Theorization of Community-based Problem Solving in PHC

近年来，健康问题、卫生专业人员与非专业人员之间的关系、家庭组成的变化、行业的变化以及社区组织和功能的变化都发生了变化。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，从不仅仅是一个国家的角度，而是从国际层面研究基于社区的健康问题的角度，就这一主题进行合作和工作。本研究的主要主题集中在“社区为基础”的术语和各种解释/理解。这一基本而又极其重要的观点是通过以下方面加以审查的：1）以社区为基础的活动与以医院和/或机构为基础的活动相对立的想法。2)在认识到医生、健康和医学专家在社区医学和社区卫生中的主要作用和领导力的同时;在以社区为基础的情况下，其特点是公民和非专业人士在活动中发挥主要作用并承担主要负担。3)以社区为基础的工作原则是，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掌握自己的生活和作出必要的个人生活方式改变上。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，当地调查的重点是贫困、低收入、残疾人、老年人以及糖尿病和艾滋病患者等，此外，还审查了自助团体、支助网络和其他志愿团体等志愿团体活动的最近形成和发展情况。

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.