Thai Public Health Policy and Decentralization: a Case of Pro-Social Rule Breaking of Thai Local Health Staff
Keywords:
Pro-social rule breaking, Public health decentralization, Thai local health staffAbstract
The study examines the pro-social rule breaking theory to understand the motivation and behavior of Thai local health staff over the rule breaking for local people/patients' benefit. This theory demonstrates why local staff tend to use their discretion to accomplish their jobs for the local people's benefit, although their discretions may contrast with the rules, especially the central administration’s rules and procedures. The factors behind local staff rule-breaking consist of three levels of analysis within the local workplaces: individual, relational, and organizational factors. The research intends to demonstrate the reason behind the use of discretion among Thai local health staff who work in local administration's health facilities for the social benefits of local people as their clients.
The research analysis was from an original questionnaire (n=205; 51.25% response), and the multiple regression model analyzed the relations of all variables. The results of the research analysis demonstrated that pro-social rule breaking behaviors are positive with local health staff conscientiousness and educational background. So, the research suggests that conscientiousness is the only theoretical factor that can convince Thai local health staff to break the rules, while other factors have no significant relationship with pro-social rule breaking behaviors.
Finally, the research suggests policy recommendations for strengthening the human resource development of Thai local health staff by supporting the role of public health unions and associations to protect Thai local health staff’s interest and to control the standardization of discretion and pro-social rule breaking of Thai local health staff.
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