Theorization of Community-based Problem Solving in PHC

近年来，健康问题发生了变化，卫生专业人员和非专业人员之间的关系发生了变化，家庭组成发生了变化，工业发生了变化，社区的组织和功能也发生了变化。发达国家和发展中国家之间的变化程度正在迅速成为一个问题。这项研究汇集了来自美国(夏威夷)、泰国和日本的研究人员，不仅从一个国家的角度，而且通过在国际层面上审查基于社区的健康问题，在这一主题上进行合作和工作。本研究的主题集中在“社区为本”的概念和各种解释/理解上。这一基本但极其重要的观点通过：1)社区活动而不是以医院和/或机构为基础的想法来检验。2)在承认医生、卫生和医疗专家在社区医学和社区卫生中的主要作用和领导作用的同时；在以社区为基础的情况下，特点是公民和普通人在活动中发挥主要作用和承担主要负担。3)以社区为基础的工作的原则是，重点应放在与健康有关的社会、环境和行政因素上，而不是把重点放在每个人控制自己的生活和做出必要的个人主义生活方式改变上。4)以社区为基础的“社区”的含义包括加强公民、组织和机构之间的合作、协作和组织。地方调查的主要重点是贫困、低收入、残疾人、老年人以及糖尿病和艾滋病患者等，并着眼于加强合作和建立支持系统。此外，还考察了自助小组、支持网络和其他志愿者小组等志愿团体活动的较新形成和发展。

Recent years have seen changes in health problems, the relationship between health professionals and lay people, changes in family composition, changes in industry, accompanied by changes in the organization and function of the community. The degree of change between developed and developing countries is rapidly becoming an issue. This research brings together researchers from the U.S. (Hawaii), Thailand and Japan to collaborate and work on this topic from the perspective of not just one country but rather by examining community-based health problems on an international level. The main theme of this research focuses on the term and the various interpretations/understandings of "community-based". This basic yet extremely important point is examined through : 1) the idea of community-based activity as opposed to hospital and/or institution-based. 2) While recognizing the major role and leadership of physicians, health and medical specialists in community medicine and community health ; in community-based, the characteristic is that the citizens and lay people play the main role and bear a major part of the burden in activities. 3) Community-based works on the principle that emphasis should be on health-related social, environmental and administrative elements, in contrast to the focus being on each person taking control of his/her life and making the individualistic lifestyle changes needed. 4) The "community" in community-based includes in its meaning the strengthening of cooperation, collaboration and organization among citizens, organizations and institutions.The main focus of the local surveys was on poverty, low-income, handicapped, elderly as well as diabetic and AIDS patients, etc., and looked at strengthening cooperation and the establishment of support systems.In addition, the rather recent formation and development of activities of voluntary groups such as self-help groups, supportive networks and other volunteer groups was examined.