Development of the Primary Health Care System in Chaloemphrakiat District after the Transferal of Sub-district Health Promoting Hospital to the Provincial Administrative Organization

Abstract

The objective of this action research was to analyze current situations, development, and evaluation of Chaloempharakiat primary health care system after the transfer of the subdistrict health promoting hospital to Nakhon Ratchasima Provincial Administrative Organization (PAO). Samples were 8 executives from the district level, 20 practitioners from the district level, 20 practitioners from the subdistrict level, 50 practitioners from the community level, and 5 groups of clients totaling 75 persons. Instruments used included document analyses, in-depth interviews, focus group discussions, expert opinions, area follow-up visits, service recipient satisfaction and quality of life questionnaires. Quantitative data analysis was done using descriptive statistics

Results showed that 1) results from the context analysis of the current situation showed the overall average at a high level (=3.92, SD=0.62), the input factors at a moderate level (=3.57, SD=0.58), process at a moderate level (=3.64, SD=0.56) and product at a high level (=0.65, SD=0.48). Barriers included increased works but inadequate personnel; 2) according to the system development, success factors included strong leadership, readiness for development, systematic and integrated management, partner participation and actions according to plans and goals. The developed model for the primary health care system consisted of 1 goal, 4 issues, and 15 measures; and 3) overall satisfaction was at a high level (=4.05, SD=0.47), while the quality of life of service recipients was at a moderate level (=3.39, SD=0.64). It was recommended that partners’ participation should be built with more communication channels.