Objective The trend of population aging in the 21st century is especially prominent in Thailand. Hence, age related diseases such as diabetes, hypertension and chronic obstructive pulmonary disease has become top ranked causes of mortality in Thailand. As those functional limitations increase, the assistance by village health volunteers (VHVs) has become more necessary. However there is high turnover rate of VHVs in Thailand. This study, therefore, aimed to identify predictors that lead to the VHVs’ intention to leave their roles as elderly caregivers. Methods A cross-sectional descriptive study was conducted in February, 2014. A total of 415 self-administered questionnaires were distributed to the VHVs who have engaged in elderly home care in Mueang district in Nakhon Ratchasima province, Thailand. Chi-square tests and multiple logistic regression analyses were employed to identify significant predictors of the VHVs’ turnover intention. Results Approximately one-third of VHVs (33.5%) intended to leave volunteering in elderly care. Significant predictors of VHVs’ intention to leave elderly care were: volunteering duration of≤6 years (Adjusted Odds Ratio (AOR)＝2.69, 95% CI＝1.33-5.40), having no other responsibilities (AOR＝2.40, 95% CI＝1.38-4.18), being absent more than once a month (AOR＝2.25, 95% CI＝1.28-3.95) and low level of job satisfaction (AOR＝5.62, 95% CI＝2.26-13.99). VHVs who were poorly satisfied with their roles were 5.62 times more likely to leave elderly care than those who highly satisfied when adjusting for other factors. Conclusion Improving work place supports and incentives to promote job satisfaction will result in a reduction in VHVs’ turnover intention.
Objectives Recently, there has been an increasing focus on nutrition in international health cooperation. However, little attention has been paid on global nutrition issues and their methodologies in Japan. One of the possible reasons is that the whole picture cannot be clearly grasped, because nutrition issues and actions have been considered separately at international organizations such as WHO, FAO, and UNICEF. Therefore, the aim of this study was to examine the trends in food and nutrition policy framework, dietary recommendations and nutritional requirements formulated by international organizations through a review of published nutrition policy guidelines and standards since the 1990s. Method Policy guidelines, technical reports, annual reports, and other relevant materials published between 1990 and 2015, available on the WHO, FAO and UNICEF websites, were reviewed. Then, we extracted the study focused on nutrition problems and their solutions. The purpose and contents of each document and guidelines were identified and categorized in a summary table, so as to investigate their feasures and time trend. Results This study identified 22 statements on food and nutrition policy frameworks, 14 dietary recommendations and nutritional requirements, and 5 information systems. It was revealed that, in the 1990s, the focus was to develop and standardize the methods for nutritional assessment of children. The goal during this period was to achieve food-based security through improvement in energy and nutrient intakes such as proteins and vitamin A, so as to reduce severe child malnutrition and maternal mortality. Later, various recommendations were formulated on double burden of malnutrition, the importance of breastfeeding and the context of the food system and nutrition in the 2000s, and on noncommunicable disease prevention and control policies and practical methodologies to reduce nutrition disparities after 2010. Several information systems were established, which have been utilized as the evidence database to develop policy frameworks.