Tailor-Made Distance Education as a Retention Strategy: The "Learning at the Workplace" Program in Thailand

Tailor-Made Distance Education as a Retention Strategy: The "Learning at the Workplace" Program in Thailand

Prathurng Hongsranagon (Chulalongkorn University, Thailand)
DOI: 10.4018/978-1-61520-885-2.ch010
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In rural areas of Thailand, health center personnel are responsible for primary health care. The opportunity for continuing education is imperative in the attraction and retention of these workers at their primary locations. The provision of continuing education also increases the quality and spectrum of health care available for the local people leading to better health outcomes for the Thai population. Distance education is one promising form of continuing education involving the use of advanced communication technologies to allow health center staff to continue to work and study off-campus. This chapter describes a tailor-made “Learning at the Workplace” distance education program provided to Thai rural health center personnel through the College of Public Health Sciences at Chulalongkorn University. Focus group discussions and selected quantitative research methods are recommended to evaluate the effectiveness of this learning model and determine the educational needs of health workers. Learning at the Workplace is expected to make a new contribution to the local needs of continuing education among the health care workforce in Thailand. This chapter emphasizes the potential that distance education offers to attract and retain health care personnel as well as the importance of providing a tailor-made curriculum in response to different regional and epidemiological factors.
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Levels of Health Care Services in Thailand

Thailand’s health care services are divided into five levels based on the complexity of services provided.

  • 1.

    Self Care Level: Encompasses health services concerned with the potential of individuals to care for their own health and the health of their families.

  • 2.

    Primary Health Care Level: Encompasses health services implemented at the community level. Primary health care incorporates the four cornerstones of the public health discipline: health promotion, health prevention, treatment, and rehabilitation. It uses minimal technology and is provided by community volunteers.

  • 3.

    Primary Care Level: Encompasses health services provided through formal health care personnel such as physicians. This level covers four different groups:

    • a.

      Village-level community public health centers responsible for 500-1,000 individuals

      • b. Tambon-level health centers responsible for 1,000-5,000 individuals

        • c.

          Local medical clinics

        • d.


  • 4.

    Secondary Care Level: Encompasses health services offered through medium-size hospitals in both the public and private sectors.

  • 5.

    Tertiary Care Level: Encompasses health services offered through large hospitals in both the public and private sectors.

This chapter focuses primarily on the tambon-level health centers considered the first line of (formal) health service operating closest to the community. According to a report from the Thailand Health Profile 2001-2004, there were 9,765 tambon (rural) health centers in the country (Noree, Chokchaichan, & Mongkolporn, 2005, p.4). The function of health care workers operating at this level is to focus on health promotion, health prevention, and treating patients within a designated area of responsibility. The health care workforce operating at these health centers are midwives, nurses, community dentists, and public health technical officers. For job orientation and academic knowledge, health center workers rely on community hospitals in their respective clusters to give support (Mongkolporn, Ankleepan, Kanchanachitra, & Tangcharoensathien, 2005, pp. 6-7).

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