Readiness of Provincial Administration Organization to Transfer Responsibilities of Subdistrict Health Promoting Hospital

Abstract

Background:  This study assessed the readiness of personnel working in Subdistrict Health Promoting Hospitals (SHPHs) to transfer responsibilities from the Ministry of Public Health to Provincial Administrative Organizations (PAOs). Although the transfer of Subdistrict Health Promoting Hospitals to Local Administrative Organizations (LAOs) has been implemented in Thailand since 2008, it has not been implemented according to the government's plan and hasn't achieved the expected results. 

Objectives: The study is to scrutinise the factors contributing to the alacrity of SHPH personnel in Trang province for policy implementation related to mission transfer to the Trang provincial administrative organization (TPOA) and network.

Methods: The research applied a mixed-method approach, including both qualitative and quantitative approaches (QUAL + QUAN) with semi-structured interviews. 403 samples from the questionnaire were collected from public health personnel working at SHPHs. The Index of Item Objective Congruence (IOC) ranged from 0.80 to 1, and the Cronbach’s alpha coefficient was 0.96. Exploratory cross-sectional descriptive research was conducted to examine factors affecting the readiness of personnel in SHPHs in Trang province for policy implementation related to mission transfers to the TPOA.

Results: This study put on scrutiny the impact of healthcare personnel performance in Trang Province, Thailand, on self-assessment of service standards at SHPHs following the mission transfer to TPOA. Leadership and governance emerged as the strongest predictors, with personnel rating it higher (OR=8.2, 95% CI=3.57-19.30). Other significant predictors included Financing (OR=3.40, 95% CI=1.61-7.37), Information Systems (OR=2.8-3.0), and Health Workforce (marginal significance). These findings accentuated the strong influence of leadership, governance, and financing on personnel performance and transfer expectations.

Conclusion: The findings highlight the strong influence of leadership, governance, and financing on personnel performance and transfer expectations, with notable associations in medical products, vaccines and technologies and health services delivery, demonstrating the crucial roles these factors play in service delivery outcomes.