From village health volunteers to paid care givers: the optimal mix for a multidisciplinary home health care workforce in rural Thailand

Abstract

Background Thailand is a rapidly aging society, which places high demand on home health care services for the elderly. The shortage of health care workforce in rural areas is a crucial obstacle to the delivery of adequate home health care services. The appropriate skill-mix between multidisciplinary health team and care givers (CGs) is an attractive solution for improving home health care services in rural Thailand. This study assessed the potential of trained CGs to provide home health care services and projected what the optimal mix for a multidisciplinary home health care team in rural Thailand would be in 2030. Methods Eleven pilot districts in Thailand were recruited for the study. Secondary data were collected along with surveys of home health care providers. A total of 130 care managers (nurses) and 351 care givers (CG) were recruited for the survey. Workload, skill-mix potential, and acceptance of care givers were assessed in the surveys. The results from secondary data and the survey were used to project the health workforce requirements in 2030. Results It is projected that in 2030 the number of elderly living in rural areas will be 7,156,700 (27% of the projected rural population). Of this, 20.3% will be home-bound, 1.1% will be bed-ridden and 1.6% will need rehabilitation. The main members of the multidisciplinary health workforce involved in home health care were nurses, doctors, and physiotherapists. The home health care services that were provided by the multidisciplinary health workforce included patient assessment, development of a care plan and case conference, home visits, and teaching and supervision of CGs. The CGs were village health volunteers trained to carry out regular home visits to patients. The CGs provided assistance with the activities of daily living, basic health services, moral support to patients and relatives, and surveillance of the home environment during home visits. CGs were well accepted by both the health professionals and the patients. Projections showed that 16,094 nurses, 1,542 doctors, 1,022 physiotherapists and 50,148 CGs will be required in 2030 to meet the needs of the dependent elderly for home health care in rural Thailand. Conclusion With the increased need for home health care services in the future, appropriate team work between the members of the multidisciplinary health team and the CGs in the community is the appropriate solution for likely shortages of health professional workforce.

The trend in density of skilled health personnel in BRICS countries: Implication for China and India

“…The development of interprofessional teams and the balance between nurses and other supportive personnel, including community health workers and care workers, are crucial to ensuring healthcare services are delivered effectively and efficiently. The current study, however, fails to address 63 …”

“…The current study, however, fails to address. 63 Wide variations in availability and accessibility of healthcare services persist between rural and urban, developed and underdeveloped, regions and the population covered by different health insurances in India, 56,64 China, 28,54 and other BRICS countries. 65,66 Using national-level indicators of health workforce inevitably missed the opportunity to evaluate the equity of access to health care, the key theme of SDG.…”

Napredno timsko delo v zdravstvu, kombinacija znanja in spretnosti: pregled literature

“…In institutional care (Lovink et al, 2019), a greater number of registered nurses is associated with a higher quality of care and lower costs of treatment. In the care of the elderly at home, the introduction of paid caregivers, who under the guidance of a qualified nurse enable better and faster access to care in the home environment (Pagaiya et al, 2021). The inclusion of various experts in the interdisciplinary team for the care of older adults is the basis for facing challenges in the design of long-term care activities (Koopmans et al, 2018).…”

The regulation of healthcare professions and support workers in international context

“…This model for students was certainly extant in India, where the motivation and experience of community health workers has also potentially enabled them to become WHO-designated One Health Activists [ 42 ]. In Thailand too non-professional paid care givers recruited from village health volunteers are trained to provide personal assistance and health services to the elderly in their community—with technical support from a multidisciplinary health team of doctors, nurses, and physiotherapists [ 43 ]. Positive as these developments are, there remain reservations.…”