Health Services Readiness, Accessibility and Utilization of Maternal and Child Health Services, after transfer of Subdistrict Health Promoting Hospital to Provincial Administrative Organization (PAO)

Abstract

This study aims to examine the readiness of maternal and child health (MCH) service provision at Subdistrict Health Promoting Hospitals (SHPHs) that have been transferred to Provincial Administrative Organizations (PAOs). It used a concurrent mixed-methods study. The study population includes Chief executive of PAO, Director of Public Health Division, Director of Subdistrict Health Promoting Hospital, Provincial Public Health Medical Officer, District Public Health Officer and Director of Community Hospital. SHPH service personnel, women of reproductive age (15-49 years) as the target group, community leaders, and public health volunteers. The findings show that some SHPHs transferred to PAO still lack their own office space, have insufficient personnel to provide comprehensive services, and lack mechanisms for supervision, monitoring, and reporting. There is no clear provincial strategic plan for maternal and child health, and service readiness is inadequate. Cooperation with local public health agencies is weak, and there are problems linking maternal and child health data reporting. Nevertheless, service users are satisfied with access to and use of MCH services, with no complaints reported. Recommendations from this study include that PAO and provincial public health offices jointly develop provincial/district public health strategic plans and collaboratively supervise, monitor, and evaluate implementation. The Department of Health should develop management models for MCH services that align with the context of SHPH transfers.