Coalition formation to address structural determinants of methamphetamine use in Thailand.
Despite two recent government-sponsored 'wars on drugs', methamphetamine use continues to be a pervasive problem in Thailand. Out of concern for reported human rights abuses, there has been a call from the international community to take a different approach from the government's 'zero tolerance'. This paper describes the adaptation of the Connect to Protect® coalition formation process from urban U.S. cities to three districts in northern Thailand's Chiang Mai province, aimed to reduce methamphetamine use by altering the risk environment. Project materials, including manuals and materials (e.g. key actor maps and research staff memos), were reviewed to describe partnering procedures and selection criteria. Potential community partners were identified from various government and community sectors with a focus on including representatives from health, police, district and sub-district government officials. Of the 64 potential partners approached, 59 agreed to join one of three district-level coalitions. Partner makeup included 25% from the health sector, 22% who were sub-district government officials and 10% were representatives from the police sector. Key partners necessary for endorsement of and commitment to the coalition work included district-level governors, police chiefs and hospital directors for each district. Initial coalition strategic planning has resulted in policies and programs to address school retention, youth development initiatives and establishment of a new drug treatment and rehabilitation clinic in addition to other developing interventions. Similarities in building coalitions, such as the need to strategically develop buy-in with key constituencies, as well as differences of whom and how partners were identified are explored.
Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, USA Johns Hopkins Bayview Medical Center, Mason F. Lord Building, Center Tower Suite 4200, 5200 Eastern Avenue, Baltimore, MD 21224-2780, USA nwillard@jhmi.edu.
Nancy
N
Willard
Research Institute for Health Sciences, Chiang Mai University, Chiang Mia, Thailand.
Bangorn
B
Srirojn
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Nicholas
N
Thomson
Research Institute for Health Sciences, Chiang Mai University, Chiang Mia, Thailand.
Apinun
A
Aramrattana
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Susan
S
Sherman
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Noya
N
Galai
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
David D
DD
Celentano
Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Jonathan M
JM
Ellen
D019969:Amphetamine-Related Disorders / Q000517:prevention & control*; D057191:Capacity Building / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration*; D003256:Community Participation; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D008694:Methamphetamine; D013785:Thailand
D008694:Methamphetamine
coalitions; community development; risk environment; structural change