SUMMARY REPORT

The Integrated Planning and Strengthening Partnership Approach for

Community-based Quality of Life Development for the Thai Elderly
Project
by Jumroon Mikhanorn*

1. Background

The Thai National Family Planning Program has, over the past 35 years, been
extremely successful in reducing population growth rates. This initiative, however,
has indirectly facilitated a number of previously unforeseen health and social welfare
related problems. A growing concern, in Thailand, is the dramatic increase in the
number of elderly people living in all geographic areas of the country. A rapidly
increasing aging population, complicated by new socio-economic forces that have
transformed traditional societies into integral members of the global community, is an
immediate concern for many countries in Asia. The negative consequence of this so-
called “unplanned development” has already affected the quality of life for many
elderly people living in both urban and rural areas of Thailand. As such an important
priority for Thailand, over the next decade, will be to help strengthen and develop
appropriate quality of life strategies and programmes for its “senior citizens” or its
elderly population. The Royal Thai Government has already begun to explore several
interventions aimed at successfully addressing this issue.

A review of existing health data seems to indicate that in every province in the
country all basic health service facilities [i.e. general hospitals, community hospitals,
and health centres in urban and/or rural areas] have established at least one
Community-based Organization for the Elderly (CBOE). These CBOEs, or “Health
and Welfare Clubs for the Elderly” are responsible for the health and welfare of the
local elderly population. The CBOEs are known in Thai as “Chomrom Phoo Soong
Ayu”. The majority of these CBOEs, however, are not well organized, and they lack
the necessary technical and financial support needed to function as designed even
though they have been set-up as part of the Primary Health Care strategy of the
national health care delivery system.

The Foundation for Life Development, which is an NGO established under the
Patronage of HRH Princess Galyani Vadhana Krom Luang Narathiwas
Rajanagarindra, in junction with the ASEAN Institute for Health Development
(AHID/Mahidol University), and the Department of Medical Services (Ministry of
Public Health) conducted the Centre’s first workshop on 7 September 2005. “The
Integrated Planning and Strengthening Partnership Approach for Community-Based
Quality of Life Development for the Thai Elderly Project” was formulated as a result of
this workshop.

According to the Project Planning Phase all concerned parties supported a fund
raising proposal made by The Foundation for Life Development. This proposal was
subsequently submitted to the National Lottery Office of the Ministry of Finance,
requesting that a 10-million Baht grant be made available to establish a “Quality of
Life Development Centre for the Elderly” in Kanchanaburi province. The proposal
also contained a request for an additional 10 million Baht grant to establish a second
“Quality of Life Development Centre for the Elderly” in Mae Hong Sorn province.
These 2 grants were approved in February 2007.

* MD, MPA (Hons), DPH (RCP London&RCS England)

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In 2007 the AIHD/Mahidol University and The Foundation for Life Development, in
close cooperation with various departments from the MOPH [i.e. the Department of
Medical Services, the Department of Health, & the Department of Health Services
Support] implemented “The Integrated Planning and Strengthening Partnership
Approach for Quality of Life Development for the Thai Elderly Project” to support
CBOEs operating in Kanchanaburi Province. The initiative was designed to
strengthen the CBOEs by creating well-organized and competent “Elderly Volunteer
Teams” who could subsequently assess the needs as well as implement specific
activities for the elderly using a Participatory Action Research approach model. This
approach was expected to serve as an appropriate model for future Project
replication in Mae Hong Sorn and other provinces in Thailand.

2. Objectives:

2.1 General Objectives: To support community-based quality-of-life

development programmes for Thailand’s elderly population in order to comply
with an acceptable WHO standard, through existing ”Health and Welfare
Clubs” or Community-based Organizations for the Elderly (CBOEs) within the
Provincial Health System [which is based upon a Primary Health Care
approach].

2.2 Specific Objectives:

(1) Obtain adequate financial resources, through NGO donations, to support
the construction and establishment of a provincial “Elderly Quality of Life
Centre” in Kanchanaburi Province, to serve as a multi-sectoral
community-based headquarters for a provincial CBOE support network,
(2) Mobilize elderly individuals, retired from appropriate organizations with
suitable health status and social background, to participate as members
of the “Elderly Volunteer Group (EVG)”. The members of the EVG are
expected to become key team members of the Participatory Action
Research (PAR) Team,
(3) Support human capacity building of the EVG through appropriate
orientation and PAR processes to form an effective EVG Network. This
also includes the formulation of an Action Plan for the Provincial Quality of
Life Development Centre, as well as the construction and establishment
of this centre [physically adjacent to the Provincial Hospital] which will be
supported by the Governor of Kanchanaburi province. The EVG will
continue to work on the PAR process for the Action Plan in order to
establish an organization called, “The Association of Kanachanburi
Community-based Organizations (CBOEs) for the Elderly”. This
association will be based at the Kanchanburi Quality of Life Development
Centre, of which all CBOEs located in province will be members,
(4) Establish Mobile Elderly Volunteer Teams (MEVTs) to be responsible for
implementing the various outreach programmes of the Quality of Life
Development Centre, and/or as requested by the member CBOEs,
(5) Review and modify the “model” so that it can shortly be replicated to Mae
Hong Sorn as well as eventually to other provinces in Thailand.

3. Methodology:

The Project’s primary methodology was a Participatory Action Research

(PAR) approach. The following diagram illustrates the overall Project
conceptual framework:

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 The Project Conceptual Framework

The Life Development Foundation

Kanchanaburi Province
MOPH The Elderly Volunteer
Group (EVG)
MOI
AIHD/Mahidol University The Community- based
Organization for the Elderly
(CBOE)
MSDHS

Social Preparation for Community

Leadership and Elderly Volunteer
Development

PAR Team Building Data Collection and

Documentary Research

PAR W orkshop

Establishment of The Provincial QoL Development Centre for the Elderly

Establishment of the Association for CBOEs in the Province

Strengthening Highlighting Replication of the

of CBOEs Lessons Learned Project key features

Conducting a “National Seminar on Strengthening of the

CBOEs as a Key Feature of Healthy Communities Based
on PHC in Thailand

Report Publishing and Distribution

*N.B MOPH : Ministry of Public Health

MOI : Ministry of Interior
MSDHS : Ministry of Social Development and Human
Security

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4. Major Activities Undertaken

A Participatory Action Research (PAR) approach was the primary

methodology used by the Project. Some of the key Project inputs and
activities were as follows:

10 January 2007 y Joint Integrated Project Steering

Committee and Project Management
Committee Meeting held at
the Kanchanaburi Provincial Health Office

19 January 2007 y The 1st Conference for the Elderly

Volunteer Group Development initiated in
Phanom Tuan District

8 February 2007 y Orientation Meeting on “Elderly Volunteer

Members” conducted at the Kanchanaburi
Provincial Health Office

14 February 2007 y Approval of the Government Lottery

Office Grant for funding the establishment
of the QOL Development Centres in
Kanchanaburi and Mae Hong Sorn

1 March 2007 y The First Joint Committee Orientation

Workshop conducted at the Kanchanaburi
Provincial Health Office

4 April 2007 y Workshop for 71 Elderly Volunteer

Members of The Life Development
Foundation conducted in Bangkok

7 June 2007 y PAR Team Workshop conducted at AIHD,

Mahidol University, Salaya Campus

8-9 June 2007 y The First PAR Workshop for 54

participants at the Pavilion
Rimkwai Resort, Kanchanaburi

6 September 2007 y PAR Team Meeting at AIHD

18-19 September 2007 y The Second PAR Workshop for 106

participants at the Wang Singha
Resort, Kanachaburi

23-24 November 2007 y The Third PAR Workshop conducted for

117 participants at Raj Supthamitr Hotel ,
Kanchanaburi, on Programmes of the
Quality of Life Development Centre

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 January - April 2008 ● Establishment of the Association of
Kanchanaburi CBOEs, who will take
care of the Kanchanaburi QOL
Development Centre for the Elderly

May - December 2008 y Implementation of the Association’s

Programmes in sustainable development
of the Kanchanaburi CBOE Association
and its CBOE network

January - September 2010 y Establishment of the Association of Mae

Hong Sorn CBOE and its provincial
CBOE Network

5. Achievement of Project Objectives

The First Participatory Action Research (PAR) Workshop took place in

Kanchanaburi Province from 8-9 June 2007. Participants included 49
members of different elderly volunteer groups located in the 13 districts of
Kanchanaburi, 5 members from The Life Development Foundation in
Bangkok, local authorities and community leaders, as well as professional
staff from AIHD and the MOPH. The workshop expected outcomes included
the following: (1) identify needs of the community-based elderly groups, (2)
develop a strategic intervention plan and action plan, and (3) share
experiences between the elderly volunteers from the Foundation’s Centre in
Bangkok and the elderly volunteers in Kanchanaburi Province.

The Second PAR Workshop for 106 participants, dealing with “Elderly
Volunteers Development”, was conducted at the Wang Sing Resort, Saiyoke
District, Kanchanaburi province. The workshop was organized to help identify
empowerment needs’ assessment tools for “Community Based Organizations
for the Elderly” (i.e. the “Chomrom Phoo Soong Ayu”) operating in
Kanchanaburi Province.

The sharing of ideas and experiences helped participants formulate the

operation plan and the functions of six working groups in support of CBOEs in
the Project intervention areas.

The Action Plan designated that the 10 million baht, donated by the
Government Lottery Office through The Life Development Foundation, be
used to construct and establish a Quality of Development Centre within the
premises of the Kanchanaburi Governor’s Office, located adjacent to the
provincial hospital. The centre’s building was also envisioned to serve as the
home office of the newly established Association of the Community-Based
Organizations for the Elderly (CBOEs) for Kanchanaburi province.

6. Project Outcomes

The PAR Workshops, for volunteer-team participants, held at Muang District,

Kanchanaburi Province on 23-24 November 2007 were very productive. The
purpose of these workshops was to facilitate the PAR process to help
highlight the lessons learned among Elderly Volunteer Groups. This included

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 a review of the planning, monitoring, and evaluation of the Quality of Life
Centre established in Kanchanaburi, whose main role was to improve
support for all CBOEs in the province.

The workshop also identified ways to recruit Elderly Volunteers to work as

the Founding Committees of the Provincial Association for CBOEs”, which
will eventually be legally incorporated to serve as the owner of the newly
developed Quality of Life Development Centre.

At the present time the replication of the new Kanchanaburi Model Quality of
Life Development Centre in Mae Horng Sorn is progressing according to
plan. The facility has successfully been constructed as well as appropriately
furnished to serve as a provincial Quality of Life Development Centre. The
two centres in Kanachanaburi and Mae Hong Sorn are used to
accommodate their respective associations for Community-based
Organizations for the Elderly (CBOEs). In summary the Community-based
Quality of Life Development for the Thai Elderly Project, in both
Kanachanaburi and Mae Hong Sorn, have been integrated within their
provincial health care delivery systems, based upon a PHC approach, and
this process is ready for further replication to other provinces in Thailand.

7. Lessons Learned

It is evident, from observations and anecdotal reports, that healthy senior citizens in
Kanachanaburi, many of whom have a wealth of professional and personal
experience, are finding it difficult to identify constructive activities or things to do with
respect to earning their living as well as enjoying a productive and rewarding social
life that includes serving their friends and neighbors. Whenever they are encouraged
and supported to do so, however, the results are very impressive. These individuals
are eager to share their knowledge and experiences to improve the quality of life for
themselves and their neighbors.

At the present time a group of approximately 60 Elderly Volunteers are actively

enrolled in participating in a wide array of activities aimed at supporting the newly
established Quality of Life Centre for the Elderly in Kanchanaburi province. Many of
these individuals are highly competent in various fields related to the activities that
have been recently undertaken by the CBOEs. They have expressed their
willingness to share their knowledge and experiences with other Elderly Volunteers in
Kanchanaburi province as well as with elderly members of the Foundation’s Centre in
Bangkok. The approach implemented by the present Project can serve as an
excellent model for new social movements in the context of community-based quality
of life development for the elderly living in Kanchanaburi as well as in other provinces
of Thailand. A group of elderly volunteers have formally agreed to be trained to serve
in the following Elderly Volunteer Teams (EVTs):

1. Management Team
2. Elderly Services Programme on Health and Social Welfare Team
3. Social Assistance for the Disabled, Sick, and Under-served Elderly Team
4. Fund Raising and Community Empowerment Team

The volunteer teams have been organized to work as mobile outreach teams to
support all accessible CBOEs throughout the province in order to strengthen and
empower all CBOEs to ensure sustainability as well as to replicate the appropriate
components of this model.

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The lessons learned in both Kanchanaburi and Mae Hong Sorn will be reviewed and
utilized by the Project for further development and replication to other provinces. The
model has already been replicated to Mae Hong Sorn in 2008, and it will hopefully be
expanded to other geographic areas in the coming years ahead. The Government
Lottery Office has already approved 20 million baht to cover the costs of constructing
2 Quality of Life Development Centres, and it is expected that similar grants will be
available to other provinces in the future. Through a process of integrated planning
and partnership development, an appropriate model for a Community-based Quality
of Life Development Programme for the Thai Elderly can be successfully
incorporated within the existing provincial health care delivery system that is based
upon a Primary Health Care approach.