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Original Article
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Journal of Health Science 2008 Vol. 17 Supplement I
SI208
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°“√»÷°…“ ‡¡◊ËÕ«—π∑’Ë 22 ‡¡…“¬π 2547 ≥ ÀâÕߪ√–™ÿ¡
1 ”π—°ß“πª≈—¥°√–∑√«ß “∏“√≥ ÿ¢ ·≈–‰¥â¡’°“√
ª√—∫ª√ÿß·°â ‰¢ ‡æ◊ËÕ„Àâº≈°“√»÷°…“«‘®—¬¡’§«“¡ ¡∫Ÿ√≥å
¬‘Ëߢ÷Èπ
º≈°“√»÷°…“
º≈®“°°“√ªØ‘√Ÿª√–∫∫√“™°“√
®“°°“√ªØ‘√Ÿª√–∫∫√“™°“√·≈–À≈—°ª√–°—π ÿ¢¿“æ∂â«πÀπâ“ ∑”„Àâ¡’°“√‡ª≈’ˬπ·ª≈ß°“√®—¥ √√ß∫- ª√–¡“≥‡æ◊ËÕ°“√¥”‡π‘πß“π “∏“√≥ ÿ¢„π√–¥—∫®—ßÀ«—¥
µ“¡π‚¬∫“¬À≈—°ª√–°—π ÿ¢¿“æ∂â«πÀπâ“ (30 ∫“∑
√—°…“∑ÿ°‚√§) ∑”„Àâ¡’°“√®—¥ √√ß∫ª√–¡“≥„π°“√®—¥
∫√‘°“√ ÿ¢¿“æ ‡ªìπ 2 ª√–‡¿∑ §◊Õ(5)
1. ß∫ª√–¡“≥∑’ËÕ¬Ÿà„π√–∫∫À≈—°ª√–°—π ÿ¢¿“æ
∂â«πÀπâ“ (UC: Universal Coverage) ´÷Ë߇ªìπß∫ª√–¡“≥
√“¬À—« §√Õ∫§≈ÿ¡°“√„Àâ∫√‘°“√¥â“π “∏“√≥ ÿ¢‡©æ“–
§π‰∑¬‡∑à“π—Èπ ∑”„Àâ§π‰√â —≠™“µ‘·≈–°≈ÿà¡™“µ‘æ—π∏ÿåµà“ßÊ
‡¢â“‰¡à∂÷ßÀ≈—°ª√–°—π ÿ¢¿“æ·≈–√–∫∫∫√‘°“√ “∏“√≥ ÿ¢
2. ß∫ª√–¡“≥ ”À√—∫°“√¥”‡π‘πß“π “∏“√≥ ÿ¢
∑—Ë«‰ª (Non UC) ‡ªìπß∫ª√–¡“≥∑’Ë„™â„π°“√∫√‘À“√
ß“π·≈–¥”‡π‘πß“π “∏“√≥ ÿ¢∑—Ë«‰ª ‡™àπ °“√§«∫§ÿ¡
‚√§ ß“π«‘™“°“√ ß“π ÿ¢»÷°…“ ´÷Ëßß∫ª√–¡“≥¥—ß
°≈à“«πâÕ¬¡“°‡¡◊ËÕ‡∑’¬∫ —¥ à«π°—∫ß∫ª√–¡“≥µ“¡√–∫∫
UC àߺ≈„À₧√ß°“√µà“ß Ê ∑’ˇ°’ˬ«¢âÕß°—∫§π‰√â —≠™“µ‘
‰∑¬ ¢“¥§«“¡µàÕ‡π◊ËÕß„π°“√¥”‡π‘πß“π
“‡Àµÿ·≈–ªí≠À“ “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“
1. ªí≠À“‚√§µ‘¥µàÕ∑’Ë ”§—≠ ·≈–‚√§ª√–®”∂‘Ë𠇙àπ
‡Õ¥ å «—≥‚√§ ¡“≈“‡√’¬ ‡∑â“™â“ß Õÿ®®“√–√à«ß ‰¢â°“à À≈—ß·Õàπ(6) πÕ°®“°π’Ȭ—ßæ∫‚√§∑’Ë “¡“√∂ªÑÕß°—π‰¥â
¥â«¬«—§´’π(7) ‡™àπ ‚√§‚ª≈‘‚Õ (µ“√“ß∑’Ë 1)
2. ªí≠À“°“√ √â“߇ √‘¡ ÿ¢¿“æ ‚¥¬‡©æ“–Õπ“¡—¬
Journal of Health Science 2008 Vol. 17 Supplement I
SI210
·¡à·≈–‡¥Á° ‡π◊ËÕß®“°°“√¢“¥‚Õ°“ °“√‡¢â“∂÷ß∫√‘°“√
“∏“√≥ ÿ¢ ∑”„Àâ¡’°“√µ“¬¢Õ߇¥Á°∑“√°·≈–¡“√¥“
À≈—ߧ≈Õ¥ √«¡∑—Èߢ“¥°“√«“ß·ºπ§√Õ∫§√—«(8)
3. ªí≠À“Õπ“¡—¬ ‘Ëß·«¥≈âÕ¡ ‰¥â·°à °“√ ÿ¢“¿‘∫“≈
°“√°”®—¥¢¬–∑’ˉ¡à∂Ÿ°µâÕß ·≈–∑’ËÕ¬ŸàÕ“»—¬·ÕÕ—¥ Õ—π‡ªìπ
·À≈àß·æ√à√–∫“¥¢Õß‚√§µ‘¥µàÕµà“ß Ê ‰¥âßà“¬
4. ªí≠À“¬“‡ 浑¥∫πæ◊Èπ∑’Ë Ÿß ·≈–°“√≈—°≈Õ∫
𔬓‡ 浑¥‡¢â“ª√–‡∑»∑’ˬ—߉¡à “¡“√∂®–§«∫§ÿ¡‰¥â 5. ªí≠À“Õ◊Ëπ Ê ‰¥â·°à ªí≠À“·√ßß“πµà“ߥ⓫∑’Ë º‘¥°ÆÀ¡“¬ ªí≠À“Õ“™≠“°√√¡ ªí≠À“°“√§â“¡πÿ…¬å
´÷Ëß∑⓬∑’Ë ÿ¥·≈⫬àÕ¡ àߺ≈°√–∑∫µàÕªí≠À“ “∏“√≥ ÿ¢
∂“π°“√≥å®—ßÀ«—¥∑’Ë¡’§«“¡√à«¡¡◊Õ°—∫Õߧå°√‡Õ°™π
Àπ૬ߓπ “∏“√≥ ÿ¢‰¥â¡’§«“¡√à«¡¡◊Õ°—∫Õߧå°√
‡Õ°™πÕ¬Ÿà·≈â« 8 ®—ßÀ«—¥ ‰¥â·°à ‡™’¬ß√“¬ ‡™’¬ß„À¡à
·¡àŒàÕß Õ𠵓° °“≠®π∫ÿ√’ √“™∫ÿ√’ ™ÿ¡æ√ ·≈–√–πÕß à«π®—ßÀ«—¥ ∑’ˉ¡àæ∫Õߧå°√‡Õ°™π‡¢â“¡“¥”‡π‘πß“π
¥â“π “∏“√≥ ÿ¢ 2 ®—ßÀ«—¥ ‰¥â·°à ®—ßÀ«—¥‡æ™√∫ÿ√’ ·≈–
ª√–®«∫§‘√’¢—π∏å
ª√–‡¿∑¢ÕßÕߧå°√‡Õ°™π∑’Ë¡’§«“¡√à«¡¡◊Õ°—∫Àπ૬ߓπ “∏“√≥ ÿ¢¿“§√—∞
1. Õߧå°√√–À«à“ߪ√–‡∑» ‰¥â·°à UNHCR, IOM, WHO, Kenan Institute Asia, Global Fund
2. Õߧå°√‡Õ°™π ‰¥â·°à ¡Ÿ≈π‘∏‘·¡àøÑ“À≈«ß (Mae Fah Luang Foundation) ¡Ÿ≈π‘∏‘»ÿ¿π‘¡‘µ (World Vi- sion) ‡ÕÁ¡æ“«‡«Õ√å (Empower) ¡“§¡æ—≤π“ª√–™“°√
·≈–™ÿ¡™π (PDA) ¡“§¡«“ß·ºπ§√Õ∫§√—«·Ààߪ√–‡∑»
‰∑¬ ( «∑.), International Rescue Committee (IRC), ARC International, Medicins Sans Froutier (MSF), Maetao Clinic, Handicap International (HI), MHD, MAP Foundation ¡Ÿ≈π‘∏‘√—°…å‰∑¬
Àπ૬ߓπ„π —ß°—¥¢Õß°√–∑√«ß “∏“√≥ ÿ¢∑’Ë¡’§«“¡
µ“√“ß∑’Ë 1 ‡ª√’¬∫‡∑’¬∫°“√‡®Á∫ªÉ«¬¢Õß™“«æ¡à“¥â«¬‚√§µ‘¥µàÕ∑’Ë ”§—≠ 5 ‚√§ 3 Õ—π¥—∫·√° „π 10 ®—ßÀ«—¥™“¬·¥π‰∑¬-æ¡à“
‚√§µ‘¥µàÕ∑’Ë ”§—≠ªï 2543-2546
≈”¥—∫ ®—ßÀ«—¥ À¡“¬‡Àµÿ
Õÿ®®“√–√à«ßÕ¬à“ß·√ß ¡“≈“‡√’¬ «—≥‚√§ ‡∑â“™â“ß ‡Õ¥ å
1 ‡™’¬ß√“¬ 2
2 ·¡àŒàÕß Õπ 1
3 ‡™’¬ß„À¡à 1
4 µ“° 2 1 1 1 2
5 °“≠®π∫ÿ√’ 2
6 √“™∫ÿ√’
7 ‡æ™√∫ÿ√’
8 ª√–®«∫§’√’¢—π∏å 3 2
9 ™ÿ¡æ√
10 √–πÕß 3 3
À¡“¬‡Àµÿ ¢âÕ¡Ÿ≈®“°°“√π”®”π«πºŸâªÉ«¬™“«æ¡à“®”·π°µ“¡√“¬®—ßÀ«—¥®“° ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥¡“®—¥‡√’¬ß≈”¥—∫ 1,2 ·≈– 3
®“°µ“√“ß∑’Ë 1 ®–‡ÀÁπ‰¥â«à“ ‚√§µ‘¥µàÕ∑’Ë ”§—≠ 5 Õ—π¥—∫·√°∑’Ëæ∫„πºŸâªÉ«¬™“«æ¡à“ ‡ªìπ‚√§∑’ˇ°‘¥®“° ¿“æ¿Ÿ¡‘»“ µ√å∑’ˇªìπ¿Ÿ‡¢“·≈–ªÉ“∑’Ë¡’
Õ“°“»√âÕπ™◊Èπ ‚¥¬¡’¬Ÿß‡ªìπæ“À– ·≈–‚√§∑’ˇ°‘¥®“°æƒµ‘°√√¡°“√∫√‘‚¿§Õ“À“√·≈–πÈ”∑’Ë¡’°“√ªπ‡ªóôÕπ‡™◊ÈÕ‚√§ µ≈Õ¥®π惵‘°√√¡°“√„™â â«¡
∑’ˉ¡à∂Ÿ° ÿ¢≈—°…≥–
√à«¡¡◊Õ°—∫Õߧå°√‡Õ°™π
1. Àπ૬ߓπ “∏“√≥ ÿ¢¿“§√—∞∑’Ë¡’§«“¡√à«¡¡◊Õ
°—∫Õߧå°√‡Õ°™π à«π¿Ÿ¡‘¿“§ ‰¥â·°à ”π—°ß“π “∏“√≥- ÿ¢®—ßÀ«—¥ ·≈– ∂“π∫√‘°“√ “∏“√≥ ÿ¢∑’˵—ÈßÕ¬Ÿà„π∫√‘‡«≥
™“¬·¥π‰∑¬-æ¡à“ à«π°≈“ß ‰¥â·°à ”π—°ß“πª≈—¥
°√–∑√«ß “∏“√≥ ÿ¢ °√¡·≈–°Õßµà“ß Ê „π —ß°—¥
°√–∑√«ß “∏“√≥ ÿ¢
2. Àπ૬ߓπ “∏“√≥ ÿ¢¡’À≈“¬Àπ૬ߓπ∑’Ë¡’
§«“¡√à«¡¡◊Õ°—∫Õߧå°√‡Õ°™π ®“°°“√»÷°…“≈—°…≥–
¢Õߧ«“¡√à«¡¡◊Õ æ∫«à“ Õߧå°√‡Õ°™π à«π¡“°¬—ߢ“¥
°“√ª√– “πß“π„π°√–∫«π°“√·°âªí≠À“·≈–æ—≤π“
‡™àπ °“√√à«¡À“ªí≠À“ °“√√à«¡«“ß·ºπ °“√√à«¡
¥”‡π‘π°“√ ·≈–°“√√à«¡ª√–‡¡‘πº≈ √«¡∑—È߉¡à¡’°“√µ—Èß
‡ªÑ“À¡“¬√à«¡„π°“√¥”‡π‘πß“π
√Ÿª·∫∫°“√‡¢â“¡“¥”‡π‘πß“π¢ÕßÕߧå°√‡Õ°™π
1. ¥”‡π‘πß“πµ“¡§”√âÕߢբÕßÀπ૬ߓπ “∏“√≥- ÿ ¢¿“§√—∞ ‡™àπ ¡Ÿ≈π‘∏‘»ÿ¿π‘¡‘µ ¡“§¡«“ß·ºπ
§√Õ∫§√—«·Ààߪ√–‡∑»‰∑¬
2. ¥”‡π‘πß“π‚¥¬ºà“π°“√ª√– “πß“π®“°Àπ૬
ß“π à«π°≈“ߢÕß°√–∑√«ß “∏“√≥ ÿ¢ ‚¥¬¡’°“√∑”
∫—π∑÷°¢âÕµ°≈ߧ«“¡√à«¡¡◊Õ„π√–¥—∫ à«π°≈“ß·≈– à«π
¿Ÿ¡‘¿“§ ‡™àπ IOM (International Organization of Mi- gration)
3. ¥”‡π‘πß“π‚¥¬°“√ª√– “πß“π°—∫Àπ૬ߓπ
√“™°“√„πæ◊Èπ∑’Ë ‡™àπ ¡Ÿ≈π‘∏‘»ÿ¿π‘¡‘µ Maetao Clinic
√Ÿª·∫∫§«“¡√à«¡¡◊Õ√–À«à“ßÀπà«¬ß“π¿“§√—∞·≈–Õߧå°√
‡Õ°™π
1. √Ÿª·∫∫§«“¡√à«¡¡◊Õ¿“¬„πª√–‡∑» ¡’¥—ßπ’È 1.1 π— ∫ πÿ π ß ∫ ª √ – ¡ “ ≥ „ Àâ À πà « ¬ ß “ π “∏“√≥ ÿ¢‡ªìπºŸâ¥”‡π‘πß“π ‚¥¬°“√®—¥∑”‚§√ß°“√ ‡æ◊ËÕ
¢Õ√—∫ß∫ª√–¡“≥ π—∫ πÿπ®“°Õߧå°√√–À«à“ߪ√–‡∑»
‡™àπ Õߧ尓√Õπ“¡—¬‚≈° (WHO)
1.2 Õߧå°√‡Õ°™π∫“ßÕߧå°√‡¢â“¡“¥”‡π‘π ß“π “∏“√≥ ÿ¢„πæ◊Èπ∑’Ë ‚¥¬¡’∫ÿ§≈“°√·≈–ß∫ª√–¡“≥
¢Õßµπ‡Õß ´÷Ëß “¡“√∂·∫à߇∫“¿“√–°“√¥”‡π‘πß“π¢Õß Àπ૬ߓπ “∏“√≥ ÿ¢ ‡™àπ ¡Ÿ≈π‘∏‘»ÿ¿π‘¡‘µ ‡ÕÁ¡æ“«‡«Õ√å ¡“§¡æ—≤π“ª√–™“°√·≈–™ÿ¡™π (PDA)
1.3 Õ ß §å ° √ ‡ Õ ° ™ π · ≈ – Õ ß §å ° √ √ – À «à “ ß ª√–‡∑»‡¢â“¡“¥”‡π‘πß“π “∏“√≥ ÿ¢„πæ◊Èπ∑’Ëæ—°æ‘ß
™—Ë«§√“« ‡™àπ ARC, IRC, UNHCR
1.4 Õߧå°√√–À«à“ߪ√–‡∑»‡¢â“¡“√à«¡»÷°…“
ªí≠À“ √à«¡«“ß·ºπ π—∫ πÿπß∫ª√–¡“≥·≈–¥”‡π‘π ß“π√à«¡°—∫Àπ૬ߓπ “∏“√≥ ÿ¢ ‡™àπ IOM
1.5 °“√„Àâ∫√‘°“√ “∏“√≥ ÿ¢„Àâ·°à™“«æ¡à“
‚¥¬·æ∑¬å™“«æ¡à“ ‡™àπ Maetao Clinic ¡Ÿ≈π‘∏‘»ÿ¿π‘¡‘µ 1.6 °“√·≈°‡ª≈’ˬπ¢âÕ¡Ÿ≈¢à“« “√ ‚¥¬¡’°“√
ª√–™ÿ¡§«“¡√à«¡¡◊Õ¥â“π “∏“√≥ ÿ¢ √–À«à“ßÀπ૬- ß“π “∏“√≥ ÿ¢¿“§√—∞ ·≈–Õߧå°√‡Õ°™π∑”„Àâ¡’™àÕß-
∑“ß°“√ª√– “πß“πÕ¬à“߉¡à‡ªìπ∑“ß°“√¡“°¢÷Èπ 2. √Ÿª·∫∫§«“¡√à«¡¡◊Õ√–À«à“ߪ√–‡∑» ¡’¥—ßπ’È
2.1 §«“¡√à«¡¡◊Õ·∫∫¢â“¡æ√¡·¥π (Cross Border) ‚¥¬Àπ૬ߓπ “∏“√≥ ÿ¢√à«¡°—∫Õߧå°√
‡Õ°™π‡¢â“‰ªæ—≤π“‚√ß欓∫“≈ ·≈–æ—≤π“»—°¬¿“æ
¢Õß∫ÿ§≈“°√¥â“π “∏“√≥ ÿ¢„π‚√ß欓∫“≈∑’ËÕ¬Ÿà„°≈â
∫√‘‡«≥·π«™“¬·¥π¢Õߪ√–‡∑»‰∑¬ ‡æ◊ËÕ‡ªìπ°“√ °—¥-
°—ÈπºŸâªÉ«¬™“«æ¡à“∑’ˇ¢â“¡“√—∫°“√√—°…“欓∫“≈„π ∂“π∫√‘°“√ “∏“√≥ ÿ¢™“¬·¥π„πΩíò߉∑¬ ·≈–‡ªìπ
°“√ªÑÕß°—π§«∫§ÿ¡·À≈àß‚√§µ‘¥µàÕ∑’Ë®– àߺ≈°√–∑∫µàÕ ª√–™“™π∑’ËÕ“»—¬Õ¬Ÿà∫√‘‡«≥™“¬·¥π‰∑¬-æ¡à“
2.2 °“√ π—∫ πÿπß∫ª√–¡“≥„ÀâÀπ૬ߓπ “∏“√≥ ÿ¢¢Õß∑—Èß Õߪ√–‡∑»‡ªìπºŸâ¥”‡π‘πß“π ‚¥¬
°“√®—¥∑”‚§√ß°“√‡æ◊ËÕ¢Õ√—∫ß∫ª√–¡“≥ π—∫ πÿπ®“°
Õߧå°√‡Õ°™π ‡™àπ Global Fund ´÷Ëß„À⧫“¡™à«¬‡À≈◊Õ
„π°“√·°âªí≠À“‚√§µ‘¥µàÕ 3 ‚√§ §◊Õ ‡Õ¥ å «—≥‚√§·≈–
¡“≈“‡√’¬(9) ·µà‰¡à§√Õ∫§≈ÿ¡‚√§µ‘¥µàÕÕ◊ËπÊ ∑’ˇªìπªí≠À“
“∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“
Journal of Health Science 2008 Vol. 17 Supplement I
SI212
ªí®®—¬∑’Ë¡’º≈µàÕ°“√¥”‡π‘πß“π “∏“√≥ ÿ¢™“¬·¥π
√–À«à“ßÀπà«¬ß“π¿“§√—∞·≈–Õߧå°√‡Õ°™π 1. ªí®®—¬·Ààߧ«“¡ ”‡√Á®
1.1 ºŸâ∫√‘À“√Àπ૬ߓπ “∏“√≥ ÿ¢ ‡ÀÁ𧫓¡
”§—≠¢Õߪí≠À“ “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“(1) ·≈–
‡ÀÁ𧫓¡ ”§—≠¢Õß°“√π”‡Õ“Õߧå°√‡Õ°™π‡ªìπÀÿâπ à«π
„π°“√¥”‡π‘πß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“
1.2 °“√ª√–™ÿ¡√à«¡°—π√–À«à“ßÀπ૬ߓπ “∏“√≥ ÿ¢¿“§√—∞·≈–Õߧå°√‡Õ°™π ‡æ◊ËÕ·≈°‡ª≈’ˬπ
¢âÕ¡Ÿ≈¢à“« “√Õ¬à“ßµàÕ‡π◊ËÕß·≈– ¡Ë”‡ ¡Õ °àÕ„À⇰‘¥ —¡- æ—π∏¿“æ∑’Ë¥’µàÕ°—π ·≈–≈¥™àÕß«à“ߢÕß¿“§ à«πµà“ß Ê
„π°“√∑”ß“π√à«¡°—πÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ(10)
1.3 °“√¬Õ¡√—∫ §«“¡»√—∑∏“ ·≈– —¡æ—π∏-
¿“æ à«π∫ÿ§§≈∑’Ë¥’ àߺ≈„Àâ°“√ª√– “π°“√¥”‡π‘π ß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“‡ªìπ‰ªÕ¬à“ß√“∫√◊Ëπ
1.4 ∑—°…–∑’Ë®”‡ªìπ¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢
„π°“√∑”ß“π√à«¡°—∫Õߧå°√‡Õ°™π ‡™àπ °“√‡®√®“µàÕ√Õß
¿“…“ “°≈
2. ªí®®—¬§«“¡≈⡇À≈«
2.1 °ÆÀ¡“¬‰¡à‡Õ◊ÈÕµàÕ°“√¥”‡π‘πß“π¢Õß Õߧå°√‡Õ°™π∫“ßÕߧå°√∑’Ë¡’≈—°…≥–°“√¥”‡π‘πß“π∑’Ë º‘¥°ÆÀ¡“¬ ‡™àπ Maetao Clinic ∑’ˇªî¥„Àâ∫√‘°“√
“∏“√≥ ÿ¢‚¥¬·æ∑¬å™“«æ¡à“ ¢—¥°—∫æ√–√“™∫—≠≠—µ‘
¢Õß ¿“«‘™“™’æ ∫—≠≠—µ‘«à“ ç·æ∑¬åµà“ß™“µ‘‡¢â“¡“
∑”ß“π„πª√–‡∑»‰∑¬‰¥â®–µâÕß Õ∫¢÷Èπ∑–‡∫’¬π·≈–‰¥â
√—∫„∫Õπÿ≠“µ°“√ª√–°Õ∫‚√§»‘≈ª–„πª√–‡∑»‰∑¬
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Àπ૬ߓπ “∏“√≥ ÿ¢¿“§√—∞‰¥â
2. ¿“…“∑’Ë„™â„π°“√ ◊ËÕ “√‡ªìπÕÿª √√§µàÕ°“√
¥”‡π‘πß“π
3. ∑à“∑’¢Õß√—∞∫“≈ªí®®ÿ∫—π∑’˧àÕπ¢â“ß®–‰¡à‡ÀÁπ
§«“¡ ”§—≠„π°“√∑”ß“π¢ÕßÕߧå°√‡Õ°™π¡“°π—°
«‘®“√≥å
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¢Õß·µà≈–æ◊Èπ∑’Ë ´÷Ëß„π√–¬–·√°§«√ “πµàÕ§«“¡√à«¡¡◊Õ
‡¥‘¡∑’Ë¡’Õ¬Ÿà·≈â«°—∫Õߧå°√‡Õ°™π·≈–Àπ૬ߓπÕ◊Ëπ∑’Ë
‡°’ˬ«¢âÕß ‚¥¬Àπ૬ߓπ “∏“√≥ ÿ¢¿“§√—∞§«√ π—∫ πÿπ
·≈–Õ”π«¬§«“¡ –¥«°„Àâ°—∫Õߧå°√‡Õ°™π·≈–Àπ૬- ß“πÕ◊Ëπ∑’ˇ°’ˬ«¢âÕß „π°‘®°√√¡∑’ˇªìπª√–‚¬™πåµàÕß“π “∏“√≥ ÿ¢„Àâ¡“°∑’Ë ÿ¥ „π√–¬–µàÕ‰ª§«√· «ßÀ“
§«“¡√à«¡¡◊Õ®“°Õߧå°√‡Õ°™π‡æ‘Ë¡(11) ‚¥¬‡©æ“–„π æ◊Èπ∑’Ë∑’ˬ—߉¡à¡’Õߧå°√‡Õ°™π‡¢â“¡“¥”‡π‘πß“π
2. ∑—°…–∑’Ë®”‡ªìπ ”À√—∫‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢
√–¥—∫æ◊Èπ∑’Ë
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·≈–°“√‡¢â“∂÷ß™ÿ¡™π
2.3 ∑—°…–¥â“π°“√ ◊ËÕ “√¿“…“™“µ‘æ—π∏ÿåµà“ßÊ
·≈–¿“…“ “°≈
Õ¬à“߉√°Áµ“¡ ·π«∑“ß°“√æ—≤π“»—°¬¿“æ
¢Õ߇®â“Àπâ“∑’Ë “∏“√≥ ÿ¢√–¥—∫æ◊Èπ∑’Ë „π·µà≈–®—ßÀ«—¥
Õ“®®–·µ°µà“ß°—π ¢÷ÈπÕ¬Ÿà°—∫∫√‘∫∑¢Õßæ◊Èπ∑’Ë »—°¬¿“æ
¢Õ߇®â“Àπâ“∑’Ë §«“¡®”‡ªìπ‡√àߥà«π ·≈–ß∫ª√–¡“≥∑’Ë
„™â„π°“√æ—≤π“»—°¬¿“æ
3. °“√·°âªí≠À“ “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“ ∑’Ë
‰¥âº≈®–µâÕß·°âªí≠À“·∫∫Õߧå√«¡°“√®—¥∑”·ºπ
·¡à∫∑°“√·°âªí≠À“·≈–æ—≤π“ß“π “∏“√≥ ÿ¢™“¬·¥π
‰∑¬-æ¡à“√–¥—∫™“µ‘ ‡æ◊ËÕ„™â‡ªìπ°√Õ∫·π«∑“ß°“√
¥”‡π‘πß“π√à«¡°—π√–À«à“ßÀπà«¬ß“π¿“§√—∞Õ◊Ëπ·≈–
Õߧå°√‡Õ°™π ‡π◊ËÕß®“°ªí≠À“ “∏“√≥ ÿ¢™“¬·¥π‰∑¬- æ¡à“∑’ˇ°‘¥¢÷Èπ ∫“ߪí≠À“¡’ “‡ÀµÿÕ—π‡ªìπº≈æ«ß¡“®“°
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ªí≠À“‡»√…∞°‘®·≈– —ߧ¡ ´÷ËßÕ¬Ÿà¿“¬„µâÕ”π“® ∫∑∫“∑
·≈–¿“√°‘®¢ÕßÀ≈“¬°√–∑√«ß(12)
¢âÕ‡ πÕ·π–‡™‘ßπ‚¬∫“¬
1. à«π°≈“ß
1.1 „™âª√–‚¬™π宓°ß“π “∏“√≥ ÿ¢‡ªìπ·°π- π”„π°“√øóôπøŸ °√–™—∫§«“¡ —¡æ—π∏å∑«‘¿“§’ ‚¥¬‡ √‘¡
√â“ߧ«“¡ —¡æ—π∏å∑’Ë¥’·≈–§«“¡‰«â«“ß„®√–À«à“ß ª√–™“™π µàÕª√–™“™π Àπ૬ߓπµàÕÀπ૬ߓπ √—∞∫“≈
µàÕ√—∞∫“≈
1.2 °“√‡µ√’¬¡§«“¡æ√âÕ¡‡æ◊ËÕ√Õß√—∫ªí≠À“
“∏“√≥ ÿ¢∑’ˇ°‘¥¢÷Èπ®“°°“√æ—≤π“
‡π◊ËÕß®“°ªí≠À“ “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“ ·¡â
®–‰¡à‡¥àπ™—¥ ·µà®“°°“√æ—≤π“µà“ß Ê ‡™à𠂧√ß°“√
æ—≤𓇙◊ËÕ¡‚¬ß∑“ߧ¡π“§¡ ·π«µ–«—πÕÕ°-µ° (æ¡à“-
‰∑¬-≈“«-‡«’¬¥π“¡) °“√ à߇ √‘¡°“√§â“·π«™“¬·¥π
®÷ß∑”„À⧓¥°“√≥å«à“„πÕ𓧵ªí≠À“¥—ß°≈à“«®–‡æ‘Ë¡¢÷Èπ
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√Õß√—∫ªí≠À“ “∏“√≥ ÿ¢∑’Ë®–‡°‘¥¢÷Èπ À√◊Õ‰¡à¡’°“√·°â ªí≠À“Õ¬à“߇√àߥà«π®–°≈“¬‡ªìπªí≠À“ – ¡‡√◊ÈÕ√—ß
¬“°µàÕ°“√·°â ‰¢
1.3 °“√æ—≤π“ß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬- æ¡à“ ∑’Ë “¡“√∂¥”‡π‘πß“π‰¥â „π√–¬–·√°¿“¬„µâ
∑√—欓°√Õ—π®”°—¥ §«√√à«¡¡◊Õ°—∫Õߧå°√‡Õ°™π∑’Ë¡’Õ¬Ÿà
·≈â«„πæ◊Èπ∑’Ë·≈–· «ßÀ“§«“¡√à«¡¡◊Õ®“°Õߧå°√‡Õ°™π Õ◊ËπÊ
2. à«π¿Ÿ¡‘¿“§
2.1 º≈—°¥—π„Àâ¡’°“√®—¥∑”√–∫∫¢âÕ¡Ÿ≈¢à“« “√
“∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“ „À⇢⓰—∫√–∫∫¢âÕ¡Ÿ≈
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Àπ૬ߓπ¿“√√—∞ »—°¬¿“æ¿“§√—∞ »—°¬¿“æ¿“§‡Õ°™π Õߧå°√‡Õ°™π
1. ®. 1. °“√§«∫§ÿ¡‚√§ 1. ‘∑∏‘¡πÿ…¬™π 1. Õߧå°√√–À«à“ߪ√–‡∑»
2. Õ./ Õ. 2. °“√√—°…“欓∫“≈ 2. ß∫ª√–¡“≥ 2. Õߧå°√æ—≤π“‡Õ°™π
3. √æ»./√æ∑. 3. °“√ àßµàÕ 3. ‘Ëß·«¥≈âÕ¡ 3. Õߧå°√‡Õ°™π
4. √æ™. 4. °“√ à߇ √‘¡ 4. °“√¥”‡π‘πß“π∑’Ë
√«¥‡√Á«¬◊πÀ¬ÿàπ
°√Õ∫°≈‰° à߇ √‘¡ π—∫ πÿπ„À⇰‘¥§«“¡√à«¡¡◊Õ ß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“ ‰¥â√—∫°“√·°â‰¢
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§«“¡√à«¡¡◊Õ
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¡πÿ…¬ —¡æ—π∏å
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Journal of Health Science 2008 Vol. 17 Supplement I
SI214
¢à“« “√ ÿ¢¿“檰µ‘ ‡æ◊ËÕ‡ªìπ∞“π¢âÕ¡Ÿ≈„π°“√»÷°…“
«‘‡§√“–Àå ∂“π°“√≥å Õ—π®–π”¡“„™âª√–‚¬™πå„π°“√
«“ß·ºπ°“√¥”‡π‘πß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“
‰¥âÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ
2.2 §«√¡’°“√»÷°…“ªí≠À“ “∏“√≥ ÿ¢™“¬-
·¥π‰∑¬-æ¡à“„πæ◊Èπ∑’Ë ‡æ◊ËÕπ”º≈°“√»÷°…“¡“„™â„π°“√
®—¥∑”·ºπß“π/‚§√ß°“√ Õ—π®–™à«¬„Àâ°“√·°âªí≠À“
“∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“¡’§«“¡ Õ¥§≈âÕß°—∫
∂“π°“√≥å∑’ˇªìπÕ¬Ÿà®√‘ß
¢âÕ‡ πÕ·π–‡™‘ߪؑ∫—µ‘°“√
1. à«π°≈“ß
1.1 ”π—°π‚¬∫“¬·≈–¬ÿ∑∏»“ µ√å §«√
∑∫∑«π∫∑∫“∑ ¿“√°‘® ·≈–ª√—∫‚§√ß √â“ßÕߧå°√„Àâ
‡À¡“– ¡ ‡æ◊ËÕ∑”Àπâ“∑’ˇªìπ·°πª√– “πÀ≈—°„πß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“ „π¿“æ√«¡
1.2 °“√®—¥°≈‰° ·≈–‡§√◊Õ¢à“¬°“√ª√– “π ß“π∑—Èß„π√–¥—∫ à«π°≈“ß·≈– à«π¿Ÿ¡‘¿“§ ‡æ◊ËÕ “¡“√∂
ª√– “πß“π·≈–‡™◊ËÕ¡‚¬ß∑—ÈߢâÕ¡Ÿ≈·≈–°“√¥”‡π‘πß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“
1.3 °“√æ—≤π“∑—°…–‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢„π
√–¥—∫æ◊Èπ∑’Ë ‡æ◊ËÕ„Àâ¡’»—°¬¿“æ„π°“√¥”‡π‘πß“π “∏“√≥ ÿ¢
™“¬·¥π‰∑¬-æ¡à“ √à«¡°—∫Õߧå°√‡Õ°™π·≈–Àπ૬ߓπ Õ◊Ëπ Ê ∑’ˇ°’ˬ«¢âÕß
2. à«π¿Ÿ¡‘¿“§
2.1 °“√®—¥∑” ”¡–‚πª√–™“°√√“¬§√—«‡√◊Õπ
‡æ◊ËÕ„Àâ ‰¥â¢âÕ¡Ÿ≈‡™‘ߪ√‘¡“≥∑’˧√∫∂â«π‡ªìπªí®®ÿ∫—π Õ“®
„™â«‘∏’°“√ ”√«® ‡æ◊ËÕ∑√“∫®”π«π°≈ÿࡇªÑ“À¡“¬∫√‘°“√
∑’Ë·∑â®√‘ß „π°√≥’∑’ˉ¡à “¡“√∂‡ªî¥‡º¬¢âÕ¡Ÿ≈‰¥â §«√¡’
°“√®—¥∑”∞“π¢âÕ¡Ÿ≈‡©æ“–°‘® ‡æ◊ËÕ®–‰¥â∑√“∫À≈—°·À≈àß
∑’ËÕ¬ŸàÕ“»—¬ Õ—π®–π”¡“„™âª√–‚¬™πå„π°“√«“ß·ºπß“π “∏“√≥ ÿ¢
2.2 §«√®—¥„Àâ¡’°“√ª√–™ÿ¡√à«¡°—π√–À«à“ß Àπ૬ߓπ “∏“√≥ ÿ¢¿“§√—∞„πæ◊Èπ∑’Ë·≈–Õߧå°√‡Õ°™π
∑’Ë¥”‡π‘πß“π “∏“√≥ ÿ¢„πæ◊Èπ∑’Ë ‡æ◊ËÕ·≈°‡ª≈’ˬπ¢âÕ¡Ÿ≈
‡Õ° “√Õâ“ßÕ‘ß
1. ”π—°«‘™“°“√ “∏“√≥ ÿ¢. °≈¬ÿ∑∏姫“¡√à«¡¡◊Õ¥â“π “∏“√≥ ÿ¢
™“¬·¥π. ππ∑∫ÿ√’: Õߧ尓√√—∫ àß ‘π§â“·≈–æ— ¥ÿ¿—≥±å; 2542.
2. ”π—°π‚¬∫“¬·≈–¬ÿ∑∏»“ µ√å. °“√ “∏“√≥ ÿ¢‰∑¬. ππ∑∫ÿ√’:
°√–∑√«ß “∏“√≥ ÿ¢ ; 2540.
3. °√¡«‘‡∑» À°“√. ¢âÕ¡Ÿ≈·≈–π‚¬∫“¬¢Õß·À≈àߧ«“¡√à«¡¡◊Õ
°—∫µà“ߪ√–‡∑». °√ÿ߇∑æ¡À“π§√: §ÿ√ÿ ¿“; 2544
4. ”π—°ß“πÀ≈—°ª√–°—π ÿ¢¿“æ·Ààß™“µ‘. æ√–√“™∫—≠≠—µ‘À≈—°
ª√–°—π ÿ¢¿“æ·Ààß™“µ‘ æ.». 2545. ππ∑∫ÿ√’: ”π—°ß“π À≈—°ª√–°—π ÿ¢¿“æ·Ààß™“µ‘ ; 2545.
5. ”π—°ß“πªØ‘√Ÿª√–∫∫ ÿ¢¿“æ·Ààß™“µ‘. çÕ–‰√‡ªìπÕ–‰√? „π
°√–· °“√‡ª≈’ˬπ·ª≈ßé. ππ∑∫ÿ√’: ”π—°ß“πªØ‘√Ÿª√–∫∫
ÿ¢¿“æ·Ààß™“µ‘; 2544.
6. «‘™—¬ ‚™§«‘«—≤π. ª√‘∑—»πå‚√§µ‘¥µàÕ. ππ∑∫ÿ√’: ‚§√ß°“√
¢à“« “√·≈–· «ßÀ“§«“¡√à«¡¡◊Õ„π°“√æ—≤π“ß“π “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“ „Àâ¡’ª√– ‘∑∏‘¿“楒¬‘Ëߢ÷Èπ 2.3 §«√¡’°“√®—¥ª√–™ÿ¡√–À«à“ß®—ßÀ«—¥™“¬·¥π
‰∑¬§Ÿà°—∫√—∞™“¬·¥π¢Õß À¿“ææ¡à“ ‡æ◊ËÕ·≈°‡ª≈’ˬπ
‡∑§‚π‚≈¬’·≈–¢âÕ¡Ÿ≈¢à“« “√
2.4 §«√π”ª√–‡¥Áπªí≠À“ “∏“√≥ ÿ¢™“¬·¥π
‰∑¬-æ¡à“ ‰ª Ÿà°“√·°â ‰¢·∫∫∫Ÿ√≥“°“√ ¿“¬„µâ°“√
∫√‘À“√√“™°“√®—ßÀ«—¥·∫∫∫Ÿ√≥“°“√ (ºŸâ«à“ CEO) ∑’ˇπâπ
°“√¥”‡π‘πß“π·∫∫ AFP (Area, Function and Par- ticipation Approach) ·≈– à߇ √‘¡„ÀâÕߧå°√ª°§√Õß- à«π∑âÕß∂‘Ëπ‡¢â“¡“¡’ à«π√à«¡„π°“√¥”‡π‘πß“π‡æ‘Ë¡¡“°¢÷Èπ
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√—∞·≈–Õߧå°√‡Õ°™π ¥—ß√Ÿª∑’Ë 1
°‘µµ‘°√√¡ª√–°“»
¢Õ¢Õ∫§ÿ≥ πæ.¥”√ߧå ∫ÿ≠¬◊π ∑’ˉ¥â„À⧔ª√÷°…“
°√Õ∫·π«§‘¥„π°“√»÷°…“«‘®—¬ ·≈–¢Õ¢Õ∫§ÿ≥ºŸâ∫√‘À“√
π—°«‘™“°“√ ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢ ‡®â“Àπâ“∑’ËÕߧå°√‡Õ°™π
·≈– ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥∑’Ë„À⧫“¡√à«¡¡◊Õ ·≈–
π—∫ πÿπ°“√¥”‡π‘πß“πÕ¬à“ߥ’¬‘Ëß®π∑”„Àâ√“¬ß“π°“√
»÷°…“ ”‡√Á®≈ÿ≈à«ß‰ª¥â«¬¥’
Abstract Cooperation between Governmental and Non Governmental Organizations On Thailand-Myanmar Border Health Development
Rossukon Kangvallert*, Krisnan Lawnub*, Supawan Manimnakorn*, Lampoon Ingkapakorn*, Supparaporn Thammachart*
*Bureau of Policy and Strategy Office of the Permanent Secretary, Ministry of Public Health Journal of Health Science 2008; 17:SI207-15.
This qualitative research was a situation analysis on public health issues and coordination between Governmental Organizations (GOs) and Non- Government Organizations (NGOs) along Thailand-Myanmar Border. Both qualitative and evidence-based quantitative data were collected in 10 provinces by focus group interviewing, in-depth interviewing, observation and document re- views. All data were analyzed and verified to ensure that the accuracy and consistency results were reported.
Results of this study revealed that major public health problems along border area were com- municable diseases, mother and child health including family planning, environmental health and narcotic in hill tribe areas. Eight of ten provinces have established coordinating mechanism working with local NGOs and international NGOs organizations. The key success factors included aware- ness of governmental authorities, regular meetings to share experiences and information between GOs and NGOs lead to more efficient cooperation and relationship. The weakness factors were no clear policy on Thailand- Myanmar border health development and different on language. Recom- mendations include setting up a collaborative frameworks which are site specific and health man- power development related to necessary skills, proactive working technique and communication skills. In addition, MOPH should establish a core coordinating body that could serve as a focal point in coordination of the Thailand-Myanmar border public health program implementation among re- lated organizations at all levels.
Key words: cooperation, Thailand-Myanmar border, border health
«— ¥‘°“√«‘™“°“√ ∂“∫—πæ√–∫√¡√“™™π°; 2544
7. ”π—°ß“π‚√§µ‘¥µàÕ ‡¢µ 4. °“√«‘‡§√“–Àå ∂“π¿“æ°“√
¥”‡π‘πß“π§«∫§ÿ¡ªÑÕß°—π‚√§µ‘¥µàÕ·π«™“¬·¥π‰∑¬-æ¡à“ „π
‡¢µ “∏“√≥ ÿ¢∑’Ë 4 ªï æ.».2545. «“√ “√§«∫§ÿ¡‚√§ 2545;
29(1):30-8.
8. °ƒµ¬“ Õ“™«π‘™°ÿ≈. ‡√◊ËÕß‡æ» Õπ“¡—¬‡®√‘≠æ—π∏ÿå·≈–§«“¡
√ÿπ·√ß: ª√– ∫°“√≥å™’«‘µ¢Õß·√ßß“πÕæ¬æª√–‡∑»æ¡à“.
π§√ª∞¡: ∂“∫—π«‘®—¬ª√–™“°√·≈– —ߧ¡ ¡À“«‘∑¬“≈—¬¡À‘¥≈;
¡.ª.ª.
9. ”π—°π‚¬∫“¬·≈–¬ÿ∑∏»“ µ√å. (√à“ß) °“√»÷°…“ ∂“π°“√≥å
ªí≠À“ “∏“√≥ ÿ¢™“¬·¥π‰∑¬-æ¡à“. ππ∑∫ÿ√’: ”π—°π‚¬∫“¬
·≈–¬ÿ∑∏»“ µ√å; 2547.
10. πƒ¡≈ ªîµ‘∑“π—π∑å. ª√– ‘∑∏‘º≈Õߧ尓√¢Õß¡Ÿ≈π‘∏‘»ÿ¿π‘¡‘µ
·Ààߪ√–‡∑»‰∑¬ : ªí®®—¬·≈–ªí≠À“∑’Ë∑â“∑“¬ (ª√‘≠≠“»‘≈ª
»“ µ√å¡À“∫—≥±‘µ), “¢“√—∞»“ µ√å. ¡À“«‘∑¬“≈—¬‡°…µ√-
»“ µ√å; 2545.
11. °√–∑√«ß “∏“√≥ ÿ¢. “∏“√≥ ÿ¢‰∑¬‰√âæ√¡·¥π. °√ÿ߇∑æ-
¡À“π§√ : Õߧ尓√ ߇§√“–Àå∑À“√ºà“π»÷°; 2538.
12. ¥π—¬ °‘µ‘¿√≥å. ¥—™π’™’È«—¥°“√æ—≤π“ª√–‡∑»‰∑¬. «‘∑¬“π‘æπ∏å ª√‘≠≠“‚∑. °√ÿ߇∑æ¡À“π§√: ¡À“«‘∑¬“≈—¬∏√√¡»“ µ√å; 2544
