Development of an Integrated District-Level Management Model to Enhance Health and Social Security for Vulnerable Groups in Saraburi Province

Abstract

This mixed-methods study was conducted to develop and test an integrated district-level management model to strengthen health and social security for vulnerable populations in Saraburi Province. Conducted over 12 months, the research comprised three phases: (1) assessing current implementation and management mechanisms for improving the quality of life of vulnerable groups; (2) developing the integrated management model; and (3) testing the model’s effectiveness. Participants included district health board members, experts, and members of vulnerable population groups. Data were collected using questionnaires, in-depth interviews, evaluation forms, observation records, a model operational manual, and focus group discussions. Data analysis involved descriptive and inferential statistics, along with content analysis. The results revealed that the overall implementation of quality-of-life development was at a high level, while the management mechanisms were at a moderate level. Key limitations included insufficient intersectoral integration, inadequate resources, and fragmented information systems. Promising opportunities for improvement were leadership commitment and strong community–local government networks. The developed D-SAFE Model consisted of five steps: Diagnostic Assessment (D), Stakeholder Synergy (S), Action Planning (A), Field Implementation (F),and Evaluation and Enhancement (E). The model demonstrated high appropriateness in both content and structure. Post implementation evaluation showed high mean scores for perceived usefulness (4.40) and feasibility (4.35) on a 5-point scale. While perceived benefits did not differ between urban and rural areas, a statistically significant difference in feasibility was found (p<0.05), with higher feasibility reported in urban contexts. Key success factors included policy support, cross-sectoral collaboration, personnel readiness, and an accessible information system. In conclusion, the D-SAFE Model proved to be a applicable framework for strengthening the health and social security of vulnerable populations at the district level in Saraburi Province.