Paradigm shifts for community health development by medical professions: A case study of health promoting hospitals devolved to local government in Thailand

Abstract

© Universiti Putra Malaysia Press. Paradigm is important to determine people's ideas, beliefs, values, and life-style of the people and understanding their problems. The first paradigm that had influence over the ideas, beliefs, values and practices of most people in earlier times was called Normal Science until the scientific revolution era. Where prior knowledge cannot explain a phenomenon or a new discovery occurs, for people in the community to agree with a new practice for changing behaviour and making life better, it's called a paradigm shift. This research aims to study and offer a new paradigm for community health development that the medical profession currently practices as Thailand's community health development paradigms are both biological models and centralisation, these present limitations on promoting people's health achievement and well-being. This research is "ethnography" based. Participants were selected from the health promoting hospitals in two areas in Thailand. The interviewees consisted of 11 participants. This research indicated that community health development comprised the community-based, holistic health, and decentralisation methodologies. The medical profession has many paradigms for integrating knowledge, skills and ability; the research limitation being longer time-scale and higher budgets. Paradigm shifts for community health development by the medical profession found benefits in decentralisation, community based solutions and holistic health. This study suggested that these issues should be studied, in addition to the impacted paradigms on community health status, within the next devade. The value of this study was to highlight the importance of initiating, implementing, and maintaining community health and to provide insights into the conditions that should be considered when planning and developing community health.