Integrating Primary Health Care Systems between the Provincial Public Health Office and the Chanthaburi Provincial Administrative Organization
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Abstract
BACKGROUND: The transfer of primary health care functions in accordance with the Decentralization Act B.E. 2543 (2000) has encountered several challenges, obstacles, and operational limitations.
OBJECTIVE: This study aimed to examine the current situation and to develop integrated guidelines for strengthening the primary health care system between the Provincial Public Health Office and the Provincial Administrative Organization in Chanthaburi Province.
METHODS: A mixed-methods study employing a convergent parallel design was conducted. Quantitative data were collected using structured questionnaires from 342 participants selected through simple random sampling. Qualitative data were obtained from 29 key informants through focus group discussions. Quantitative data were analysed using descriptive statistics (mean and standard deviation) and inferential statistics (ANOVA), while qualitative data were analysed through content analysis. The study was conducted between October 2024 and April 2025.
RESULTS: Quantitative findings significantly supported the qualitative results, revealing statistically significant differences in perceptions between organizations regarding roles and responsibilities, the workforce, and performance indicators (p<0.001). The proposed integration framework emphasized service quality and equitable access for the population through a dual governance structure. Under this structure, the Provincial Public Health Office assumes responsibility for academic oversight and standard setting, while the Provincial Administrative Organization is responsible for operational management. This arrangement operates under clearly defined shared governance mechanisms and aligns with the six components of the health system based on the Six Building Blocks framework, alongside the principles of Primary Health Care.
CONCLUSION: The integrated framework for the primary health care system following decentralization clearly delineates the relationship between regulatory (oversight) roles and administrative (managerial) roles. The application of these findings should consider contextual limitations and local variations to ensure appropriateness and sustainability across different settings.
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References
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