Evaluation of Management of Community Health Security Funds for Controlling Diabetes and Hypertension by Subdistrict Administration Organization, Northern Region

Abstract

This exploratory sequential mixed-method study sought to assess how community health security funds (CHSFs) were managed for the diabetes and hypertension control and prevention project under the framework of the CIPP model. The quantitative phase aimed to evaluate the management capability of the CHSFs using an assessment form specifically designed for the management of diabetes and hypertension prevention and control projects. The study settings included 16 CHSF model areas in northern Thailand, with a sample of 73 CHSF committee members. The qualitative phase involved in-depth interviews with ten members of the target CHSF committees, while focus groups were conducted with ten participants, including health volunteers, using semi-structured questions. Descriptive statistics were used to analyze the quantitative data, while qualitative data were transcribed for content analysis, and triangulation was applied for validation.

The quantitative research findings revealed that two model-area settings were identified for A+ grade level, whereas 14 settings remained at A grade level. Qualitative phase denoted that: 1) Context: All units were ready in terms of management and administration of CHSFs; 2) Input factors: there was systematic management with the use of databases for planning public health services and ensuring continuity of care. Personnel were well-versed in the regulations governing fund management and budget utilization.; 3) Process: Community organizations and public participation raised awareness of health issues. Budget plans for continuous care were in place; 4) Outputs: There were effective referral systems and continuity of care. The management of model health security funds was efficient and served as a learning center; 5) Outcomes: Health expos and collaborative efforts among the public were key success factors. The research findings indicated that most CHSFs are capable and prepared to achieve the goals of the National Health Security Fund. Therefore, the success of transforming fund management into learning centers requires active public participation in health self-care using local wisdom to ensure sustainable health outcomes.