monitoring of key health indicators triams at … of key health indicators (triams) at subdistrict...

REPORT

Monitoring of Key Health Indicators (TRIAMS) at Subdistrict Health Facilities Level in Tsunami-

affected Provinces in Thailand

Prepared by

Pratap Singhasivanon Irwin F. Chavez

Tanapat Chupraphawan Wanchai Maneebunyang Sutthiporn Prommongkol Sumrerng Prommongkol Phiraphon Chusongsang

Surapon Yimsamran

Faculty of Tropical Medicine Mahidol University

INTRODUCTION

The South Asian tsunami of 2004 has claimed thousands of lives and left

thousands of families homeless. Affected countries and their respective governments

alongside local and international non-governmental organizations have initiated numerous

programs for the reconstruction and rehabilitation of the affected areas. Recovery

activities are still ongoing and several are still being planned.

Of major interest now is to evaluate the progress of recovery in the affected areas.

The Tsunami Recovery Impact Assessment and Monitoring Systems (TRIAMS) have

been set up to initiate processes and strengthen regional and national mechanisms to

facilitate planning for further recovery activities, hence, the formulation of numerous core

Figure 1. Tsunami-affected areas in Thailand

and country-specific impact assessment and monitoring indicators under 4 major

headings: 1) vital needs, 2) basic social services, 3) infrastructure, and 4) livelihoods. But

in order to succeed in monitoring such indicators, a detailed and reliable database is

critical which necessitated the conduct of this survey.

The contents of this report are based on the survey of health-related TRIAMS

indicators. The survey was carried out from Nov 2006 to January 2007 in the 6 tsunami-

affected areas in Southern Thailand (Fig 1).

SPECIFIC OBJECTIVES:

1. To measure the impact of the tsunami on health using key indicators derived from

the TRIAMS.

2. To generate a baseline database of health-related indicators in the tsunami-

affected villages.

MATERIALS AND METHODS

Study area and data collection

Areas for this survey were confined to the tsunami affected of provinces of

Phangnga, Krabi, Phuket, Ranong, Trang and Satun wherein 408 out of the total 1,946

villages were affected1. The proportion of affected districts and subdistricts are listed on

the table below. Plates 1 & 2 show the district and subdistrict boundaries of the tsunami-

affected areas.

Table 1. Distribution of Tsunami-affected Areas by Administrative Level1

District Subdistrict Village Province Total Affected % Total Affected % Total Affected %

Krabi 8 5 62.5 61 22 36.1 379 114 30.1Phangnga 8 5 62.5 49 16 32.7 317 66 20.8Phuket 3 3 100.0 17 11 64.7 96 59 61.5Ranong 5 3 60.0 30 9 30.0 174 47 27.0Satun 10 4 40.0 95 16 16.8 713 70 9.8Trang 7 4 57.1 36 13 36.1 267 52 19.5

Total 41 24 58.5 288 87 30.2 1,946 408 21.0

ID DISTRICT 1 Muang Krabi 2 Ko Lanta 3 Khlong Thom 4 Ao Luk 5 Nua Khlong 6 Ko Yao 7 Takua Thung 8 Takua Pa 9 Khura Buri

10 Thai Muang 11 Muang Phuket 12 Kathu 13 Thalang 14 Muang Ranong 15 Kapoe 16 Suk Samran 17 Muang Satun 18 Tha Phae 19 Langu 20 Thung Wa 21 Kantrang 22 Palian 23 Sikao 24 Hat Samran

Plate 1

ID SUBDISTRICT ID SUBDISTRICT 1 Sai Daeng 45 Khlong Prasong

2 Pak Nam 46 Nua Khlong

3 Ngao 47 Khlong Khamot

4 Ko Phayam 48 Talingchan

5 Ratchakrut 49 Khlong Khanan

6 Kapoe 50 Ko Sriboya

7 Muang Kluang 51 Khlong Thom Tai

8 Bang Hin 52 Huai Nam Khao

9 Na Kha 53 Khlong Yang

10 Kamphuan 54 Ko Klang

11 Khura 55 Ko Lanta Noi

12 Ko Phra Thong 56 Saladan

13 Bang Wan 57 Ko Lanta Yai

14 Ko Kho Khao 58 Khlong Phon

15 Bang Muang 59 Sai Khao

16 Khukkhak 60 Khao Mai Kaeo

17 Lam Kaen 61 Bo Hin

18 Thung Maphrao 62 Mai Fat

19 Thai Muang 63 Bang Sak

20 Na Toei 64 Ko Libong

21 Khok Kloi 65 Na Klua

22 Lo Yung 66 Kan Tang Tai

23 Khlong Khian 67 Ban Na

24 Ko Yao Noi 68 Hat Samran

25 Ko Yao Yai 69 Tase

26 Phru Nai 70 Suso

27 Mai Khao 71 Ko Sukon

28 Sa Khu 72 Tha Kham

29 Choeng Tale 73 Na Thon

30 Kammala 74 Thung Bu Lang

31 Karon 75 Khon Khlan

32 Rawai 76 Laem Son

33 Chalong 77 Kamphaeng

34 Wichit 78 Pak Nam

35 Ratsada 79 La Ngu

36 Ko Kaeo 80 Ko Sarai

37 Pa Khlok 81 Sakhon

38 Laem Sak 82 Tha Phae

39 Ao Luk Noi 83 Chebilang

40 Khao Khram 84 Ban Khuan

41 Khao Thong 85 Tanyongpo

42 Nong Tale 86 Khlong Khut

43 Ao Nang 87 Puyu

44 Sai Thai - -

Plate 2

Data on specific key health indicators were collected from local health

facilities/offices. As annexed in the TRIAMS workshop report2, data for country

indicators vary in terms of their geographic scale (i.e. subdistrict or district levels). To

address this, subdistrict data were collected from health centers while district data were

taken from each district’s respective health office and community hospital. The table

below shows the list of identified indicators and their respective sources.

Table 2. Sources of Data for Key Health-related Indicators

AREA of RECOVERY INDICATOR HEALTH

CENTER COMMUNITY

HOSPITAL

DISTRICT HEALTH OFFICE

Crude mortality rate + + Demographic indices Under 5 mortality rate + +

% population with access to water from an improved source + +

% population without basic sanitation facilities + +

Measles immunization coverage + + % of low birth weight (LBW) newborns + + % of children <5 who are underweight + +

Vital needs

% children <5 who are wasting (moderate & severe) + +

No. of hospital beds per 10,000 population (in-patient and maternity) +

No. of outpatient consultations/person/year +

% children 12-23 months who are fully immunized against all antigens + +

No. of health facilities with Emergency Obstetric Care per 10,000 population +

Adequate antenatal coverage (at least 4 visits during a pregnancy) + +

% subdistrict covered by outreach psychological support by community workers

+

Access to basic social services

% birth attended by skilled birth attendant + +

Infrastructure % destroyed/damaged health facilities rebuilt or rehabilitated +

Data collection instruments

Standardized checklists and record forms translated into Thai language were used

to extract the relevant information on the listed health indicators from health centers,

district health offices, and community hospitals (ANNEXES I to VI).

Data management and analysis

Collected data were organized and processed using Microsoft® Access and

Microsoft® Excel. Maps were created with ArcView® 3.3 using the ESRI shapefile

specification (*.shp). Spatial analysis was performed using GeoDa™ 0.95i. Results are

presented through thematic maps and summary statistics.

Spatial analyses of the various indicators were carried out. These include the

identification of local clusters using Moran’s I for spatial autocorrelation at the subdistrict

level. The analysis considers the attribute values of each subdistrict and compares it with

the same attribute values of other adjacent areas considered as “neighbors”. A “neighbor”

in this case is an affected subdistrict that shares a common border with one or more other

affected subdistricts. This manner of identifying neighbors is called the rook contiguity.

Through the evaluation of how each subdistrict is related to each other in terms of

location and contiguity gives rise to numeric spatial weights essential in the calculation of

the relevant statistics.

Presence of global or overall clustering is given by the Moran’s I with p-values

calculated based on conditional permutation as implemented in GeoDa. The level of

significance was set at 0.05 under 999 permutations. Moreover, significant local

clustering was assessed using local Moran statistics calculated through randomization

(using 999 permutations). Subdistricts are then classified into 5 categories: not

statistically significant, HIGH-HIGH, LOW-LOW, HIGH-LOW, and LOW-HIGH

clusters.

In the analysis, a subdistrict with high attribute value contiguous to one or more

neighboring areas with similarly high values are classified as HIGH-HIGH clusters.

Conversely, areas with low values in proximity to neighboring areas with similarly low

values are classified as LOW-LOW clusters. HIGH-LOW clusters are areas with high

values surrounded by areas with low values, while LOW-HIGH clusters are areas with

low values surrounded by areas with high values. HIGH-LOW and LOW-HIGH clusters

are also known as spatial outliers since the neighboring values don’t agree with the local

values. HIGH-HIGH and LOW-LOW locations indicate positive local spatial

autocorrelation (spatial clusters) while HIGH-LOW and LOW-HIGH locations indicate

negative local spatial autocorrelation (spatial outliers)4. While spatial clusters may

highlight areas where recovery activities need to be strengthened, spatial outliers may

also provide insights where levels of specific indicators are not distributed

homogeneously.

DEMOGRAPHIC INDICES

Indicators such as crude and under 5 death rates give an overall picture of the

current standards of health in the surveyed areas. Crude death rates in the tsunami-

affected districts range from 1.8 per 1,000 population in Nua Khlong, Krabi to 17 per

1,000 in Muang Ranong, Ranong. On average, the crude death rate in the affected district

is at 4.63 + 2.95 per 1,000 (Table 3). Mortality rates of children under 5 years were

highest in Hat Samran, Trang with 5 per 1,000. Followed by Muang Ranong, Ranong

with 4.6 per 1,000 along with 11 other districts with rates <5 per 1,000. Other remaining

districts recorded zero under 5 death rates (Fig 2). Plates 3 to 10 illustrate the subdistrict-

level demographic indices in detail.

Table 3. Summary Statistics for District-Level Demographic Indices Thailand, 2006

Demographic indices No. of districts Mean SD Min Max Crude death rate 23 4.63 2.95 1.80 17.00 Under 5 death rate 20 0.89 1.47 0 5.00

Figure 2. Demographic Indices in Tsunami-affected Districts Thailand, 2006

Plate 3

Plate 4

ID SUBDISTRICT POPULATION CRUDE DEATH RATE (/1,000)

UNDER 5 DEATH RATE (/1,000)

1 Sai Daeng 4459 5.34 0.00 2 Pak Nam 7455 6.82 0.00 3 Ngao 6941 1.46 0.00 4 Ko Phayam 521 5.17 0.00 5 Ratchakrut 7663 4.38 0.00 6 Kapoe 6832 2.40 0.15 7 Muang Kluang 2997 2.10 0.00 8 Bang Hin 3888 2.39 - 9 Na Kha 4985 0.41 - 10 Kamphuan 4861 2.69 4.20

MEAN 3.32 0.54 SD 2.01 1.48 MIN-MAX 0.41-6.82 0-4.20

Plate 5



11 Khura 10745 1.61 - 12 Ko Phra Thong 898 4.69 33.00 13 Bang Wan 6193 0.15 0.00 14 Ko Kho Khao 833 2.35 - 15 Bang Muang 9980 11.35 - 16 Khukkhak 4127 3.86 0.00 17 Lam Kaen 5390 4.37 1.63 18 Thung Maphrao 8483 2.99 - 19 Thai Muang 11661 3.10 1.15 20 Na Toei 8365 2.53 - 21 Khok Kloi 10985 6.52 - 22 Lo Yung 5522 2.87 0.00 23 Khlong Khian 4009 2.98 - 24 Ko Yao Noi 4493 2.40 0.83 25 Ko Yao Yai 2408 2.40 0.00 26 Phru Nai 5528 2.70 0.37

MEAN 3.55 4.11 SD 2.51 10.85

MIN-MAX 0.15-11.35 0-33

Plate 6



27 Mai Khao 10181 2.87 0.00 28 Sa Khu 3642 2.87 0.00 29 Choeng Tale 10921 4.57 8.50 30 Kammala 3750 4.00 0.00 31 Karon 5112 5.91 0.32 32 Rawai 9902 4.49 0.64 33 Chalong 9585 5.15 0.88 34 Wichit 27401 4.49 0.88 35 Ratsada 20198 4.43 0.64 36 Ko Kaeo 7387 6.40 0.76 37 Pa Khlok 9007 3.34 0.00

MEAN 4.41 1.15 SD 1.13 2.47

MIN-MAX 2.87-6.40 0-8.50

Plate 7



38 Laem Sak 5313 3.38 0.00 39 Ao Luk Noi 5143 2.08 0.55 40 Khao Khram 8480 2.95 0.86 41 Khao Thong 5092 4.15 0.00 42 Nong Tale 7616 3.63 0.00 43 Ao Nang 5911 2.10 1.90 44 Sai Thai 10482 1.51 0.00 45 Khlong Prasong 4150 3.00 0.50 46 Nua Khlong 10778 - - 47 Khlong Khamot 4597 2.44 0.98 48 Talingchan 5191 3.07 0.33 49 Khlong Khanan 7342 3.07 - 50 Ko Sriboya 4221 1.66 0.00 51 Khlong Thom Tai 9731 3.98 1.34 52 Huai Nam Khao 7371 3.03 0.00 53 Khlong Yang 4777 - - 54 Ko Klang 6376 - - 55 Ko Lanta Noi 4204 - - 56 Saladan 3237 - - 57 Ko Lanta Yai 5220 - - 58 Khlong Phon 15814 5.00 - 59 Sai Khao 8721 1.80 0.00

MEAN 2.93 0.46 SD 0.97 0.61 MIN-MAX 1.51-4.15 0-1.90

Plate 8



60 Khao Mai Kaeo 5439 3.47 0.00 61 Bo Hin 7211 3.46 0.00 62 Mai Fat 6484 1.77 0.00 63 Bang Sak 4548 0.00 0.00 64 Ko Libong 5794 3.87 6.45 65 Na Klua 4097 6.10 0.00 66 Kan Tang Tai 6784 4.70 3.94 67 Ban Na 8996 6.41 0.00 68 Hat Samran 7769 1.99 0.00 69 Tase 3964 5.00 5.00 70 Suso 6021 4.72 0.00 71 Ko Sukon 2435 1.99 0.00 72 Tha Kham 8980 6.32 0.00

MEAN 3.83 1.18 SD 1.98 2.31 MIN-MAX 0-6.41 0-6.45

Plate 9



73 Na Thon 5489 1.55 0.00 74 Thung Bu Lang 2164 3.04 0.00 75 Khon Khlan 2009 4.22 0.00 76 Laem Son 3288 30.52 0.20 77 Kamphaeng 15897 - - 78 Pak Nam 8719 7.20 0.00 79 La Ngu 17983 4.03 0.03 80 Ko Sarai 4807 - - 81 Sakhon 6294 6.00 - 82 Tha Phae 8197 1.36 - 83 Chebilang 7940 - - 84 Ban Khuan 8951 - - 85 Tanyongpo 2767 - - 86 Khlong Khut 14565 - - 87 Puyu 2782 - -

MEAN 7.24 0.04 SD 9.62 0.08 MIN-MAX 1.36-30.52 0-0.20

Plate 10

VITAL NEEDS

These indicators focus on specific and basic needs such as food, water, and

sanitation which require immediate responses2 along with several nutritional indicators.

The following table and figures show the baseline data for these vital needs indicators.

Table 4. Summary Statistics for District-level Vital Needs Indicators Thailand, 2006

Vital needs No. of districts Mean SD Min Max

% Population with access to water from an improved source 24 97.80 6.04 74.4 100.00

% Population without basic sanitation facilities 21 1.17 2.88 0 12.20

Measles immunization coverage 24 98.80 2.41 90.00 100.00 % Low birth weight (LBW) newborns 24 5.29 2.59 1.20 10.70 % Children <5 who are underweight 24 5.96 7.66 0.10 38.10 % Children <5 who are wasting 17 5.23 6.17 0 25.20

Figure 3a. Vital Needs Indicators in Tsunami-affected Districts Thailand, 2006

Percent population with access to water from an improved source was lowest in

Ko Lanta district, Krabi with 74.4% followed by Kathu district, Phuket with 83.6%. The

rest of the affected districts have 90%-100% of its population with access to water.

Incidentally, the highest percentage of population without basic sanitation facilities was

highest in Ko Lanta, Krabi with 12.2%. Khlong Thom and Nua Khlong districts in Krabi

province both have 1% while Hat Samran and Kantrang districts of Trang have 1.2% and

4.2%, respectively. Khura Buri, Phangnga have 5% of its population without basic

sanitation facilities while the rest of the affected districts have such facilities (Fig 3a).

Figure 3b. Vital Needs Indicators in Tsunami-affected Districts

Thailand, 2006

Ko Lanta, Krabi have the lowest measles immunization coverage with 90%

followed by Thai Muang, Phangnga with 95%. Rest of the other affected districts has

more than 95% coverage as shown in Figure 3b. In the same figure, the proportion of low

birth weight (LBW) outcomes in each district is also illustrated. Percent LBW is highest

in Ko Lanta, Krabi with 10.7% closely followed by Hat Samran, Trang with 9.5% and

8.3% in both Palian, Trang and Ko Yao, Phangnga. On the other hand, the lowest

percentage of LBW outcomes is in Nua Khlong, Krabi.

Figure 3c. Vital Needs Indicators in Tsunami-affected Districts Thailand, 2006

Proportion of children under 5 years who are underweight was highest in Ko

Lanta, Krabi with 38.1% followed by Hat Samran, Trang (13.6%) and Kapoe, Ranong

(11.3%). The rest of the affected districts have <10% underweight children as shown in

Fig 3c above. From the same population of children under 5, the reported percentage of

wasting is highest in Ko Lanta, Krabi with 25.2%, Kapoe, Ranong with 11.3%, Hat

Samran, Krabi with 10.7%, and the remaining districts with less than 10%. Suk Samran

district in Ranong has no reported occurrence of wasting (Fig 3c).

Plates 11 to 22 illustrate detailed subdistrict-level data on the various vital needs indicators.

Plate 11

Plate 12

Plate 13

Plate 14

Plate 15

Plate 16

ID SUBDISTRICT POPULATION % WITH

ACCESS TO WATER

% WITHOUT BASIC

SANITATION

% MEASLES IMMUNIZATION

COVERAGE %

LBW % UNDER WEIGHT

% WASTING

1 Sai Daeng 4459 100.00 0.00 100.00 0.00 5.90 0.002 Pak Nam 7455 100.00 0.00 100.00 0.00 1.23 0.003 Ngao 6941 100.00 0.00 100.00 0.00 13.33 0.004 Ko Phayam 521 100.00 0.00 100.00 0.00 5.88 0.005 Ratchakrut 7663 100.00 0.00 98.82 0.00 3.20 0.006 Kapoe 6832 96.84 0.00 90.00 5.08 1.81 2.007 Muang Kluang 2997 95.00 0.00 100.00 0.00 4.90 0.008 Bang Hin 3888 100.00 0.00 100.00 4.60 5.40 0.009 Na Kha 4985 100.00 0.00 100.00 3.12 10.42 10.00

10 Kamphuan 4861 100.00 0.00 100.00 12.50 5.80 4.00MEAN 99.18 0.00 98.88 2.53 5.79 1.60SD 1.77 0.00 3.14 4.07 3.69 3.24

MIN-MAX 95-100 0.00 90-100 0-12.5 1.23-13.33 0-10

Plate 17


ACCESS TO WATER

% WITHOUT BASIC

SANITATION


COVERAGE %

LBW %

UNDER WEIGHT

% WASTING

11 Khura 10745 95.00 5.00 100.00 7.18 6.85 7.0012 Ko Phra Thong 898 16.43 0.00 83.33 16.66 13.33 -13 Bang Wan 6193 100.00 0.00 100.00 8.06 2.08 4.0014 Ko Kho Khao 833 100.00 0.00 100.00 0.00 0.00 0.0015 Bang Muang 9980 95.00 0.00 100.00 5.37 5.42 -16 Khukkhak 4127 90.14 0.00 100.00 5.06 2.26 0.0017 Lam Kaen 5390 100.00 0.00 95.00 12.22 5.22 9.0018 Thung Maphrao 8483 100.00 0.00 96.00 3.60 4.80 7.0019 Thai Muang 11661 100.00 0.00 100.00 8.71 4.60 0.0020 Na Toei 8365 100.00 0.00 97.00 10.95 4.46 6.0021 Khok Kloi 10985 100.00 0.00 100.00 4.44 3.24 -22 Lo Yung 5522 100.00 0.00 100.00 - 6.63 -23 Khlong Khian 4009 100.00 0.00 100.00 6.52 4.76 5.0024 Ko Yao Noi 4493 100.00 0.00 100.00 2.38 0.12 0.0025 Ko Yao Yai 2408 100.00 0.00 100.00 11.54 0.34 -26 Phru Nai 5528 100.00 0.00 100.00 10.45 1.23 -

MEAN 93.54 0.31 98.21 7.54 4.08 3.8SD 20.76 1.25 4.29 4.34 3.33 3.52

MIN-MAX 16.43-100.00 0-5 83.33-100.00 0-16.66 0-13.33 0-9

Plate 18


ACCESS TO WATER

% WITHOUT BASIC

SANITATION


COVERAGE % LBW % UNDER

WEIGHT %

WASTING

27 Mai Khao 10181 100.00 0.00 100.00 5.00 1.60 1.0028 Sa Khu 3642 100.00 0.00 100.00 6.30 3.90 2.0029 Choeng Tale 10921 100.00 0.00 100.00 4.20 0.53 0.0030 Kammala 3750 67.20 0.00 98.00 6.20 0.63 1.0031 Karon 5112 100.00 0.00 100.00 6.25 2.01 2.0032 Rawai 9902 100.00 0.00 100.00 3.57 1.67 2.0033 Chalong 9585 100.00 0.00 100.00 6.15 1.35 1.0034 Wichit 27401 100.00 0.00 100.00 3.12 0.77 1.0035 Ratsada 20198 100.00 0.00 100.00 14.75 10.86 11.0036 Ko Kaeo 7387 100.00 0.00 100.00 5.00 1.54 2.0037 Pa Khlok 9007 100.00 0.00 100.00 9.20 0.02 0.00

MEAN 97.02 0.00 99.82 6.34 2.26 2.09SD 9.89 0.00 0.60 3.24 3.03 3.05

MIN-MAX 67.20-100.00 0.00 98-100 3.12-14.75 0.02-10.86 0-11

Plate 19


ACCESS TO WATER

% WITHOUT BASIC

SANITATION


COVERAGE %

LBW %

UNDER WEIGHT

% WASTING

38 Laem Sak 5313 98.00 0.20 100.00 0.00 6.13 7.0039 Ao Luk Noi 5143 100.00 0.00 100.00 98.00 4.34 4.0040 Khao Khram 8480 100.00 0.00 100.00 5.00 0.30 0.0041 Khao Thong 5092 100.00 0.00 98.36 6.32 4.46 2.0042 Nong Tale 7616 100.00 0.00 100.00 0.13 2.70 0.0043 Ao Nang 5911 100.00 0.00 100.00 0.00 0.00 0.0044 Sai Thai 10482 100.00 0.00 100.00 4.26 0.90 0.0045 Khlong Prasong 4150 100.00 0.00 97.18 4.76 0.30 0.0046 Nua Khlong 10778 100.00 0.00 99.48 8.19 0.93 0.0047 Khlong Khamot 4597 92.00 0.00 98.00 5.90 6.10 4.0048 Talingchan 5191 100.00 0.00 100.00 3.85 2.46 5.0049 Khlong Khanan 7342 100.00 0.00 100.00 1.59 2.76 0.0050 Ko Sriboya 4221 100.00 0.00 100.00 0.00 0.93 0.0051 Khlong Thom Tai 9731 96.20 1.59 100.00 5.47 2.36 2.0052 Huai Nam Khao 7371 72.10 0.00 100.00 0.00 2.30 0.0053 Khlong Yang 4777 73.46 69.07 73.44 15.87 1.98 3.0054 Ko Klang 6376 74.18 7.39 84.19 5.12 1.19 2.0055 Ko Lanta Noi 4204 74.26 29.16 88.34 18.75 6.55 5.0056 Saladan 3237 74.54 21.19 69.36 11.11 1.51 5.0057 Ko Lanta Yai 5220 71.33 19.08 77.11 6.25 1.51 9.0058 Khlong Phon 15814 100.00 0.00 100.00 0.00 1.22 2.0059 Sai Khao 8721 95.00 0.00 100.00 6.00 1.60 1.00

MEAN 91.87 6.71 94.79 9.39 2.39 2.32SD 11.82 16.18 9.69 20.41 1.95 2.63

Min-Max 71.33-100 0-69.07 69.36-100 0-98 0-6.55 0-9

Plate 20


ACCESS TO WATER

% WITHOUT BASIC

SANITATION


COVERAGE %

LBW %

UNDER WEIGHT

% WASTING

60 Khao Mai Kaeo 5439 100.00 0.00 100.00 1.00 18.00 5.0061 Bo Hin 7211 100.00 0.00 100.00 5.88 5.29 2.0062 Mai Fat 6484 97.79 0.00 100.00 8.16 2.99 0.0063 Bang Sak 4548 100.00 0.00 100.00 12.69 1.94 -64 Ko Libong 5794 97.80 9.13 92.10 4.54 4.51 5.0065 Na Klua 4097 100.00 0.00 100.00 4.61 0.48 -66 Kan Tang Tai 6784 95.95 9.02 100.00 3.45 1.57 -67 Ban Na 8996 100.00 0.00 100.00 0.00 0.00 6.0068 Hat Samran 7769 100.00 0.00 100.00 0.00 8.80 9.0069 Tase 3964 100.00 1.15 100.00 9.52 4.81 2.0070 Suso 6021 100.00 0.00 100.00 0.00 2.07 2.0071 Ko Sukon 2435 100.00 0.00 100.00 0.00 15.00 10.0072 Tha Kham 8980 100.00 0.00 100.00 0.00 22.50 5.00

MEAN 99.35 1.48 99.39 3.83 6.76 4.60SD 1.31 3.38 2.19 4.25 7.24 3.20 Min-Max 95.95-100 0-9.13 92.1-100 0-12.69 0-22.5 0-10

Plate 21


ACCESS TO WATER

% WITHOUT BASIC

SANITATION


COVERAGE %

LBW % UNDER WEIGHT

% WASTING

73 Na Thon 5489 100.00 0.00 100.00 2.22 7.67 8.0074 Thung Bu Lang 2164 100.00 0.00 100.00 3.70 1.08 1.0075 Khon Khlan 2009 100.00 0.00 100.00 2.94 7.50 1.0076 Laem Son 3288 100.00 0.00 95.00 9.75 14.53 8.0077 Kamphaeng 15897 100.00 0.00 100.00 0.00 1.50 1.0078 Pak Nam 8719 100.00 0.00 100.00 0.00 4.23 6.0079 La Ngu 17983 100.00 0.00 100.00 4.44 5.83 19.0080 Ko Sarai 4807 100.00 0.00 100.00 8.82 6.10 1.0081 Sakhon 6294 100.00 0.00 100.00 2.50 1.60 1.0082 Tha Phae 8197 100.00 0.00 100.00 3.30 1.08 0.0083 Chebilang 7940 100.00 0.00 100.00 10.94 2.69 0.0084 Ban Khuan 8951 100.00 0.00 100.00 7.09 5.57 3.0085 Tanyongpo 2767 100.00 0.00 100.00 - 3.12 1.0086 Khlong Khut 14565 100.00 0.00 100.00 5.74 1.76 4.0087 Puyu 2782 100.00 0.00 100.00 4.35 6.77 2.00

MEAN 100.00 0.00 99.67 4.69 4.74 3.73SD 100.00 0.00 1.29 3.39 3.62 5.01

Min-Max 100.00 0.00 95-100 0-10.94 1.08-14.53 0-19

Plate 22

Table 5. Spatial Autocorrelation of Subdistrict-level Vital Needs Indicators in Thailand, 2006

Vital needs Moran’s I* p-value

% Population with access to water from an improved source 0.283 0.015

% Population without basic sanitation facilities 0.305 0.009 Measles immunization coverage 0.696 0.001 % Children <5 who are underweight 0.040 0.276

* using rook contiguity

Figure 4a. Cluster Maps of Vital Needs Indicators in Tsunami-affected Subdistricts Thailand, 2006

Table 5 shows the Moran’s I and the corresponding p-value for each indicator.

Positive Moran’s I values indicate that attributes of areas and their neighbors tend to be

similar. On the other hand, negative Moran’s I values suggest that the attribute of the

areas under study differ from the attributes of neighboring areas. From the same table, it

can be seen that at the subdistrict level, there is significant global clustering (p < 0.05) of

3 vital needs indicators (% population with access to water from an improved source, %

population without basic sanitation facilities, and measles immunization coverage).

Looking at the local clusters for % population with access to water (Fig 4a),

Khlong Yang and Saladan subdistricts in Krabi show significant LOW-LOW clustering

with the adjacent subdistricts. Raw data can be seen on (Plate 18). Choeng Tale

subdistrict in Phuket showed significant HIGH-LOW clustering since its indicator

measured 100% while its neighbor Kammala has only 67.2%. It also follows that

Kammala is a LOW-HIGH cluster. Other significant LOW-HIGH clusters are present in

Khura, Ko Phra Thong, Bang Wan, Ko Kho Khao & Ko Yao Noi (Phangnga), Pa Khlok

(Phuket), Ko Sriboya, Khlong Prasong & Laem Sak (Krabi), Kan Tang Tai & Ko Sukon

(Trang), and Ko Sarai subdistrict (Satun) as illustrated in Fig 4a.

Significant HIGH-HIGH clusters for percent population without basic sanitation

facilities occur in 4 subdistricts in Krabi: Ko Klang (7.39%), Ko Lanta Noi (29.16%),

Saladan (21.19%), and Ko Lanta Yai (19.08%). It’s worth to note that the highest for this

indicator is in Khlong Yang subdistrict, Krabi with 69.07% (Plate 18). The HIGH-LOW

clusters are in Ko Libong, Trang and Khura subdistrict, Phangnga. Conversely, the

number of LOW-HIGH clusters is more predominant with 11 subdistricts in all (Fig 4a).

Figure 4b. Cluster Maps of Vital Needs Indicators in Tsunami-affected Subdistricts Thailand, 2006

Measles immunization coverage show significant LOW-LOW clustering in Ko

Klang (84.19%), Ko Lanta Noi (88.34%), Saladan (69.36%), and Ko Lanta Yai (77.11%)

subdistricts in Krabi. The rest of the significant clusters are LOW-HIGH clusters in 14

subdistricts: Ko Phra Thong, Bang Wan, Ko Kho Khao, Na Toei & Ko Yao Noi

(Phangnga), Kammala & Pa Khlok (Phuket), Laem Sak & Ko Sriboya (Krabi), Ko

Libong, Kan Tang Tai & Ko Sukon (Trang), and Laem Son & Ko Sarai (Satun).

For the percentage of underweight children under 5, despite the lack of global

clustering (Table 5) a HIGH-HIGH cluster was detected in Bo Hin, Trang along with 10

other LOW-HIGH clusters.

ACCESS TO BASIC SOCIAL SERVICES

In the aftermath of the tsunami, the delivery of health and other basic services

have been affected. The following section summarizes the baseline levels of indicators

related to access to basic social services at the district and subdistrict scales.

Table 6. Summary Statistics for District-level Access to Basic Social Services in Thailand, 2006

Access to basic social services No. of districts Mean SD Min Max

No. of hospital beds per 10,000 population (in-patient and maternity) 23 18.14 18.58 0 67.33

No. of outpatient consultations/person/year 23 3.43 2.23 1.05 9.04

% Children 12-23 months who are fully immunized against all antigens 24 98.64 2.01 92.50 100.00

Adequate antenatal coverage (at least 4 visits during a pregnancy) 24 92.29 10.05 58.90 100.00

No. of health facilities with Emergency Obstetric Care per 10,000 population 23 0.23 0.20 0 0.80

% Birth attended by skilled birth attendant 24 99.91 0.29 98.70 100.00

% Subdistrict covered by outreach psychological support by community workers

24 58.56 40.45 0 100.00

Figure 5a. Access to Basic Social Services in Tsunami-affected Districts Thailand, 2006

District-level distribution of categorized hospital beds per 10,000 population is

illustrated on Figure 5a above. The highest ratio was observed in Muang district in Phuket

with 67.33 per 10,000. It also has the most number of hospital beds with 503. Khura Buri

and Takua Thung districts in Phangnga follow with a bed ratio of almost 50 per 10,000.

Five other districts belong to the 20 – 50 beds per 10,000 category; Ko Yao & Thai

Muang (Phangnga), Muang Ranong (Ranong), and Langu & Tha Phae (Satun). The

remaining districts have <20 beds per 10,000 with the lowest ratio in Ko Lanta, Krabi

with 3.57 beds per 10,000.

Figure 5b. Access to Basic Social Services in Tsunami-affected Districts

Thailand, 2006

The number of outpatient consultations per person/year average at 3.43+2.23;

lowest in Takua Pa, Phangnga with 1.05; highest in Takua Thung, Phangnga with 9.04

followed by Nua Khlong, Krabi with 8.51 and Kathu, Phuket with 8.05 consultations per

person/year. The percentage of children 12-23 months fully immunized against all

antigens reflect high coverage in all districts averaging 98.64% with two districts below

95% coverage (Fig 5b) wherein the lowest is 92.5% in Kantrang, Trang followed by Ko

Lanta, Krabi with 94.9%. Exactly half of the affected districts have recorded full

coverage: Ao Luk, Khlong Thom, and Nua Khlong in Krabi; Ko Yao, Phangnga; Tha

Lang and Muang Phuket in Phuket; Kapoe, Ranong; Muang Satun, Langu, and Tha Phae

in Satun; and Hat Samran & Sikao in Trang.

Figure 5c. Access to Basic Social Services in Tsunami-affected Districts

Thailand, 2006

The availability of emergency obstetric care in the affected districts is illustrated

in Figure 5c. The districts of Khura Buri (Phangnga), Ko Lanta (Krabi), Langu (Satun),

and Suk Samran (Ranong) reported to having no emergency obstetric care services. In all

the affected districts, percentage of women who received adequate antenatal care average

at 92.29% +10.05. Four districts, namely Khura Buri (Phangnga), Ko Lanta (Krabi),

Muang Satun (Satun), and Suk Samran (Ranong) have antenatal coverage less than 90%

(Fig 5b) while Ao Luk, Krabi and Muang Phuket, Phuket reported 100% antenatal

coverage.

Figure 5d. Access to Basic Social Services in Tsunami-affected Districts Thailand, 2006

The percentage of subdistricts covered by outreach psychological support by

community workers reported 100% coverage in 5 districts in Phangnga, 2 districts in

Ranong, and 1 each in Phuket and Satun (Fig 5d). However, 4 districts namely, Ko Lanta

(Krabi), Langu (Satun), Muang Ranong (Ranong), and Kathu (Phuket) reported not

having this basic social service in any of their subdistricts. Meanwhile, almost all districts

reported 100% births delivered by skilled birth attendants with the exception of Palian,

Trang with 98.7% followed by Tha Phae with 99.3%, and Muang Satun, Satun with

99.9%.

The following plates (Plates 23 to 31) show detailed data on the indicators for

basic social services at the subdistrict level.

Plate 23

Plate 24

Plate 25

ID SUBDISTRICT POPULATION % 12-23 MONTHS WHO ARE IMMUNIZED

% WITH ADEQUATE ANTENATAL CARE

% BIRTHS BY SKILLED BIRTH ATTENDANTS

1 Sai Daeng 4459 100.00 100.00 100.00 2 Pak Nam 7455 92.31 100.00 100.00 3 Ngao 6941 75.00 100.00 100.00 4 Ko Phayam 521 100.00 100.00 100.00 5 Ratchakrut 7663 87.74 96.88 100.00 6 Kapoe 6832 90.00 96.95 100.00 7 Muang Kluang 2997 100.00 86.00 100.00 8 Bang Hin 3888 100.00 100.00 100.00 9 Na Kha 4985 100.00 68.75 100.00

10 Kamphuan 4861 100.00 87.50 100.00 MEAN 94.51 93.61 100.00SD 8.38 10.22 100.00

Min-Max 75-100 68.75-100 100.00

Plate 26




11 Khura 10745 100.00 100.00 100.00 12 Ko Phra Thong 898 80.00 100.00 100.00 13 Bang Wan 6193 100.00 95.16 100.00 14 Ko Kho Khao 833 100.00 90.00 100.00 15 Bang Muang 9980 100.00 96.77 100.00 16 Khukkhak 4127 100.00 91.14 100.00 17 Lam Kaen 5390 97.00 92.22 100.00 18 Thung Maphrao 8483 94.00 95.45 100.00 19 Thai Muang 11661 99.20 94.00 100.00 20 Na Toei 8365 96.00 83.01 100.00 21 Khok Kloi 10985 98.00 95.35 100.00 22 Lo Yung 5522 100.00 100.00 100.00 23 Khlong Khian 4009 100.00 100.00 100.00 24 Ko Yao Noi 4493 100.00 97.50 100.00 25 Ko Yao Yai 2408 100.00 100.00 100.00 26 Phru Nai 5528 100.00 95.24 100.00

MEAN 97.76 95.37 100.00SD 5.07 4.66 100.00

Min-Max 80-100 83.01-100 100.00

Plate 27




27 Mai Khao 10181 100.00 98.00 100.00 28 Sa Khu 3642 100.00 100.00 100.00 29 Choeng Tale 10921 100.00 95.00 100.00 30 Kammala 3750 98.00 90.00 100.00 31 Karon 5112 100.00 100.00 100.00 32 Rawai 9902 100.00 100.00 100.00 33 Chalong 9585 100.00 100.00 100.00 34 Wichit 27401 100.00 100.00 100.00 35 Ratsada 20198 100.00 100.00 100.00 36 Ko Kaeo 7387 100.00 100.00 100.00 37 Pa Khlok 9007 100.00 97.00 100.00

MEAN 99.82 98.18 100.00SD 0.60 3.19 100.00

Min-Max 98-100 90-100 100.00

Plate 28




38 Laem Sak 5313 100.00 100.00 100.00 39 Ao Luk Noi 5143 100.00 98.00 100.00 40 Khao Khram 8480 100.00 100.00 100.00 41 Khao Thong 5092 96.45 90.53 100.00 42 Nong Tale 7616 100.00 100.00 100.00 43 Ao Nang 5911 100.00 100.00 100.00 44 Sai Thai 10482 100.00 100.00 100.00 45 Khlong Prasong 4150 97.30 90.48 100.00 46 Nua Khlong 10778 99.47 91.89 100.00 47 Khlong Khamot 4597 98.00 100.00 100.00 48 Talingchan 5191 100.00 100.00 100.00 49 Khlong Khanan 7342 100.00 100.00 100.00 50 Ko Sriboya 4221 100.00 100.00 100.00 51 Khlong Thom Tai 9731 100.00 95.89 100.00 52 Huai Nam Khao 7371 100.00 100.00 100.00 53 Khlong Yang 4777 87.34 61.53 82.14 54 Ko Klang 6376 79.67 64.28 100.00 55 Ko Lanta Noi 4204 92.04 91.66 97.02 56 Saladan 3237 68.36 89.71 100.00 57 Ko Lanta Yai 5220 84.34 92.59 100.00 58 Khlong Phon 15814 100.00 100.00 100.00 59 Sai Khao 8721 100.00 99.00 99.00

MEAN 95.59 93.89 99.01 SD 8.39 10.76 3.82

Min-Max 68.36-100 61.53-100 82.14-100

Plate 29




60 Khao Mai Kaeo 5439 100.00 98.00 100.00 61 Bo Hin 7211 94.73 94.73 100.00 62 Mai Fat 6484 100.00 100.00 100.00 63 Bang Sak 4548 100.00 90.32 98.38 64 Ko Libong 5794 100.00 90.90 100.00 65 Na Klua 4097 100.00 100.00 100.00 66 Kan Tang Tai 6784 97.88 100.00 100.00 67 Ban Na 8996 100.00 100.00 100.00 68 Hat Samran 7769 100.00 100.00 100.00 69 Tase 3964 100.00 98.00 100.00 70 Suso 6021 100.00 100.00 100.00 71 Ko Sukon 2435 100.00 95.00 100.00 72 Tha Kham 8980 100.00 100.00 100.00

MEAN 99.43 97.46 99.88 SD 1.53 3.57 0.45

Min-Max 94.73-100 90.32-100 98.38-100

Plate 30




73 Na Thon 5489 100.00 84.44 100.00 74 Thung Bu Lang 2164 100.00 100.00 100.00 75 Khon Khlan 2009 100.00 91.18 100.00 76 Laem Son 3288 100.00 100.00 100.00 77 Kamphaeng 15897 100.00 100.00 100.00 78 Pak Nam 8719 100.00 100.00 100.00 79 La Ngu 17983 100.00 100.00 100.00 80 Ko Sarai 4807 100.00 82.35 97.06 81 Sakhon 6294 100.00 100.00 100.00 82 Tha Phae 8197 100.00 92.13 100.00 83 Chebilang 7940 100.00 94.53 100.00 84 Ban Khuan 8951 100.00 92.91 100.00 85 Tanyongpo 2767 100.00 97.96 100.00 86 Khlong Khut 14565 100.00 51.67 100.00 87 Puyu 2782 100.00 86.96 100.00

MEAN 100.00 91.61 99.80 SD 100.00 12.61 0.76

Min-Max 100.00 51.67-100 97.06-100

Plate 31

Table 7. Spatial Autocorrelation of Subdistrict-level Access to Basic Social Services Indicators in Thailand, 2006

Access to basic social services Moran’s I* p-value

% Children 12-23 months who are fully immunized against all antigens 0.489 0.001

Adequate antenatal coverage (at least 4 visits during a pregnancy) 0.380 0.005

% Birth attended by skilled birth attendant -0.026 0.280 * using rook contiguity

The global Moran’s I for the % children 12-23 months fully immunized against all

antigens and adequate antenatal coverage show highly significant positive spatial

autocorrelation (Table 7) which indicates the presence of clustering of the said attributes

in the surveyed areas. To verify this, Figures 6a and 6b illustrate the local clusters for

these indicators.

Figure 6a below shows four LOW-LOW clusters were detected in Ratchakrut

(Ranong), Ko Lanta Noi, Saladan & Ko Lanta Yai (Krabi). One HIGH-LOW cluster was

also detected in Muang Kluang, Ranong. LOW-HIGH clusters again show predominance

with 12 subdistricts.

Figure 6a. Cluster Maps of Access to Basic Social Services in Tsunami-affected Subdistricts

Thailand, 2006

Figure 6b. Cluster Maps of Access to Basic Social Services in Tsunami-affected Subdistricts

Thailand, 2006

Spatial analysis of adequate antenatal coverage has detected LOW-LOW clusters

in Ko Klang (Krabi), and Ban Khuan & Puyu subdistricts in Satun. The rest of the local

clusters identified were LOW-HIGH clusters in 11 subdistricts.

Although the percentage of births attended by skilled birth attendants are 100% in

almost all subdistricts, only 2 HIGH-HIGH clusters were detected: Khura, Phangnga and

Tha Kham, Trang. HIGH-LOW clusters were detected in Huai Nam Khao, Ko Klang and

Saladan subdistricts in Krabi. Adjacent to these areas are 2 significant HIGH-LOW

clusters in Khlong Yang and Ko Lanta Noi also in Krabi. Other HIGH-LOW clusters

identified are in Ko Phra Thong, Bang Wan, Ko Kho Khao & Ko Yao Noi (Phangnga),

Pa Khlok (Phuket), Laem Sak, Ko Sriboya & Sai Khao (Krabi), Bang Sak, Kan Tang Tai

& Ko Sukon (Trang), and Ko Sarai (Satun) (Fig 6b).

INFRASTRUCTURE

Health facilities and its services are vital in ensuring the well-being of the

population within its catchment area. Several of these health facilities have been affected

by the tsunami. The succeeding section summarizes the extent of the damage as well as

the current state of these facilities.

Table 8. Summary Statistics for District-level Health-related Infrastructure Indicators in Thailand, 2006

Rehabilitation and

reconstruction No. of districts Mean SD Min Max

% Damaged/destroyed health facilities 24 6.91 12.08 0 50.00

% Health facilities rebuilt or rehabilitated 9 77.78 44.09 0 100.00

Figure 7. Rehabilitation and Reconstruction in Tsunami-affected Districts

Thailand, 2006 A total of 9 districts have reported to have at least one health center under their

supervision have been damaged or destroyed by the tsunami as seen in Figure 7. These

districts include Muang Ranong (6.67%), Kapoe (14.29%) & Suk Samran (25%) in

Ranong, Takua Pa (11.11%) and Khura Buri (16.67%) in Phangnga, Muang Phuket

(22.22%) & Kathu (50%) in Phuket, Palian (5.56%) in Trang, and Thung Wa (14.29%) in

Satun. Among these districts, all damaged or destroyed health centers have been repaired

or rehabilitated except the ones in Muang Ranong, Ranong and Kathu, Phuket (Fig 7).

PROBLEMS ENCOUNTERED & LIMITATIONS

Data collection

The biggest challenged encountered by our team of surveyors was the

unavailability of some data at the time of the survey. To solve this, the appropriate

checklists were given to local health personnel and subsequently have them sent as

priority mail to the Faculty of Tropical Medicine, Mahidol University. However, some

still failed to forward the information needed which resulted to a few indicators having

missing data.

Spatial analysis

Indicators with missing values have been dropped from the analysis since existing

methods and computer packages do not have adjustments for missing observations. So

only those with complete data can be analyzed. Furthermore, results of the spatial

analyses are purely exploratory and require more data to carry out more in-depth and

sophisticated analyses.

CONCLUSIONS AND RECOMMENDATIONS

Since data presented in this report shows baseline statistics for various health

indicators, constant surveillance of such variables is vital in monitoring the progress of

recovery activities. While all efforts have been made to collect data for all areas of

interest, some information were either inaccessible or not available which resulted to

missing information. The presence of capable local personnel who can manage and

analyze such data efficiently and promptly alongside a surveillance system to monitor all

indicators of interest (both health and non-health) will assure constant flow of high

quality data.

REFERENCES

1. Faculty of Tropical Medicine, Mahidol University. GIS Mapping of Health

Facilities in the 6 Tsunami-affected Provinces in Southern Thailand. 2005.

2. United Nations, World Health Organization, and International Federation of Red

Cross and Red Crescent Societies. Tsunami Recovery Impact Assessment and

Monitoring System. 2006

3. Anselin L. An Introduction to Spatial Autocorrelation Analysis with GeoDa. 2003.

4. Anselin L. Exploring Spatial Data with GeoDa™: A Workbook. Revised version.

2005

ANNEX I

Checklist for DISTRICT HEALTH OFFICE (DHO)

District Health Office ………………………………………. Address.………………………………………. ………………………………………. ………………………………………. ………………………………………. ………………… Tel ………………………………………. Fax ………………………………………. Recent health indicators in the population under responsibility of this DHO 1) Crude mortality rate (per 1000) 2) Children <5 mortality rate (per 1000) 3) % population with access to water from improved sources

4) % population without basic sanitation facilities 5) Measles immunization coverage (%)

6) % of children <5 who are underweight

7) % of children <5 who are wasting

8) % of low birth weight (LBW) newborns

9) % of children 12-23 months who are fully immunized against all antigens

10) Adequate antenatal coverage (at least 4 visits during pregnancy)

11) % birth attended by skilled birth attendants

12) Number of subdistricts in this district

13) Number of subdistricts covered by outreach psychological support by community workers

14) Number of Health Centers under supervision of this DHO

15) Number of Health Centers destroyed/damaged by tsunami

16) Number of Health Centers rebuilt of rehabilitated

Collector__________________

Position__________________

Date__________________

A

ANNEX II

Checklist for HEALTH CENTER

Health Center ………………………………………. Address.………………………………………. ………………………………………. ………………………………………. ………………………………………. ………………… Tel ………………………………………. Fax ………………………………………. Recent health indicators in the population under responsibility of this Health Center 1) Crude mortality rate (per 1000) 2) Children <5 mortality rate (per 1000) 3) % population with access to water from improved sources

4) % population without basic sanitation facilities 5) Measles immunization coverage (%)

6) % of children <5 who are underweight

7) % of children <5 who are wasting


9) % of children 12-23 months who are fully immunized against all antigens

10) Adequate antenatal coverage (at least 4 visits during pregnancy) (%)

11) % birth attended by skilled birth attendants

Collector__________________

Position__________________

Date__________________

B

ANNEX III

Checklist for HOSPITAL

Hospital ………………………………………. Address.………………………………………. ………………………………………. ………………………………………. ………………………………………. ………………… Tel ………………………………………. Fax ………………………………………. Recent health indicators in the population under responsibility of this Hospital 1) Number of population in the catchment area of this hospital 2) Number of hospital beds (in-patient and maternity) 3) Number of outpatient consultations per year

4) Availability of Emergency Obstetric Care in this hospital Yes No


6) Adequate antenatal coverage (at least 4 visits during pregnancy) (%)

Collector__________________

Position__________________

Date__________________

C

ANNEX IV

แบบบันทึกขอมูลจากสํานักงานสาธารณสุขอําเภอ โครงการสํารวจคุณภาพชีวิตของประชาชนในพื้นท่ีประสบภัยคลื่นสึนามิ

สํานักงานสาธารณสุขอําเภอ..............................................................................

ที่อยู : เลขที่........ ..... หมูที่........... บาน........................................ ตําบล..............................................

อําเภอ.......................................................... จังหวัด...................................................................

โทรศัพท............................................. โทรสาร............................................

ดัชนีสาธารณสุขปจจุบันในประชากรที่อยูในความรับผิดชอบของสํานักงานสาธารณสุขอําเภอนี้

1. อัตราตายอยางหยาบ (Crude mortality rate) _____ /1,000 ปชก.

2. อัตราตายในเด็กอายุต่ํากวา 5 ป ____ /1,000 ปชก. เด็ก <5 ป

3. รอยละของประชากรที่มีน้ําใชจากแหลงน้ําที่สะอาด รอยละ

4. รอยละของประชากรที่ไมไดรับการบริการพื้นฐานดานสุขาภิบาล รอยละ

5. อัตราครอบคลุมของการไดรับวัคซีนปองกันโรคหัด รอยละ

6. รอยละของเด็กต่ํากวา 5 ปที่มีภาวะน้ําหนักต่ํากวาเกณฑอายุ รอยละ

7. รอยละของเด็กต่ํากวา 5 ปที่มีภาวะน้ําหนักต่ํากวาเกณฑความสูง รอยละ

8. รอยละของเด็กเกิดใหมทีม่ีน้ําหนัก <2500 กรัม รอยละ

9. รอยละของเด็กอายุ 12-23 เดือน ที่ไดรับภูมิคุมกันโรคครบทุกชนิดที่กําหนด

รอยละ

10. รอยละของหญิงฝากครรภที่ไดรับการตรวจกอนคลอดครบ 4 ครั้ง รอยละ

11. รอยละของการคลอดโดยแพทย/พยาบาล/ผดุงครรภทีไ่ดรับการอบรมแลว

รอยละ

12. จํานวนตําบลที่อยูในอําเภอนี้ ตําบล

13. จํานวนตําบลที่มีทีมงานจิตวิทยาใหความชวยเหลือหลังเกิดสึนามิ ตําบล

14. จํานวนสถานีอนามัย ที่อยูในความรับผิดชอบของ สสอ. นี้ แหง

15. จํานวนสถานีอนามัย ที่เสียหายจากคลื่นสึนามิ แหง

16. จํานวนสถานีอนามัย ที่ไดรับการสรางใหมหรือฟนฟูแลว แหง

ผูบันทึก................................................................

ตําแหนง..................................................................

AA

วันที่................................................................

ANNEX V

แบบบันทกึขอมูลจากสถานีอนามัย

โครงการสาํรวจคุณภาพชีวิตของประชาชนในพื้นที่ประสบภัยคลื่นสึนาม ิ

ชื่อสถานีอนามัย..............................................................................

ที่อยู : เลขที่........ ..... หมูที่........... บาน........................................ ตําบล....................................................

อําเภอ.......................................................... จังหวัด.........................................................................

โทรศัพท............................................. โทรสาร............................................

ดัชนีสาธารณสุขปจจุบันในประชากรที่อยูในความรับผิดชอบของอนามัยน้ี

1. อัตราตายอยางหยาบ _____ /1,000 ปชก.

2. อัตราตายในเด็กอายุต่ํากวา 5 ป ____ /1,000 ปชก. เด็ก <5 ป

3. รอยละของประชากรที่มีน้ําใชจากแหลงน้ําที่สะอาด รอยละ

4. รอยละของประชากรที่ไมไดรับการบริการพื้นฐานดานสุขาภิบาล รอยละ

5. อัตราครอบคลุมของการไดรับวัคซีนปองกันโรคหัด รอยละ

6. รอยละของเด็กต่ํากวา 5 ปที่มีภาวะน้ําหนักต่ํากวาเกณฑอายุ รอยละ

7. รอยละของเด็กต่ํากวา 5 ปที่มีภาวะน้ําหนักต่ํากวาเกณฑความสูง รอยละ

8. รอยละของเด็กเกิดใหมทีม่ีน้ําหนัก < 2500 กรัม รอยละ

9. รอยละของเด็กอายุ 12-23 เดือน ที่ไดรับภูมิคุมกันโรคครบทุกชนิดที่กําหนด

รอยละ

10. รอยละของหญิงฝากครรภที่ไดรับการตรวจกอนคลอดครบ 4 ครั้ง รอยละ

11. รอยละของการคลอดโดยแพทย/พยาบาล/ผดุงครรภทีไ่ดรับการอบรมแลว

รอยละ

ผูบันทึก................................................................

ตําแหนง..................................................................

วันที่................................................................

B

ANNEX VI

แบบบันทกึขอมูลจากโรงพยาบาลชมุชน

โครงการสาํรวจคุณภาพชีวิตของประชาชนในพื้นที่ประสบภัยคลื่นสึนาม ิ

ชื่อโรงพยาบาล..............................................................................

ที่อยู : เลขที่........ ..... หมูที่........... บาน........................................ ตําบล....................................................

อําเภอ.......................................................... จังหวัด.........................................................................

โทรศัพท............................................. โทรสาร............................................

ดัชนีสาธารณสุขปจจุบันในประชากรที่อยูในความรับผิดชอบของโรงพยาบาลชุมชนน้ี

1. จํานวนประชากรที่อยูในเขตรับผิดชอบของโรงพยาบาลนี้ คน

2. จํานวนเตียงผูปวยในและเตียงคลอด เตียง

3. จํานวนผูปวยนอกตอป รายตอป

4. โรงพยาบาลนี้มีบริการผูปวยภาวะฉุกเฉินทางดานสูติศาสตรหรือไม? มี

ไมม ี

5. รอยละของเด็กเกิดใหม (ที่คลอดในร.พ.นี้) ที่มีน้ําหนัก <2500 กรัม รอยละ

6. รอยละของหญิงฝากครรภที่ไดรับการตรวจกอนคลอดตั้งแต 4 ครั้งขึ้นไป

รอยละ

ผูบันทึก................................................................

ตําแหนง..................................................................

วันที่................................................................

C

monitoring of key health indicators triams at … of key health indicators (triams) at subdistrict...

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