An Assessment of the Workloads of Rural Health Centres in Khon Kaen, Northeast Thailand

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Lertchai Charerntanyarak
Nigel Lewin
Mary-Jean Mackie
David Urassa
Aroon Jirawatkul
Sastri Saowakontha

Abstract

A cross sectional descriptive study to assess the health centre staff workload and associated factors in Nong Rua district, Khon Kaen Province, was researched from January to April 1991.

Health centre yearly records, staff, patient and community interviews, and focus groups were the tools used to determine the health centre workload and community utilisation.

The reuslts showed that in the district, health centres had a higher average promotive workload (64.1%) in relation to other activities followed by administrative (25.6%), curative (7.2%) and lastly preventive workload (3.1%)

These results are comparable to the Ministry of Public Health’s guidelines regarding the distribution of services, which recommend 75% of time be spent in promotive and preventive activities with 25% for administrative and curative services.  In this district 4 of the 13 health centres studied performed above their expected workload with 9 below.  In relation to actual workload, 2 of the health centres were under staffed and 4 overstaffed.

Distance from the health centre to the district hospital, and the cost of service, did not seemed to affect health centre utilisation and the existence of traditional healers, private clinics and the district hospital did not seemed to affect directly health centre workload.  Although patients seemed to utilise the other health services in conjunction with the health centres.  The choice of whether to use a health centre appears to be determined by perceived seriousness of the illness, the time the illness occurs, and the person’s perception as to who will give the best treatment.

The finding showed a difference between the expected and actual work performed but although statistically significant in reality.  If expected targets were to be reached there would need to be an overall increase of three staff in the district.

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