Participatory Action for Change(PAC)...An approach to health system development
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complex nature of health systems(including health care systems) posted a new challenge for the system development at all levels. PAC addresses the challenge using the perspective of complex adaptive system and participatory action for change.
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Participatory Action for Change(PAC)...An approach to health system development
- 1. Participatory Action for Change
- 2. Participatory Action for Change
- 3. Diminishing return performance time Paradigm shift No action talk only Incremental change Disruptive change
- 5. ศ.นพ.ไพบูลย์ สุริยะวงศ์ไพศาล ความรับผิดชอบแต่ละบุคคล โดยลาพัง เปลี่ยนสิ่งแวดล้อม Puska 2001
- 6. Societal policies and processes influencing the population prevalence of obesity COMMUNITY LOCALITY Public Transport Public Safety Health Care Sanitation Manufactured/ Imported Food Agriculture/ Gardens/ Local markets POPULATION % OBESE AND OVER-- WEIGHT WORK/SCHOOL/H OME Leisure Activity/ Facilities Labour Infections Worksite Food & Activity Family & Home School Food & Activity INDIVIDUAL Energy Expenditure Food intake : Nutrient density NATIONAL/ REGIONAL Transport Urbanization Health Social security Media & Culture Education Food & Nutrition INTERNATIONALFA CTORS Globalization of markets Development Media programs & advertising National perspective Modified from Ritenbaugh C, Kumanyika S, Morabia A, Jeffery R, Antipatis V. IOTF website 1999: http://www.iotf.org 6
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- 9. 9 NHSO 2014;Kishore S in IOM 2013 17% GDP …5/30 yr gained the causes of the causes
- 10. Participatory Action for Change
- 11. Passive or active agents
- 13. “One child one book one pen can change the world”
- 16. 11/11/2014 16
- 17. โลกสมมติ จริง เท็จ เชื่อว่าจริง ยึดมนั่ว่าจริง ปกป้องความเชื่อนัน้ โลกจริง ปรากฎการณ์ ตาม กฎธรรมชาติ อันซับซ้อน สัมผัส ท้งั5
- 18. Participatory Action for Change
- 19. 1.4000 medical and surgical procedures, 2.6000 drugs 3. 40% of coronary heart disease patients receive incomplete care, and 60% of pneumonia patients. 4. Two million people walk into hospital and get infection they didn’t have because someone forgot to wash their hands. Atul Gawande at TED2012 19
- 20. 80,000 catheter-related bloodstream infections 28,000 deaths $2.3 billion annually 1.8 to 5.2 per 1000 catheter-days 178 actions per days http://www.newyorker.com/magazine/2007/12/10/the-checklist 20
- 21. (1)wash their hands with soap, (2)clean the patient’s skin with chlorhexidine antiseptic, (3) put sterile drapes over the entire patient, (4) wear a sterile mask, hat, gown, and gloves, (5) put a sterile dressing over the catheter site once the line is in. 21
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- 29. Korn Buri DM care system 73,000 inhabitants ; 19,100 households 10,000 elderly; 15% disabled
- 31. Well motivated patients through group learning led to individuals’ invention fitting their contexts
- 33. Participatory Action for Change