Evaluation of Development of Sub-District Health Management (year 2009-2011)

Abstract

An ultimate goal of Sub-district Health Management (SHM) policy is to empower locals to handle community health. Primary Health Care Division has implemented this new program since 2009. This study evaluated of the management of this program during 2009-2011. Based on CIPP Model employing mixed methods using documentary review, questionnaire and focus group discussion.

The SHM program was officially nation-wide spelled out in the statement of the vision, mission and strategic plan by Ministry of Public Health and the Department of Health Service Support. The implementation of the SHM was launched in 2009 along with various projects and activities by the Primary Health Care Division. There were 3 levels of operators, district, sub-district and village with enough ample and well prepared manpower with allocated budgets by the government to the sub-district health management development projects. In addition there was participation of the community locally to tackle health problems in the sub-district. Activities were undertaken to modify health behaviors accordingly. Implementation process involved health management officials or workers at all levels by imparting information through that order down to the operating level in the communities. Active transmission SHM to targets was through repeated cycles of brainstorm sessions at various levels. As a result, the provinces reported such activities for 35 percent of the districts and 74.1 percent of the sub-district. In the same manner, the districts carried out this activity for 85.0 percent of the sub-districts. Eventually, through public forums, the sub-districts repeated such process in 68.6 percent of the target areas. The development of the sub-district health management system with clear documentation of strategic plans were reported in 66.1 percent of the provincial health offices, 84.0 percent of the districts health offices and 94.1 percent of the subdistricts health offices. Focus was made on the development of healthy community with the development and Tambon Health Promoting Hospital and Health volunteers. As such, the self-assessment of 375 areas, reported good level development results at a good level of 93.3 percent of them at a high level 4.8 percent and at an excellent level 7 percent. In conclusion, the SHM development has access to only the village or community level yet lack of leadership on health on health promotion dictates a call for more facilitators.