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All Journal Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Wungrath, Jukkrit
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Health Professions Public Health

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A Qualitative Exploration of Exclusive Breastfeeding Practices Among Karen Ethnicity Mothers in Northern Thailand Remote Rural Areas Ritthimon, Wanchalerm; Thongprachum, Aksara; Wungrath, Jukkrit
Kesmas Vol. 18, No. 3
Publisher : UI Scholars Hub

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Low exclusive breastfeeding rates among the Karen ethnic group in Northern Thailand's remote rural areas underscore the need to understand knowledge, attitudes, and social support to develop targeted interventions. This qualitative study examined exclusive breastfeeding practices and the factors influencing breastfeeding behavior among 14 Karen Ethnicity Mothers (KEMs) in Northern Thailand. A structured interview was used to collect the data, a triangular method to determine the data's validity, and a content analysis method to examine the data revealed seven themes and 14 subthemes. This study identified three key factors for successful breastfeeding: self-motivation, social support, and effective problem management, which included overcoming the family's anti-breastfeeding beliefs. Conversely, unsuccessful breastfeeding stemmed from four issues: inadequate maternal knowledge and misconceptions, family beliefs and culture, maternal health problems, and economic constraints. Therefore, the success of breastfeeding was heavily influenced by both personal and environmental factors. As a result, every KEM should be encouraged to recognize the importance of breastfeeding and to exclusively breastfeed for at least six months, especially those living in remote rural areas and have a different way of life than the natives.
The Effect of Fluid Overload Control Program on Knowledge and Behavior Among Caregivers of End-Stage Renal Disease Patients on Hemodialysis Ummee, Kanyanat; Rerkkasem, Kittipan; Wungrath, Jukkrit
Kesmas Vol. 18, No. 4
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End-stage renal disease (ESRD) is a pressing health issue, and patients on hemodialysis frequently grapple with fluid overload. In Chiang Mai, Thailand, from September to November 2022, this study was conducted to assess the impact of an educational program on the knowledge and behavior of caregivers managing fluid overload in ESRD patients. Using a quasi-intervention design, participants were categorized into two groups: the intervention group, which underwent the educational intervention, and the control group, which continued with standard care. The educational content was grounded in existing studiesand insights from healthcare professionals, caregivers, and patients. Post-intervention results revealed a significant enhancement in the knowledge andbehavior of caregivers in the intervention group regarding fluid overload control compared to the control group (p-value<0.05). This study emphasizes thepotential benefits of structured and evidence-based educational initiatives in equipping caregivers with the tools they need to better manage fluid balance, ultimately leading to improved patient outcomes.
The Effect of Health Promotion Program on Perceived Self-Efficacy and Self-Care Practices among Elderly with Multimorbidity in Chiang Mai, Thailand Wungrath, Jukkrit; Khumai, Nuttida; Phrommasen, Phinphot
Kesmas Vol. 17, No. 3
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Multimorbidity in the elderly is a major public health issue with serious consequences. This study investigated the effects of health promotion programs on perceived self-efficacy and self-care practices among the elderly with multimorbidity using a quasi-experimental study design from February to July 2021. The study samples were the elderly from Doi Saket District, Chiang Mai Province, Thailand, selected by a multistage random sampling technique. The experimental and control groups each comprised 40 elderlies with multimorbidity. All elderly participants took part in a 12-week health promotion program. The perceived self-efficacy and self-care practices of the study samples were assessed using interviews, and the group results were compared using the independent t-test. Repeated measures analysis of variance (ANOVA) was applied at a significance level of 0.05 for three different periods. Follow-up results after the intervention showed that the experimental group had significantly higher mean scores of perceived self-efficacy and self-care practice than the control group (p-value<0.05). The health promotion program enhanced perceived self-efficacy and self-care practices in the elderly with multimorbidity. It can also be applied to improve the quality of life of people in other age groups.
Home Births Among Ethnic Minority Communities in Bokeo Province, Lao People's Democratic Republic Wungrath, Jukkrit; Sriwongphan, Rungrasami; Kapheak, Krissana; Ritthimon, Wanchalerm
Kesmas Vol. 19, No. 4
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Home births among ethnic minorities in developing countries pose significant risks to maternal and neonatal health. In Lao PDR, the government has taken steps to manage home births through training traditional birth attendants, improving transportation, and establishing referral systems. However, high home birth rates in regions like Bokeo remain concerning. This review emphasized the need for more skilled birth attendants and better access to emergency obstetric care in rural, ethnic minority areas. This review used 40 articles published between 2000 and 2023 and highlighted gaps in research regarding healthcare access, cultural practices, socioeconomic barriers, and the role of traditional birth attendants. Suggested strategies included scholarships for midwifery training, expanding telemedicine, enhancing emergency transport, and partnering with NGOs for culturally sensitive outreach. Although each strategy has limitations, collectively, they can improve maternal and newborn health outcomes and reduce home birth risks. Addressing cultural beliefs and preferences is essential to encourage healthcare use, and community engagement plays a key role in promoting safer birth practices while respecting traditions. A holistic approach combining skilled healthcare, cultural sensitivity, and accessible services is crucial to improving maternal and newborn care in ethnic minority communities in Lao PDR.
Co-Authors Kapheak, Krissana Khumai, Nuttida Phrommasen, Phinphot Rerkkasem, Kittipan Ritthimon, Wanchalerm Sriwongphan, Rungrasami Thongprachum, Aksara Ummee, Kanyanat