Effectiveness for the Implementation of Decentralization of Health Policy at- Sub-District Health Promoting Hospitals of Health Service Area 11

Abstract

        The objective of this research is to study the effectiveness level of the implementation of health decentralization policies, the influencing factors, and the problems, obstacles, and approaches to improving the effectiveness of the implementation of health decentralization policies in sub-district health promoting hospitals under Health Service Area 11.
         This research employs a mixed-method approach: Quantitative Research: Sample group: Directors of sub-district health promoting hospitals under Health Service Area 11, totaling 250 people. Sampling method: Krejcie and Morgan formula and quota sampling. Data collection: Questionnaires with Cronbach's alpha coefficients ranging from 0.83 to 0.96. Statistics used: Percentage, mean, standard deviation, and multiple regression analysis. Qualitative Research: Data collection methods: In-depth interviews and focus group discussions from specific key informant groups of 9 people each. Data analysis: Content analysis, interpretation, and conceptual summarization.
        The findings indicate that: (1) The overall effectiveness level is high (X̅ = 3.97). (2) Factors influencing effectiveness include: Budget, financial, and resource allocation (regression coefficient=0.339). Health policy and development plans and quality of life (regression coefficient = 0.299). Personnel (regression coefficient = 0.220). The adjusted R² = 0.723 (72.3%) is statistically significant at the 0.001 level. (3) Approaches to improving the effectiveness of the implementation of health decentralization policies include: 1) Designing organizational structures that align with health system operations. 2) Creating understanding and confidence among health personnel. 3) Fair resource and budget allocation. 4) Joint development of management and budget plans.             5) Clear operational plans that align with the local population’s way of life.           6) Establishing clarity and monitoring the implementation of policies.