboration over a hundred organizations in the southern border provinces to solve the problems of quality of life among people who live in the conflict- affected areas under the concept of “area-based and people-centered development”. The population of 2,801 participants was selected by random sampling. The questionnaires used in the review include general data, the shortlist of 15 Thai happiness indicators (THI - 15), and

UCCARE Self-Assessment Form of the World Health Organization Quality of Life Index

(WHOQOL-BREF-THAI).

The integration of government agencies, the private sector, and the general public under the civil state policy has been continuously conducted in the local areas. Such integration accords with the 2030 agenda for sustainable development in terms of Goal 3 (Good health and well- being) in section 3.8 (supporting healthcare services and better quality of life and well-being).

The collaboration also corresponds to Goal 10 (Reduced inequalities) in section 10.3 (ensuring equal opportunity and eliminating inequalities of outcome).The results show that: 1. The majority of people who received public services was female, accounting for 71.8% and aged between 41-

60 years old, accounting for 45.2%. 2. 56.70% of them were happier than people who did not receive the services. 3. Before the project was implemented, the quality of life of people in Nong chik district was poor. However, the postproject results showed that the quality of life was at a good level in all aspects. 4. The project was managed to reduce duplication of efforts in the areas.

In 2018, Thailand evaluated the collaborative work using the UCCARE. The self-assessment scored 4.75 out of 5 points.

More than 100 organizations cooperate to work in the red area which needs both science and arts that are verifiable. The staff need to be sincere to discuss with local people to reduce their paranoia during home visits. They also need to have service minds to help the villagers and try to find public cooperation to make them trust in government institutions. The project tried to deliver happiness in the area, raise the quality of people's lives. For instance, where they are in trouble, there must be a project that offers help out there. Without this project, there would be no sustainable results.

Background of the problem

The unrest situation in the Southern Border Provinces with multicultural diversity and violent conflicts continuously lasts for over 15 years. This is a serious problem for the country. It is an area where people feel unsafe in life and property. People cannot live peacefully compared to other areas. Therefore, the situation has a wide impact on people’s mental health and safety and makes them difficult to work. This leads to the problems of accessing basic healthcare services because people have to change their lifestyles and live with anxiety.

NongChik district is the gateway city to Pattani Province of Thailand, consisting of 12 subdistricts and 76 villages. The weather is tropical. Most of Nong Chik people are Muslims, accounting for 87.81%. The majority of the population is farmers. Nong Chik District is among the top of unrest circumstances in the three southern border provinces where insurgency continually occurs. There were 15,123 incidents, causing 6,480 deaths, 18,233 deaths from injuries and 11,753 injuries. From the insurgency, all government sectors with more than 100 organizations in the area were willing to take care of people separately according to their own policies. Since then, the overlapping and duplication of efforts made some troubles to local

people. In the random survey, 90% of residents in Nong Chik district were less happy than people in general, and some of them had a poor quality of life. This project, therefore, aims to create a system of public participation and sustainable access as well as reduce duplication of efforts to solve problems and support the needs of people to improve the quality of life.

Therefore, there exist the integration of government organizations and the drive to participate in all multidisciplinary and professional fields of public coordination (connect people, connect work, connect the money, space welding) to increase access to healthcare services for the underprivileged, understand and reduce the suffering of the public, improve the quality of life through the process of participation in job enlargement and network expansion. This is the challenge of integrating more than 100 organizations together in the concept of "area-based, people-centered development" to collaboratively implement policies, measures, supporting people, budget and management systems from different departments. Each ministry provides cooperative support to proactively work together and move forward the community network to reduce conflicts, develop organizational culture and solve problems. The government agencies also improve the quality of life of people based on the context of the areas along with support and holistic protection based on data and needs from stakeholders gained from the SWOT analysis of the community, home visits, and morning discussions.

Project Objectives

1. to collaborate over 100 organizations in the area

2. to improve the quality of life of people in areas with conflicts in the southern border

provinces in line with the 2030 sustainable development agenda

Integral involvement over the agencies Project concept "Area-based, people-centered approach"

get policy reporting Improve the - Problems and order quality of life of needs from Design team to monitor and evaluate. people in the people area (consistent - policy, measures with SDGs and others 2030)

good mental Safe life Education development Sufficient economy

Follow the policy Operating team

The figure above demonstrates the collaborative process of over 100 organizations in the area. The purpose is to solve problems of the quality of life in the area of conflicts with armed attacks in the southern border provinces. The project can improve mindsets, reduce fragmented work, collaborate and integrate work coordination. The staff can manage and balance tasks for each agency, resulting in the reduction of people’s suffering and enhance public confidence in government organizations. Public organizations can participate in the planning, implementation, following-up, and evaluation of practical strategies to cooperatively develop basic infrastructures in the community including human resources, finance, and work processes. For example, there are regular meetings between the head of Nong Chik district, village headmen, village prototype board, and District Health Coordinating Committee.

The project was expanded from a district level into subdistrict and village levels in the red zone. The most important thing in developing a participatory service system is that people have better and more sustainable quality of life as follows:

1) Customer Focus - the orientation of government organizations to serve people with what they need is necessary. All agencies are open-minded to listen to the poor and the underprivileged and

make them gain access to public services, including physical, mental, social, economic and environmental services.

2) Integration - the collaboration of local government systems makes local people trust in the unity team of more than 100 public that fully integrated to work as a united team and reduce duplication of efforts between institutions.

3) Community Participation - every government sector has developed both vertical and horizontal collaboration to improve the quality of people’s lives.

4) Appreciation - the public sector organizations appreciate comments and recommendations from each other in order to create network culture that maximizes happiness, civic pride, and social relationships in the community.

5) Resource Sharing and Human Development - the inter-agency synergies allow government organizations to cooperatively think, plan, perform, evaluate, and analyze their healthcare operations based on CQI and PDCA cycles. They are fully willing to share resources to each other.

6) Essential Care - local people will be able to practice self-healthcare.

7) This project is consistent with the 2030 agenda for sustainable development in terms of Goal

3: Good health and well-being in section 3.8: supporting healthcare services and better quality of life and well-being. The project also corresponds to Goal 10: Reduced inequalities in section

10.3: ensuring equal opportunity and eliminating inequalities of outcome. The result is that local people are encouraged to get into self-care, which achieves the goals of Thailand Healthy

Lifestyle Strategy. Subsequently, Nong Chik district becomes a city model for Thailand Growth

Triangle development.

Literature review and related concepts

1. The study on community participation in the empowerment of schizophrenic patients in

Nong Chik District, Pattani Province (Prem Ruiddamrong, Angkana Wangtong, Doctor Anuchit

Wangthong, 2557) found that the community involvement in job motivation is the factor and resource that individuals and communities have taken part in caring for patients in the community. The treatment is patient-centered and consistent with the context of the area. As a result, public participation can reduce suspicion in government organizations and strengthen confidence in happiness sharing in the midst of the unrest situation in the southern border provinces. Happiness is a common benefit that everyone takes into consideration.

2. The study on the quality of life of people living in Ban San Tor community, Tambon Tha

Pha, Kau Ka District, Lampang (Prangtip Phakdee Khiri Praiwan, 2559) promoted the quality of life in the community. The study was based on the quality of life indicators from the World

Health Organization (WHOQOL-BREF-THAI). The results indicated that people have the good quality of life in all aspects (physical, mental, social and environmental dimensions).

3. The study on the quality of life of people living in Nakhon Chaisri District, Nakhon Pathom

(Sri Suda is expert and Somchai Likewise, found that the quality of life in Nakhon Ratchasima province is at a high level (mean = 3.60). The quality of life of people in Nakhon Pathom is good in all aspects. The average scores of each aspect were sorted by descending order. The mean of life expectancy was 3.73, followed by family (mean = 3.65), physical and mental health (mean =

3.64), economic and social (mean = 3.57), and life expectancy was the lowest (mean = 3.51). Research and development on the quality of life by Sufficiency Economy Philosophy: A Case Study of Ban Chom Chan Community, Moo 2, Sansai District, Mae Chan District, Chiang Rai Province (Kantian Manakul, 2007) found that improving the quality of life of people in the community is a time-consuming task. It is also essential to develop the quality of life in other aspects, such as economy, public health, and participation.

Research on the quality of life of diabetic patients in Nong Ya district, Suphanburi province. (Shiva Duangjuda, 2558) found that the quality of life of type 2 diabetic patients was at

a high level (mean = 3.64) when considering by age, occupation, income and marital status. The quality of life of type 2 diabetic patients was different at the significance level of 0.05. It has been showed that the participation of all government organizations and communities which includes over a hundred divisions could lead people, money, and resources to improve the quality of life. The community has not been abandoned in co-thinking, coplanning, public ownership, based on the area-based, people-centered approach. The practice is consistent with the context of each area, which could improve the quality of life, and people can live happily together. Happiness is a mutual benefit that everyone takes into consideration.

Terminology

Quality of Life refers to the four dimensions as follows: 1. Physical Dimension - the perception of a person's physical condition which affects the daily life, and so on. 2. Mental Aspect - the ability to recognize their own mental state. 3. Social Relationship - the perception of their relationship with others, and 4. Economic Environment - a perception of the environment, the economy, and income in the areas of conflicts where armed attacks are affecting the way people live.

Methodology

Previously, local organizations would organize only their own responsibility. There is no coordinator for integration. This research tends to cooperate with more than 100 local organizations to develop the quality of life for people in the southern border provinces. The study and data collection are as follows:

1. The sample population consists of local people living Nong Chik district. The sample size was

5% of the 15-60 year-old age group in Nong Chik District, Pattani Province. The participants were recruited by simple random sampling.

2. Evaluation of the quality of life of participants

2.1 Talk to the villagers to receive feedback. Understand and reduce anxiety. People are happy.

The measurement is the THI-15 shortlist of Thai happiness indexes (THI-15). There are three levels of happiness: lower than average, average, and higher than average (Appendix 1).

2.2 Review, evaluate, develop, and improve participation. Combine units that can work together.

Reduce duplication of work in the area using the self-assessment form used throughout Thailand.

- The assessment for the integration of public-private partnerships use the scoring criteria, including 1) Unity Team 2) Customer Focus 3) Community Participation 4) Appreciation

5) Resource Sharing and Human Development and 6) Essential Care. The maximum score for each criterion is worth 5. The overall score must be at least 3.

- The World Health Organization Quality of Life Index (WHOQOL-BREF-THAI) categorizes the quality of life into three levels including low, moderate, and high. (Attachment 3)

- The quality of the evaluation form has been assessed by experts in terms of content validity and suggestions in order to be suitable for the context of the area. The experts are three members including a professor from the Faculty of Nursing, Thaksin University, a professional nurse, and a public health expert.

- The form was initially implemented for 30 samples as a pilot project. The data was then analyzed by the Cronbach's alpha coefficient. The reliability of the World Health

Organization Quality of Life indicator (WHOQOL-BREF-THAI) equals to 0.92.

Rights of the participants

This study proposed and gained the ethical approval from the Research Ethics Committee

RECPTN No. 03/61 from the Pattani Provincial Public Health Office. The research has protected the rights of the sample by explaining methodology through the District Quality Development

Committee since the beginning of data collection process until the end of the study that there would be no impact on the sample population. All information or answers will be used only for educational purposes. The results would be holistically presented and do not cause any damage to any person or organization.

Results of the Project

Part 1: General data of the sample found that most of the 2,801 participants were female (71.8%) and aged between 41-60 years old (45.2%), followed by the 21-40 year-old age group (36.9%).

Part 2: Talk to the villagers to get feedback and understanding to reduce public anxiety — those people aged between 21-40 years old, accounting for 36.9%. According to the THI - 15 index of happiness index (THI - 15), it was found that 56.70% of the local people were happier than average.

Part 3: In 2018, Thailand uses a collaborative assessment form to reduce conflicts and duplication of efforts in the area through UCCARE principles. The results of self-evaluation score 4.75 out of

5 points.

Part 4: The results of the study WHOQOL-BREF-THAI Quality of Life Study (WHOQOL-

BREF-THAI) found that before conducting the project, Nong Chik people suffered from the low quality of life in some respects, while they have high quality of life in all aspects after attending the project. When considering each aspect, it was found that people had the highest quality of life and health at all levels. The mental health has the highest average score, followed by physical health, environment, economy and social relationships (Table 1).

Table 1 Average, standard deviation, and the quality of life of individuals classified by total

and individual (N = 2,801)

mean Element S.D. Quality of life

Physical health 3.51 0.79 Good

Mental health 3.69 0.85 Good

Social Relationships 3.32 0.83 Good

Economic environment 3.39 0.78 Good

Quality of life and overall health 3.50 0.78 Good

In terms of the level of the quality of life of people, when considering each activity separately, it was found that the quality of life of the majority was at a good level. In the dimension of physical health, the item with the highest average scores and good quality of life is that “how satisfied are you when you live your daily life?”. In contrast, the item with the lowest average scores and the quality of life at a medium level is that “ how much do you need to get medical treatment to work or live each day?”. In terms of mental health, the quality of life was good, with the highest score on the item stating, “to what extent do you feel your life is meaningful?”. The item with the lowest average score is that “to what extent do you concentrate on your work?”. In terms of social relationships, the item with the highest average scores and good quality of life is that “are you satisfied with being friends with other people?”. In contrast, the item with the lowest average scores and the quality of life at a medium level is that “how is your sexual satisfaction in your life?” (sexual satisfaction refers to when the sexual feelings arise and how to manage to relax those feelings, including masturbation or having sex. In terms of the economic environment, the item with the highest average scores and good quality of life is that “how satisfied are you with your house?”. In contrast, the item with the lowest average scores and the quality of life at a medium level is that “how much money do you have to pay as needed?”. The quality of life and health in overall is at a good level in all dimensions. The item with the highest average scores is that “how are you satisfied with your health now?”, while the item with the lowest average scores is that “to what extent do you think about your quality of life?”.

Discussion

This project studies the collaboration among over 100 organizations in the area to improve the quality of life. People are happy even though there are conflicts in the southern border provinces. The project manager collected data and classified them into four dimensions of the quality of life, including 1. Physical health 2. Mental health 3. Social relationships and 4. Economic environment as follow:

1. the collaboration over 100 organizations increases access to public service systems especially the disadvantaged groups in the red area, enhance understanding, and reduce suspicion. An example of a happy narrative, "New life of Alisa", reflects the successful operation of the NongChik Psychiatric Service Network in Pattani Province (Attachment 1).

On the day you wake up and see the smile and sweet words from the family, Have you ever recognized there is someone in the family get blamed and hated? On the day we were holding hands and embracing a gentle touch from the family, Did you know that someone was beaten by a family member again and again? We are unable to know this unless we have an opportunity to know her, Alisa (alias).

Alisa, a young woman with a beautiful face but with a sad expression, is often assaulted. She experienced not just a hit, but also wounds from sharp weapons and woods according to the condition she came to the hospital. The attacker is her own younger sister who has never called her a sister.

Physical care is not enough to cure the trauma in her mind. Therefore, we need to cure her mental health as well because she is a human who should be taken care with love and understanding.

Help is not just only defensive. The life of one patient is so much more valuable than what we can wait to help. Every second in her life is filled with pain. It hurts her both physically and mentally.

Today, her family members take care of her and understand her more. She has a happy face when she comes to the hospital as she does not come with blood and tears like before. On the contrary, she comes with a smile and brightness instead of a torn shirt. She comes with beautiful clothes and beautiful makeup. She does not come to get healed, but she comes to visit the staff because the staff here are like her relatives. She has changed from yesterday with no bloody tear and today she comes with a beautiful smile which makes us happy. We are happy to give love and compassion to help human beings. It is a cooperative work among 100 organizations in the area to reduce the disparity with no expectations of getting something in return, but it is a concern of human dignity.

As a result, people have better quality of life and health at a good level. When analyzing each item, it is found that people are satisfied with their good health. They are happy to be able to receive good healthcare services that can make them enjoy their lives (including happiness, and peace with hope).

2. Regarding psychological security from the cooperation of more than 100 organizations, it was found that the number of unrest incidents in the three southern border provinces has decreased from 2014 to 2017, in the following order: 33.3%, 26.74%, 20.93%, and 18.60%.

Households have more positive attitude towards government institutions. Additionally, it is found from the quality of life analysis that people affected by southern border unrest situations feel secure and happy to befriend with and trust in others.

3. In terms of social relationships, the quality of life and health in overall is at a good level. It is found that more than 100 organizations have cooperated to support various projects to reduce inequality. For example, the project of public-private collaborative partnership for Santisuk (peaceful and sustainable) district has provided 1,471 scholarships for students. The number of children reaching and going to the hospital has increased by 130 cases from 2011 to 2015 (43 cases per year in average) and by 247 cases from 2016 to 2017 (124 cases per year in average).

With respect to the sufficiency economy, the contribution of more than 100 organizations to improve the quality of life can reduce inequality. As a result, Nong Chik district won the contest for the economic triangle model for sustainable economic prosperity, which reduces poverty and enhances food security and adequate water management (Nong Chik District was awarded the National Water Management Award). Household income has increased by 90.72%. The analysis of the quality of life and health founds that people are energetic enough to do things in their daily life with a good level of support they receive. They are also happy with their housing conditions which is at a great level.

Recommendations for improving the project

Meeting and operating the plan to improve services to continuously improve the quality of life according to the Quality Cycle (CQI = PDCA: Plan Do Check Act) as follows:

1. The results of the assessment are still problematic in each item in the health dimension. 1.1. Regarding physical aspects, we need to think how to make people in the red zone realize the importance of being treated and gain more access to basic health services. It was found that people still realized the need to receive daily medical treatment. 1.2 Mental security - we reduce inequality and increase access channels to create a positive attitude towards government organizations through communication and understanding. It was found that the issue of catching up with necessary news in daily life was at a medium level. 1.3 Environmental - we improve the environment to contribute to access to public services, such as intelligence quotient (IQ) screening for school-age children. 1.4. Sufficiency Economy - it was found that people can afford to pay for their expenditure. The score was at a medium level.

2. The assessment for the development of the quality of life quality is divided by age groups to analyze and evaluate all people in each group. This assessment can be used in the District Quality of Life Committee (PCH) in Pattani Province (we are currently publishing a journal).

Contribution

The project was planned to be the center for driving those 100 organizations in the area to integrate the design, spatial management, co-thinking, analysis of the situation under the framework of overall health dimensions, including 1) health problems 2) Social environment 3) relationships 4) income. We enhance the collaboration with all related parties in the community. There are a system and network to develop the quality of life in all dimensions in the form of Multi-Disciplinary Team (PDCA Cycle Wheel). We focus on access to public services. We work proactively on the basis of the problems of each person, which are very flexible. As a result,

people in the area are not abandoned in each level. They are willing to develop a good network by two-way communication, based on the concept of “area-based, people-centered approach” to improve the quality of life according to the needs of the people. For example, where there is a public problem, there needs to be a responsible unit to respond to the situation. There must be a project manager leading to good results of the project. As a consequence, the community gains invaluable happiness and sustainable development from the integration of local public-sector institutions in the three southern border provinces.

Knowledge transfer

The integration and exchange of knowledge can improve the quality of life. 1. The evaluation of work from external organizations make us be invited as speakers for various institutions at provincial, district, provincial and national levels, such as HA National Forum at IMPACT Muang Thong Thani Nonthaburi. 2. We have been awarded as follows: The National Outstanding Living Quality Improvement Program at the national level in 2017 from the Ministry of Public Health and Ministry of Interior together with the Institute of Quality Assurance (Public Organization) Award of Excellence in Mental Health Integration, Year 2018 from the Department of Mental Health, Ministry of Public Health, the National Outstanding Achievement Award R2R 5 years (2012-2016). 3. We are selected by the Ministry of Health as a model for other government agencies at the international level such as teams from Indonesia and Malaysia which are looking forward to the cooperation between agencies across the countries. 4. We publish works in journals such as the Journal of Researchers' Association funded by Boromarajonani Nursing College, Yala Province, Journal of Nursing, Ministry of Public Health, financially supported by the Association of Nurses Alumni, Ministry of Public Health, Journal of the Psychiatric Association of Thailand, supported by Songkhla Rajanagarindra Psychiatric Hospital. Currently, we are publishing scholarly articles such as the development of the quality of life by the 3B4 basket model and the development of questionnaires for the quality of life , based on age groups in Nong Chik District, Pattani Province.

Stakeholder Engagement

The impact of the collaboration of over a hundred government agencies results in the public network that can be divided into three circles, including: 1) outer circle - the persons or organizations that make public donation and liaise with the private sector, such as private companies and stores 2) middle circle - the primary stakeholders that directly involve in the project especially government institutions, such as Nong Chik district office, the district unit under the Ministry of Social Development and Human Security, military agencies, security units, and healthcare organizations 3) inner circle - persons or organizations that cooperate with government agencies for better outcomes, namely community leaders, village health volunteers, and village sages.

The integration of three circles complies with the King Bhumibol’s philosophy of sufficiency economy, including the principles of understanding, reaching out, and developing. The collaborative synergies enhance equality for each government agency to improve the quality

of people’s lives. A clear assignment of responsibilities allows good connections and systems for the institutions in all dimensions. Furthermore, the cooperation reduces suspicions in organizational contexts. Every member of the network gives moral support to each other and strengthens social relationships to increase the capacity of individuals to work as a team.

Lessons Learned

Government organizations work in the area where need both science and art in the work. Management needs to have verifiable rules. The cooperation can improve the quality of people’s lives. Government agencies do not merely put on an act for their own benefits. they are trustworthy and service-minded to conduct home visits and acknowledge social problems in the community where the unrest circumstances exist in the southern border provinces. They have public spirits and volunteer to help civilians and deliver happiness to them. For instance, where there is a trouble, there must be a project manager. Without a team manager, there will be no sustainable results.

Success factors and support

The management for officers, multidisciplinary team, community, patients and families at all levels, encourages the discussion forum to discuss the problems based on the context of the area on the basis of “area-base, people-centered approach” to start the coordination and integrate over 100 organizations to work together. The project manager is a link between money, finance, logistics, resulting in good relationships between patients, relatives, multidisciplinary teams and networks both in organizational and community levels to build trust, reduce inequality, and mitigate the gap between public and private sectors.

(Attachment 1) Experience stories reflect the actual operation of the Nong Chik Psychiatric Service Network in Pattani Province, Thailand.

NEW LIFE OF... ALICA On the day of waking up, Fond a smile and sweet words of the family. I think that one person was back in the family do not respect that. There were holding hands embrace a gentle touch from the family. Do you know that one person was beaten by a family member? Physical abuse repeatedly. We have no way of knowing. If you do not have the opportunity to know her, Alisa (fictitious) Assalammualaikum (In the name of God, The Most Beneficent, The Most Merciful.) Miss. Tehsoh from Botong District Health Promotion Hospital Request a case when I hang up I rushed to Emergency Room immediately. When I am waiting for a case from Botong District Health Promotion Hospital. I met a girl who is close to me. She has a beautiful face, white skin, good shape but sad expression. When I got to talk to her. She has a happy and she says she has 5 siblings. She is the eldest. One brother was married and the other one are studying. She has a duty to take care of her grandmother and have a home duty. Her parents have to work out of the province. She always has abdominal pain. I had a look at her illness history. She has been diagnosed with epilepsy since childhood and is a major depressive disorder and has been physically abused by mothers. When asked the relative of the patient. Have information that her family disgusted her. Because her brain development is slower than normal. What makes you understand? She do not like anyone else and always depressed, always asking the attention of family. When she was stressed Offended, she is often aggressive. And that to others. The family is not happy with her. Sometimes the family got down with her. I cannot stand her behavior. The relatives do not understand that her behavior is caused by disease and the sickness she is. But relatives think that because of her habit and intent. In every time, she gets hurt. It's in drama, but it's more than drama because of the condition she came to the hospital, her head was cracked over and over again. Her body was toothed with some knives, her body was covered with blood and deep teeth. The one who hurt her was not her mother. I never called her brother and tell her all the time that she hated her. I do not think of her mind. What is depressing? Every time she was hurt she waved her own bus. In the blood bath and the one has committed suicide. Last time she came to the hospital's emergency department. She did not let the nurse do the wounds. When I knew that she came to the emergency department. I rushed to her side comforting her. When I saw the condition of her wounds. I feel very sorry to her. Feel pain but could not recognize her true pain. It's a lot more complicated than I feel. She is a living man. She would be very heartbroken. The family was hurt. I think your physical treatment alone. Not enough to cure the traumatic in her mind. We should keep our minds. Everyone around me should think of her mind. Think of her dignity because she is a human with heart. It should be taken care. Get love from the people around. I do not get it and been repeatedly assaulted. After that, she was attacked. But not psychologically. There are no psychiatric clinics before and no psychiatric nurse. She was not assessed for mental health and mental care as it should be after her stomach aches. She has been evaluated. My counsel until recently, she was physically abused by her brother. She was beaten to the head. Toothed with a knife and was smashed with solid. Fortunately, she was helped by her neighbors. I do not know what to do and come to the hospital. The psychiatric team thinks we should hurry to help her. In order to take care of her mental state and to prevent her from being attacked again. Psychiatry team Nongjik

Hospital Participants were assisted by a multidisciplinary team of doctor, psychiatric nurses, nurses, and psychologists and Psychiatrist Botong District Health Promotion Hospital / Bor Thong District Municipality Officer / Village Health Volunteers. It is not just about physical therapy and it's not just the setting to the life of one patient is so much more than we can wait to help. Every second of it is filled with pain. It hurts the whole body and it hurts the mind. Where others do not see. So we went down to visit her home. In order to get to talk to her parents. The doctor explained to the parents about the disease and causes of behavior. Including care and assistance with patients with nurses. Including psychologists have assessed mental health and to encourage both relatives and patients. The relatives understood and appreciated the patients more and the patients see their own value more. We have a home visit periodically. Patients were admitted to a psychiatric clinic. We named our clinic. Warm Clinic Love This warm- hearted clinic is not focused on treatment alone but we will have to take care of the patient's mind. love, understanding. The staff will be there to talk and encourage patients. We will take care of patients holistically. If we find that in some problems we cannot help or over capacity. We will be forwarding and coordinating agencies help them, for example, the treatment of sent patients found in Pattani Hospital. Financial, social and human security development in Pattani. The law of the province police prosecutor and continuous care in the community Coordinate staff District Health Promotion Hospital Village Health Volunteers etc. When she gets to help and find out. Today, her family members take care of her more and understand her more. She has a happy face color. When she came to the hospital, she did not come with blood and tears like before. She came to the clinic with a warm smile and a bright smile. She did not come with a shirt with a missing tooth. But she has come in beautiful clothes and beautiful makeup. She did not come to be healed but she came to visit the staff and she always takes her handkerchief to the staff in the clinic warm love, always like fruit balls, she said every time she did not want to eat because the staff here is like her relatives. The change of her from the bloody day, tears, being hurt until today, with a smile, beauty, brightness, it gives us who feel happy. The love that has given us love, compassion, help, and fellow man, without hope. It's a work that gives the heart. The thought of the dignity of humanity.

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(Attachment 2) Experience stories reflect the hundreds of agencies for the quality of life for disadvantaged groups. Nong Chik Hospital, Nong Chik District, Pattani Province, Thailand.

HAPPINESS HAS GIVEN

People born in this world have different ways of recruiting happiness. Some people are happy to travel to different places. Some people are happy to do many activities on this planet. For example, eating out. Watch movie, listen to music But Mrs.Mariam Duereh (Village Health Volunteers Donlak district). Her happiness is to take care of her children. Both of them are named Areduenan musa12 years old, and Sulkiflee musa 13 years old. Both children are congenital children. I cannot sit and cannot walk. Activity self-help, There are also restrictions on breathing. There are also restrictions on breathing. There are both racers. Areduenan, a brother, can rise from his seat. The body is stronger than my brother. The opportunity to go to school at home. Time to go to school, friends to help carry to school. He graduated sixth grade. But he did not study. Because high school is far away from home. Go to school Sulgifli, a younger brother, has a weaker body. Cannot get up from your seat. Weak I do not have to sit leaning against the wall. No chance to study. When the mental health team of Nongjik Hospital and Donrak Health Promotion Hospital together with Donrak Subdistrict Administration Organization, the mental health team consists of psychiatric nurses, nurses, psychologists, physical therapists, and visits to the children. When it comes to building relationships with children, children start talking more by observing and talking, children have a dull expression. Not as cheerful as it should be. Children say they are lonely because they do not have activities. No friends when asked the needs of children. Children say they want new toys and mattresses. The mattress is old and very thin. Sleep on time is not comfortable. I have a soft mattress and in Mariam house, there is a father lying sick. Self-help, The needs of the children. That might seem like something to the kids. Wanted may not be so expensive compared to the needs of others. Overwhelmed but for children. These are the mental values of children is a new mattress New toys for stimulation. The team visited the house to thank the Osotspa is very much to support the budget to help the underprivileged in Nongjik. Especially the family of Mariam from Osotspa budget, he has the opportunity to help many families. Families include this family. The children and family have new mattresses. Children have new toys. There are no toys at all. Compared to other children of the same age. The mental health team provided toys and mattresses. Everyone in the family has a smiley face. I am grateful for the help and the one who is most happy is Mariam. Mariam says that every day, she will go to work as a restaurant contractor. She has an unstable career. Who will hire her? Time to go to work to help mother care. They will return home at daytime to bring food to the family. When she talks she has a very strong attitude. She is calm and does not show signs of discouragement. She said that even though her life was difficult, she had to meet many quizzes. She will patience smile for both parents and their children. Time to work out. When I came back home, I saw my parents face. She is very happy and tired. The baby is the heart of her, and she is fortunate to continue her life and she is lucky to have a friendly neighbor. Helping her and encouraging her. Her happiness is to care for her loved ones. This is the answer to the words I have heard. The upper hand is better than the lower hand. "Being a better contributor" for the mental health team. The opportunity to care for the family. The disadvantage is that we cannot stand still, and we will try to make every effort to help these

families have a happy smile, a better quality of life. We believe that if society is full of social sharing, it will be happy. Finally, thank you Osotspa is very supportive budget that makes the dream. The hope of the mental health team in providing care to the people. The underdog is real and makes a dream. Hope of a family with difficulties. There is no other family like chance. Make a happy smile both the provider and the recipient.

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Shields Awards of support documentation demonstrates continuity of work.

Award Winners, Research Type Mental health with behavioral and mental problems from disasters. Care Guidelines: Future Perspectives Annual 2010.

Award Winners, Academic Presentations by Poster, Quality Development, Mental Health and Psychiatric Services. Annual 2010.

Outstanding Award, The Nursing Association of Thailand, South Branch Outstanding nursing year 2011.

1st runner-up, Presentation of the work of mental health holistic development by the contest mental health. Year 2012.

Outstanding Network Service Award, Psychiatric Services Network 2012

National Outstanding Award, Category: Network Service (CUP). Presentation of the work of mental health holistic development by the contest mental health. Fiscal year 2012.

Award Winners, District mental health operations Type of local government or community,Year 2012.

Received the R2R Excellent Year Award. Incorporate the R2R culture into sustainable development. Annual Report 2013.

Received the R2R Excellent Year Award. Rallies from the routine to research R2R. Annual 2014 Community involvement in the empowerment of schizophrenic patients.

National Health Service Network, Department of Mental Health,

Ministry of Public Health, Annual of 2018.

Certificate of support documentation demonstrates continuity of work.

Award Winners, Hot short film oral presentation at Pattani Provincial Quality and Innovation Festival Annual Report 2009.

Award winning poster presentation type, VIS link security remedy. Annual 2010. Re: Environment and healing.

Certificate: Nong Chik Hospital support for the Smile District Coordination with the Public service. Fiscal year 2013.

Received the R2R Excellent Year Award.2014. Project to support national research development. And the R2R Network Party.“Community participation in empowerment of schizophrenic patients. Nong Chik District, Pattani Province.” (Primary Care Services)

1st runner-up: Performance Contest Access to One page summary Psychiatric Services Pilot Space, 2016.

Institute of Hospital Accreditation (Public Organization)

Award winners: Driving the development of quality of life for disadvantaged groups. Donated by Ministry of Health and Ministry of Interior together with Institute of Hospital Quality Certification (Public Organization) District Health and Quality Development Committee Annual 2017.

Nong Chik District Quality of Life Development Committee Development continuous and sustainable results. Topics: NCDs help flood in the area. Annual of 2018.