The Model in Public Health Mission of Sub-District Health Promoting Hospitals After Transferring to the Provincial Administrative Organization

Abstract

 The purpose of this research was to study the structure, readiness of mission transferring, management of public health care system, confidence of public health personnel in transferring missions of sub-district health promoting hospitals (SHPH) to provincial administrative organization (PAO).This research was conducted under the qualitative research methodology.Data were collected through in-depth interview and focus group discussion with a purposive group of key informants, including with chief executivesof local administrative organizations at all levels,which transferred, sub-district health promoting hospitals, directors of the Public Health Division in Provincial Administrative Organization, directors of sub-district health promoting hospitals, Head of Chalermprakiat Health Center, District Public Health (DPH), Provincial Public Health Doctor or the provincial public health deputy doctor, public health officers working in sub-district health promoting hospitals with total of 25 in 6 provinces, namely Sing Buri, Saraburi, Nong Bua Lamphu, Nakhon Ratchasima, Si Sa Ket and Prachin Buri. Data was collected during April-September 2023 and analyzed by interpretation, created
conclusions and content analysis.
The research results showed that all Provincial Administrative Organizations lack the readiness to adjust the structure to support the transfer, but the sub-district health promoting hospitals level can adjust the work system to support it well. Performance of the sub-district health promoting hospitals are independent, agile, fast, and has accessed to more community problems. There are resources including budget, materials, equipment, medicines, medical supplies, as well as the development of buildings leading to more flexible operations. The health care mission remains unchanged. There are considerations to obtain indicators that are appropriate and more reflective to the problems of the area and able to work with network partners as usual. Most of the problems encountered were budget allocations or revenues transferred from the National Health Security Office (NHSO) of the host hospitals to the sub-district health promoting hospitals or some items had been not paid. In the advancement of personnel in Provincial Administrative Organizations that accept the transfers have consistently promoted to higher levels of expertise for their personnel. Suggestions are the rules, financial regulations of NHSO and the Ministry of Interior need to be improved to facilitate financial management of SHPH Land and building rights documents of SHPH must be ready to be delivered to the PAO.