Development of an Operating Model for the First 1,000 Days of Life Project under the Mechanism of District Health Board, Nakhon Ratchasima Province

Abstract

The objective of this study was to develop a model for implementing the first 1,000 days of life project using the mechanism of district health board. It was conducted as an action research in Nakhon Ratchasima Province. The main approaches included the analysis of the situation, knowledge, and satisfaction, as well as the elements that promote the success of the project. The study samples were (1) 265 health officers working in health promoting hospitals and (2) 15 members of 3 district health boards (from 3 districts in the province: Phimai, Pakchong and Nonthai). The research tools included documents analysis, questionnaires, in-depth interviews and group discussions. The analysis was performed by using frequency, percentage, mean and standard deviation for quantitative data, and classifying and grouping for qualitative data. It was found that there was assignments for meetings to formulate joint activities. Health officers still had some knowledge on the first 1,000 days of life operation. The overall satisfaction was at high level (Mean=3.79, SD=0.715). The implementation of the project followed the PDCA cycle process. For the elements promoting the success, they were: (1) the strength and unity of the district health board, (2) establishment of local network partners, (3) resource sharing, (4) selection of the health issues by the local areas, and (5) continuity of the operations. The operation of the first 1,000 days of life project utilized 7s Model principle which included clear strategic plan, focusing on the participation of personnel, executives’ consideration on and listening to the opinions of their subordinates, good experiences of the staff, knowledge and expertise of health officers, and having a common vision on the project. Such collaborative operation had resulted in the increase of desirable outcomes, for example, the increased coverage of immunization inchildren 0 - 2 years reaching 75.44 percent. The authors recommended that the project should be further strengthened through the monitoring of child development in schools, promoting oral health and the improving the referral system. It was also recommended that the approach (described as Ratchasima Model) should be implemented by district health boards nationwide.