Dusadee Aryuwat Ph.D (Demography)
Faculty of Humanities & Social Sciences Khon Kaen University
ABSTRACT
This study aimed to describe health security promotion process. The concept was based on ‘Social Capital’ which was cited by Williams (1978), Coleman (1988), Bourdieu (1998), Putnam (1993), and Woolcock (2001). Qualitative research method was applied to collect information by utilizing observation, in-depth interview, and focus group methods in households who lived in Northeastern provinces of Thailand, from August 2008 to February 2009, and it is analyzed by content analysis.
The results showed that perception of rural families about health security was covered in four health dimensions such as physical health, mental health, social health, and spiritual health. They have been promoted the processes through three types of social capital, first was “Bounding Social Capital” which was a health security by socialization such as wisdom transmitted from family genes; health care belief holding such as: nutrition and spiritualization, which show health security of rural families consisting of; physical health dimension because clean food promotes good health and mental health dimensions. When there is discomfort--their families have been healed. Secondly, another type is promoted by ’Bridging Social Capital’ it shows collective action. Those are formal types consisting of; housekeeping groups, TO BE NUMBER ONE teenage groups, health volunteer groups, funeral (cremation) groups and elderly groups. On the other hand, an informal type consisting of; cultural maintenance groups and ceremonial norms. It shows health security of families in social health dimensions because of social healing and spiritual health dimensions because of knowledge sharing. Finally, a type promoted by the ‘Linking Social Capital’ consisting of; HIV positive network groups, education camps, health security sub-district fund, health center service, Emergency Medical Service (EMS), One Tambon One Search and Rescue Team (OTOS), and good public assessment. It shows health security in families, and good physical health, because EMS and OTOS are used in a short time service. For mental health; their families have impression (no premium) and Social health because of reciprocity. Finally, spiritual health; because when there is knowledge in families, there is knowledge sharing and they would have been adoption in the future.
Keyword: Health Security, Social Capital
INTRODUCTION
Before this, the health care system had its base on local knowledge, social interaction, cultural relationship, norm, and social order. (1) People who live in family expect good health to be covered in all health dimensions contain of; physical health, mental health, social health, and spiritual health. They could decide on an alternative choice for a way of life for themselves through their own local knowledge. It seems that families were secure for life. (2)
Normally, families do what they can to promote their own happiness, but in cases ill health and discomfort, they could be accessed in the health service system. All of these, reflect “Family Health Securities” which have three indicator components consisting of; sustainable health, enabling factors, human equity factors, and basic minimum needs for their livelihood. Therefore, most of these can be covered in physical health, mental health and social health (3). From these, it shows that the effects of families living in rural areas live longer lives, are happy, and healthier. It is shown that families could be accessed in health service systems when their illnesses comply with the health system. Also, integrated functional management views consist of; economic, social, and cultural views. Including basic minimum needs for livelihood, such as: food security and nutrition, clothing, a home, education, relaxation, social interaction, and a healthy environment; all of these for family well being. As a result, these were reflected in ‘Health Security’. (4) Moreover, there is a health insurance for holistic health care (5). Social changes for livelihood in the Thai community have been affected through agricultural norms. Agricultural norms for economic and marketing forms are a big influence for health policies at present. (6)
However, families in rural communities have security systems giving solidarity within their culture. Specifically, those families living in Northeastern, Thailand. Hence, part of the community system meaning ‘Social Capital’. (7) As a result, the development in communities having a community cultural order as in the ‘Social Capital Concept’
Research question: “How do health security promotions and processes of rural families in Northeastern (E-san), Thailand develop?
Concept/theory:
‘Social Capital’ insofar as it was a power of social movements which have influenced members and individuals in calling for ‘Collective Action’.(8)
Besides, ‘Social Capital’ which consisted of; trust, norm, and networks which were reciprocity. At the top of these, it was possible for an enterprise and construction of a network. (9) (15)
In addition, ‘Bounding Social Capital’ which denotes ties between likes people in similar situations, such as immediate family, close friends and neighbors. ‘Bridging Social Capital’, which encompasses more distant ties of like persons, such as loose friendships and workmates; and ‘Linking Social Capital’ which reaches out to unlike people in dissimilar situations, such as those who are entirely outside the community, thus enabling members a leverage at a far wider range of resources than is available within the community. (10)
After this argument issue; Putnam has recently embraced Woolcock’s ideas of bounding and bridging ties, but does not really explore the logical conclusion, which is that different combinations of three types of social capital will produce difference outcomes. (11)
On balance, it seems that Coleman’s approach has the greatest potential for producing new insights into social and political behaviour. His view of social capital as a distributed resource may have been what led Robert Putnam to identify Coleman as a key influence in his own first full-length treatment of social capital (12) Putnam’s work, while popularizing the concept and bridging it to new audiences, has also been clearly rooted in empirical evidence, and this has in turn generated significant new debates as scholars seek to test his idea and evidence against their own. Bourdieu’s usage is somewhat more narrow than Coleman’s or Putnam’s, but its locations within a wider account of the social space could prove fruitful, while his debt to neo-Marxism bring a strong recognition of the connection between social capital and power—something largely ignored by Putnam and Coleman. However, even Coleman’s approach requires further refinement. It privileges particular types of social capital, in particular the family, and downplays the role of loose networks and ties. It is not only somewhat normative, but might even be accused of naivety and optimism. It is insufficiently attentive to conflict and power.
Yet, it would be wrong to follow those who believe the concept to be too loose and elastic to have any analytical value. Alejandro Portes has argued that while the concept does call attention to ‘real and important phenomena’, the time is arriving ‘at which social capital come to be applied to so many events and in so many contexts as to lose any distinct meaning’ (13) But the same could be said – indeed has been—of virtually any concept in the social sciences, including human capital, power, class and gender. It is particularly relevant to this discussion to recall that, as Raymond Williams pointed out over thirty years ago the concept of ‘community’ is used in a variety of different ways; what is more, the only thing they all had in common was that no one ever used the term unfavourably (14) So the issue is not whether a concept can be applied loosely, but whether it leads to new insights when finely applied. In drawing our attention to the ways in which networks and shared value function as a resource for people and organizations, the concept of social capital has earned its share of the social scientific limelight.
METHODS
Methodology: This paper has explored in phenomenon which was designed to reflect the empirical data in real time that it was community unit of analysis both individual and social.
Participant recruitment: This study has recruited household purposes in community which were best practiced in a health promotion process to describe health securities that cover health definitions consisting of; physical health, mental health, social health, and spiritual health.
Data collection: Data is collected through observation, in-depth interviews, and focus groups from August 2008 to February 2009. The study took place in Northeastern, Thailand, usage social capital concept exploration.
Data analysis: Data is analyzed by content analysis.
FINDINGS
The health security promotions process of rural families through social capital which are three types, consist of;
1) The health securities process promoted by family socialization that it is translated passes the gene.
Member(s) who live in families are associated function and task holders that have socialized, internalizing for ways of life such as: hygiene, food safety eating, and primary health care in education. Sometime, they have ceremonial norms which for their families well being such as: ghost worship ceremony on their farms due to conflict in spiritual health and health belief in their families which have promoted health security for; physical health and mental health dimensions.
Moreover, they have transmitted local health knowledge from generation to generation. It is the duty for rural families, who wish to grow healthy for themselves such as: hygiene, (checking their hands before eating), to protect against worm infestation, (E-san people like to eat sticky rice with their hands), to concerned about nutrition which are collected action for reproduction rice (such as GABA-rice, Hang-rice, Klong-rice and Hang-Ngog-rice). As a follow in photo l.
Photo l: housekeepers which are collected action for reproduction rice.
As a result the health security process promoted in rural families a physical health dimension, ensuring a clean hygiene process to ensure a long life.
With this, they are able to control blood sugar levels by themselves and neighboring groups which have been educated by public health personnel. Effecting patients with illnesses to have health securities in spiritual health dimensions. After this they bring knowledge within their families and promote health security. The reflection has shown that the health securities have been promoted in families and communities on a network level. In addition, they have established a DM association, and care for them-selves and reciprocity between their healths. The phenomenal that could be seen in Tambon Non-Sa-Nguan, Amphur Sriboonreuang, Nong Bua Lam Phu Province, which were collected actions for health care from DM in home and neighbor-networking, which shows that the health promoted processes consisting of; firstly, physical health dimensions so that they care for themselves. Secondly, mental health dimension so they have reciprocity. Thirdly, social health dimension which were interacted among families and networking groups. Finally, spiritual health dimension so that the neighbors have been sharing in local knowledge through interaction.
On the other hand, the rural families have established a kinship net fund in their communities which supports expenses involved for the funeral (cremation) of persons in their communities. Most families in outlying areas in the Province of Nong Bua Lamphu are poor; thus, this fund relieves the burden of each family meeting the entire expense of the funeral alone.
This fund helps each family with a sense of security. As a result this, process as well helps to promote a better health security in rural families in Northeastern, Thailand.
From these phenomena, the concept of Bourdieu (1986) has described a social capital that family solidarity (knowledge) creates a bond with neighbors, individually and socially, a call to collective action. Moreover, Putnam (2000) has explored an understanding in phenomena and established a norm and a trust networking that reciprocity, including an individual and structural level. In addition, Farr (2003) detailed that it is a good view for fellowship, mutual sympathy, and social interaction and Woolcock (2001) has defined; ‘Bounding Social Capital’ which denotes ties between immediate family and neighbor; ‘Bridging Social Capital’, which were links with close friendships among workmates and ‘Linking Social Capital’ which enables members a leverage of resources in communality (9) available within the community.
2) The health securities are promoted a process of networking with neighbors within the community.
The primary health care concept (16) at Tambon Nong Luang Amphur Phoub-rai Nong-Kai province has created action movements in communities with health volunteers, (Ore-Sor-Mor). They have promoted and produced ‘Ore-Poe-Sor’ who functions on aging health care. This function, has integrated a norm and trust communality such as; medication dosage for aging care, health education for blood sugar control, and encourages health exercise. As a result the health securities promotion processing through neighbor networking in communities It reflected on communality, relationships, and solidarity in their lives. Associated families who live in rural areas seem to have a similar familial gene. Those people living in community having health securities consist of four health dimensions; physical health security such as health exercise group, mental health security such as health care by neighbor networking, social health security such as the exercise group relationship, and spiritual health security such as knowledge sharing within the group. After that they have competed outside of their community group award which has affected group distribution, and group solidarity covered in all community social health.
As a result, if the long time association which influenced another health security such as: breast cancer screening and motivation of female groups for cervix cancer screening as well as housekeeping groups. In these, it is related that Kleinman (1980) has explored health care systems by themselves with a population consisting of; patient, family, neighbor and community. Hence, a family system that it is basic for long life. Yet, it has translated health education and health for family member(s) and other family that has trusted ties with solidarity in a family network. It is shown that the association within the group has empowered rural families a security dimension.
In addition, the community networking relationship has collected an action for health promotions association in their lives. There is shared knowledge within their communities, such as: exercise health association has established a health system in order to encourage health coaching in rural families. To encourage growing of vegetables by themselves as a means for clean food and good health. This being described as bridging social capital and communality in their lives.
‘Pra-Kru-Sudta-Photi-Kun’ the head of ‘Wad-Pho-Chai-Sri,’ Tambon Na-Seang, Amphoe Sri-Wi-Lai, Nong-Kai province, said, ‘before this, I may come into ‘Wad-Pho-Chai-Sri’ for the first time; there are people who live in this community who go to the temple as little as possible because they feel discomforted [DM]. Every Wednesday of each week, they must be going for treatment at the hospital as a follow which the physician has prescribed. Thus, they are made to re-think about the idea that as long as the community feels this way, there will be insecurity in the temple. After this idea has been changed, there will be a process toward a community cultural health promotion. Normally, at times it seems that there are not sufficient vegetables being grown in communities. It is essential to have community projects where families work together along with neighbors to plant vegetables as a means of healthy food and good nutrition. As well as a source of good food, it is a good means of exercise promoting good health. Currently these exercises have been integrated interaction into five organizations consisting of, community, temple, school, local administration and government.
Continuing after this a community promotion process for mobilization in a good health security in Tambon Nong-Seang. Finally, people who have received these products are member(s) in their communities. As a result, these phenomena for health security promotion processes being covered in health dimensions, was being health exercise programs. Socialization demonstrating social and spiritual health, in the end, affecting mental health security.
Increase, northeastern celebration is called ‘Bun’ such as ‘Bun Pha Pa Sa Mak Ki’ or ‘Bun Tord Tian’ which are celebrate cultural norms. This cultural norm at ‘Ban-Srang-Sian, Tambon Nong-Bua-Tai, Amphoe Sri-Bun-Ruang, Nong Bua Lam Phu Province. People living in this area and communities have collective celebrations. It is dependent upon communality of culture norms which affect health knowledge sharing, social interaction, and solutions for improvement for problems such as: ‘Bun Ga Thin’ freedom from alcohol. As a follow in the photo ll.
Photo ll: ‘Bun Ga Thin’ it is traditional without alcohol.
From in-depth interviews with aging woman with age estimates at 65 years, and who live in other communities, say ‘They are very happy to participate in ‘Bun Ga Thin’ because they can meet with a variety of people from other communities. They are able to ask them about their way of life, and compare with themselves about which things bring them happiness and pleasure. As a result the health securities promotion processes of rural families for mental health, social health, and spiritual health dimensions have interaction in and with a variety of families. They can share experiences between each other about confusions and thus; can restore good health securities in the mental health dimension.
On the other hand, people who live in Tambon Chian Kom, Amphoe Pak Chom, in Lioe Province, have had collective action in ‘Bun Pha Pa Sa Mak Ki’ where there has been celebrations each year and have operated health tasks such as health screening. After this from in-depth interviews with public health personnel operating in Tambon Chian Kom Health Station’s understanding has increased. Costs integrating into good health system management have a physician in service in the community. Including the passive and active health service such as: home visits availability of medicines for families. Medicine management sufficient to satisfy the people who live in rural areas. In this phenomenon we refer to health securities promotion processes in four health dimensions; physical health, primary health care; and mental health. In addition, having ‘Bun’ in a cultural norm so that they are prepared ahead of time [more than 30 days] to promote family interaction in rural areas. At the same time, to promote new local knowledge. These integrated ideas based on public space and operate to generate new wisdom and promote good mental health. It has affected local wisdom networks with distributions covered in all of the communities which promote innovative knowledge.
Likewise, in Tambon Namafuang, Amphur Muang Nong Bua Lam Phu Province, there are two types which show collective actions in formal groups consisting of; housekeeping groups who have produced GABA-rice [Hang-rice, Hang-Ngog-rice] for health, TO BE NUMBER ONE teenage groups for against drugs, health volunteer groups for primary health care, kinship cremation (funeral) fund groups for social welfare, and aging groups for spiritual encouraging. On the other hand, consisting of informal cultural maintenance groups and ceremonial groups. As a result both formal and informal groups have health security promotion processes for families; physical health programs to protect teenagers from drugs. The networking groups are encouraging. Including the promotion for opportunity in a social space are teenage actions which refer to the mental health in themselves and these actions affect their social healing. They promote knowledge through their camps before competing in social space. Relationship as Woolcock (2001) has described the ‘social capital’ concept from Williams (1978), Coleman (1988); Bourdieu (1989); Putnam (1993); Port (1998) cite in John Field (2008)(8) an issue phenomenon association which is a social capital in neighborhood communities and networking is called ‘Bridging Social Capital’ for the health security promotion processes of rural families in Northeastern, Thailand.
3) The health securities are promoted processes passes; organization, structure, institution network, and the external community links.
The communities are linked with the Government organization and Local administration. They need resources for supporting collective action in health security for funding by integration community participant. The processes of these establish a health care system based on basic needs for health securities of rural families. From observations found that the rural family has concerns for an increase in health care and consist of; people who live in Tambon Non Muang, Amphur Naklang, Nong Bua Lam Phu Province. Their participation has destroyed the larva source which has prevented Dengue Hemorrhagic Fever (DHF). Local administrations have supported budgeting for motivation awards and established a fund for communicable disease and prevention control. As a result, these are health securities promotion processes under local administration orders and laws for health security.
Besides, the linking social capital promotes various tasks such as; community movement against drugs, education camp knowledge sharing, and social immune movements in Tambon Namafuang, Amphur Muang, Nong Bua Lam Phu Province. Local administration has given social welfare for service in communities consisting of; premiums for aging and AIDS patients, public utility welfare, premium for disaster etc.—it is reflected insofar as families and their neighbors have received support from the social structure both Government organizations and local administrations which were empowered and enabled for promotion processes in health security of rural families. They have secured health, consisting of; physical, mental, social, and spiritual health, both direct and indirect.
Likewise, the families who live in rural areas when in discomfort seek emergency help from the security and rescue team. This team being, ‘One Tambon, One Search and rescue team (OTOS). They are concerned about health care for their ill. What? When? Where? and How? Their attention is directed to health and understands that sickness that should be attended to. From interviews with the public health academician, who heads the health coordination committee on district level in Sri Boon-Reuang said, ‘the peasant when they are sick— could set priorities, firstly, the priority for self care based on experience of dosages given by neighbors, if not they must go the pharmacy to receive medicines. Secondly, they depend on Primary Care Unit. (PCU) for health care from public health personnel and nurses. Finally, they would have used EMS or OTOS for referral to the hospital for care from the health provider service unit. The telephone number for this service is 1669. Those who are affected by poverty can make use of the health security as a gate way and a free choice for good health care service. This is not a paid for carrier service. From this social phenomenon, reciprocity consisting of; the patient and their family comfort, driver carrier service receiving income, and health provider services receiving point systems for claim with the global budget. Hence, health care and commonality are trusted and reflect clearly the ‘linking social capital’ enabling health security promotion processes in three dimensions; physical health, mental health and social health.
RESULTION
The vision of rural families in health securities ‘health’ is covered in four dimensions consisting of; physical health, mental health, social health, and spiritual health. They are promoted processes for health securities based on social capital as three types;
Type 1; the promotion process passes families systems which in this paper are called ‘Bounding Social Capital’. The rural families have been socialized in; local health knowledge being transmitted within kinship, health belief, physical hygiene, eating behaviors and social interaction. As a result under these promoted processes for health securities of rural families; physical health security for better eating behaviors and social interaction which affect a prolonged life and their mental health security so that member(s) in family be best advised. Hence, they minds can be set as ease.
Type 2; the promotion process passes, group and community network. This paper is called ‘Bridging Social Capital’. They have collected actions which have both formal and informal participation. The formal participant being: housekeeping groups, teenage TO BE NUMBER ONE group, kinship cremation (funeral) and aging groups, and informal participation being; cultural maintenance group and ceremonial norms group. It shows health security of families in the social health dimension because of social healing and spiritual health dimension because of knowledge sharing.
Type 3; the promotion process passes; organization, structure, and the external community links. In this paper called the ‘Linking Social Capital’ being; networks who are HIV positive, education camps, Tambon health insurance fund, PCU, EMS and OTOS. It shows promoted processes for health securities of rural families; physical health security by EMS and OTOS which the family could access health service in the National Health Insurance.
In addition, mental health security found that alternative choices for poor families were accessed for health system which did not request payment, and social health security that was constructed in social interaction because the people who act in social interaction receive reciprocity. To finalize; they would receive spiritual well being, so that the rural families receive attention to local knowledge sharing.
DISCUSION
Theoretical implication: This paper shows the concept of social capital distinct from; Williams (1978); Coleman (1988); Bourdieu (1989); Putnam (1993); Port (1998); Woolcock (2001) had studied and explored. Yet, they have agreed that finalize the social capital be changing as the economic capital according ‘Marxism Concept’. In addition, this paper finding that;
Agreement with Putnam (2000)12 was described and understood that social association types in addition were more than factors which influence health security promotion processes of rural families. There is a balance. In this time, the levels of health securities in rural families have more or less been related with the mass of social capital as three types. As a result, the rural families when sick take care of themselves with a basic local knowledge and relationship with their neighbors in their communities. These being were social healing and close associations in community. This is called ‘Bonding Social Capital’
Agreeing with Bourdieu (1986)13 he has explored a reference to human rights. This paper shows that health insurance cards cover everyone if they are registered in the Tambon health insurance fund. It has shown trust and agreement as stakeholders in the health fund which is associated what is called the, ‘Bridging Social Capital’
After this if there is no progress, they can depend on the PCU. After that they can use EMS or OTOS for referals to see a physician which can be communicated by the telephone number 1669. In agreement with Woolcock (2001)14 called the ‘Linking Social Capital’
Suggestions: In research arguments there are three social capital types consisting of; bonding social capital, bridging social capital and linking social capital which enable and empower health security promotion processes of rural families. As a result the efficiency of promotion processes must be integration in three social capitals and covered in health dimensions completely.
BIBLIOGRAPHY
1. Rivers, W. Medicine, Magic, and Religion. New York: Harcourt, Brace & Co. 1924.
2. P.wasri. Health situation Human Ideology. Bangkok: Health System Reform Institution. 1998.
3. UNDP. Human Development Index. Human Development Report. 2001.
4. Suwinai Wattatam. Indicators human security standardization. Human security institution. Society Developing and Human security. 1995.
5. Sappasit Kupprapant & Somchai Pakawiwath. Academic Seminar in yearly 1993 issue ‘Human Security’ 29-30 Nov 1993, at Ambaster city Jomtean, Chonburi. 1993.
6. Santhat Sermsri. Demography in Social Sciences. Edit 2 app. Social Health, Social Sciences Partial, Social Sciences and Humanities, Mahidol University. 1998.
7. Chartthip Nathsupa. Thai Cultural and Social Change Process. Bangkok: Julalongkorn University Publishing. 1991.
8. Bourdieu. ‘The form of Capital’, in J.G. Richardson (ed.), Handbook of Theory and Research for The Sociology of Education, New York, Greenwood Press. 1986.
9. Putnam. R. (2000). ‘Bowling Alone:the Collapse and Revival of American Community. New York: Simon and Schuster.
10. Woolcock M. The Place of Social Capital in Understanding Social and Economic Outcome’, Isuma: Canadian Journal of Policy Research. 2001.
11. John Field. SOCIAL CAPITAL. Second Edition, published in USA and Canada. By Routledge, London and New York. 2008.
12. Coleman, J. (1988) “Social Capital in the creation of Human Capital”, American journal of sociology 94 (supplement). 1988.
13. Portes, A. Social Capital: Its Origins and Applications in Modern Sociology, Annual Review of Social Sciences. 1998.
14. Williams, R. Keywords: a vocabulary of culture and society, Fontana, Lomdon. 1976.
15. Arnan Karnchanapant. Capital storming for Social. Bangkok: Local Development Institution. Civil Society 4th. 1998.
16. WHO. Alma-Ata 1978: Primary Health Care. Health For All Series No.0.1. Geneva. 1978.
