Concrete practice of community health construction: 20 years experience in Taiwan offshore islands

• Main Authors: Yu-Hsiu Liu, 劉育秀
• Other Authors: Pesus Chou
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/kr549p

碩士 === 國立陽明大學 === 公共衛生碩士學位學程 === 107 === Objective: In Taiwan, the indigenous community and offshore islands community health construction committee has been established since 2000. At the same time, the establishment of the offshore islands community health construction center has been continuously promoted. The centers have become a hub for promoting health related work in the offshore islands. However, there has not been research on the origin of this issue, development, systematic organization and discussion. Therefore, the purpose of our study was to explore specific practical experience of community health construction in offshore islands over the past 20 years. Method: The research focuses on the oral history, field observation, local interviews, and combines the data of the Health Human Rights Education Website and characteristics of community development. To Review the 20 years of counseling center for the establishments of the community health centers in the offshore islands and the importance of the public health bureau and the local committee in developing common guidance of the combination. By understanding the training of community volunteers, the participation of local community residents and the difficulty and obstacles in implementation, we will finally explore the factors that influence the promotion of sustained operations of the community health construction in the offshore islands. Results: The community health construction centers in the offshore islands has been divided into 3 stages: the establishment period of the offshore islands mechanism, the development period of the counseling team and the local conditions, and the maturity of the combining with intelligent technology. Currently, the sponsoring agencies of the 20 community health construction centers in the offshore islands are civil society organization and nongovernmental organization accounted for 50.0%, health centers accounted for 45.0%, and medical institutions accounted for only 5.0%, and community angles were more than 95%, but the number did not grow as expected. More than 100% of Penghu County and Liuqiu Township but still need to continue to train community angels. Through the joint leadership of local committee and the counselors, expedition of community residents to voluntarily participate in the activity in a bottom-up manner and the ability to proactively seek help are to be established. The research discussed two social issues, one of the new immigrant domestic violence. According to the statistics Ministry of the Interior National Immigration Agency (M.O.I.) as the end of March, 2019, the foreigners account for less than 1% of the total population, and the number of domestic violence incidents in the offshore islands account for 16%. The issue that can’t be ignored to understand and care for lives of new immigrant through home visit or family day by the community angels and managers and gradually form a community network to reduce the possibility of domestic violence. The second is solitary elder. Most of the emigration in the population in offshore islands. According to statistics of the Department of Household Registration, M.O.I., those over 65-year-old in population of offshore islands account for 1.04% of the total. According to the Ministry of Health and Welfare, the listed solitude elders in the offshore islands account for 4.8% of the over 65-year-old population, which is 3.7 times that of the national (1.3%). For the redistribution of power and resources, the guidance center recommended to adopt localized care. The proximity makes the elders feel more secure and enhances the relationship of trust. The Kinmen County and Penghu County joined with the summer volunteers from National Kinmen University and National Penghu University of Science and Technology. Injecting youth into the program, to truly implement the spirit of activating the elders and increase the willingness of the elder to go out of their homes to participate in activities. To achieve the risk and health concerns of reducing solitude elders, to continued effort of joint promotion with the non-governmental organizations to induce community awareness, will be the motivational force behind the community development. The difficulties during the execution are mainly the lack of community resources and integration, the dilemma of health care, and the poor retention of health bureau and community organizers. Recommendations for future research: firstly, sustainable development of the resources of offshore islands community; secondly, to provide community empowering; and thirdly, to cultivate the manpower resources need by the community to maintain the network of the offshore islands and sustained development. Conclusion: With the advent of Industrial Revolution 4.0, the use of high-tech products to “Self -quantification” has emerged in an endless stream that has gradually penetrated our daily lives. In 2011, the guidance center introduced the Health Human Rights Education website. After the transition period of paper period, 2018 combined with high-tech Web 2.0 into a mobile APP, it can immediately provide the elders their own current health status and intervention of health education for establishing a care and referral system. In 2015~2018, the top red-light issues was glaucoma, BMI, and sleep disorder with 25.4％, 19.3％, and 13.2％. Through referral of community angels and managers for medical treatment and follow-up household visit. Reducing irreparable diseases, and continued guidance and counseling, has gradually expanded into local villages and communities in the offshore islands.