Title: Studying & Monitoring the Development of the Transfer System of Public Health Centers to Local Government Organizations

Researchers: Somphant Techaatik*, Payao Nakham**

*

Lecturer of Social Development Management Program, Faculty of Humanities & Social Sciences, Khon Kaen Independent researcher

University
**

Abstract This study utilized qualitative study papers and reports on the process of decentralizing health care. The study employed a quantitative method, using questionnaires on 8,199 villagers. It was aimed at understanding the process of the transfer system of public health centers(PHCs) to a local government organizations(LGOs). Specifically, the study focused on the process of setting up the transfer mechanism, monitoring the product and output, analyzing and summarizing the lessons learned, as well as providing policy recommendations relating to the mechanism and structure for transferring the PHCs to the LGOs. The research was conducted from September 2007 to October 2008. Research results confirmed that the PHCs under study followed the mechanism and process of the transfer system to the LGOs. However, they encountered some difficulties pertinent to time constraints and communication problems at all levels. With respect to the product, we have discovered that there were four types of the transfer system : (1) the complete transfer of PHCs and personnel, (2) the complete transfer of PHCs and some personnel, (3) the transfer of some PHCs with all the personnel of those PHCs, (4) the transfer of some PHCs with some personnel. The majority of the PHCs employed the second type. Different types impacted the management of work, budget, personnel and materials differently. Relating to the output, we have learned that the ideas and paradigms of public health decentralization to local areas were significant and made the transfer system efficient by generating peoples participation and coordinating consistently with the network. In terms of policy and development strategy implemented at the local level, we have discovered that they emphasized the idea of service to all, stimulated proactive work, and improved policy, strategy and planning for public health and environment activities parallel to the

development of the infrastructure. Also, we discovered some problems relating to the management of work, budget, personnel, property, material, medicine and medical supplies following the imprecise rules and regulations issued by the Ministry of Public Health and the Ministry of Interior. Factors contributing to the success of the transfer included cooperation, leadership ability, having organizational vision and management ability in the LGOs. Recommendations for transferring the PHCs to the LGOs are as follows. At the policy level, the national decentralization committee should have a clear integrated policy and establish a national coordinating body to be responsible for informing the public of the value, ideas and benefits of public health decentralization. At the provincial and district levels, it is necessary to have a proper academic supporting mechanism based on the participation of all parties concerned for monitoring and supporting the transfer of the PHCs to the LGOs smoothly and to communicate efficiently with all parties concerned during and after the transfer. At the community level, we suggest that the LGOs and the PHCs should abide by the principle of peoples participation, starting from local public organizations to local civil societies in decision-making for the transfer of the PHCs to the LGOs and in supporting community health development planning. Key words: decentralization, Public Health Center, local government organization
(Published in Journal of Health Systems Research Vol.3 No.1 Jan.-Mar.2009)

Title : Farmers Expectation Concerning Sustainable Occupation for Agricultural Development : Health Aspects Researcher : Rakpracha Thisawech* * Social Development, Group 46, Kasetsart University Bangkhen Campus Abstract This research studied the expectation of agriculturists who had to build a sustainable occupation for agriculture development that would protect natural resources and the environment , decrease the adverse effect of chemicals and produce safe food and a happy social condition, among other positive outcomes. It studied personal factors , the economy , and social aspects, compared with the expectation of sustainable development. The sample comprised of 240 persons who were interviewed in order to collect data. The statistics were analyzed by percentage value, average, standard deviation, t-test , and oneway ANOVA. The study results found that most of the sampled household heads were males, aged 41 50 years, with a primary educational, lacking social position, living in their village for more than 5 years, and had been trained in agriculture by their parents. Farm size was 11 20 rais, family farm labor averaged 9 persons, the individuals had a yearly income of 50,000 99,999 baht, household expenses of 10,000 19,999 baht per year, made occupational investments of 20,000 - 40,001 baht per year, and were likely to be members of an agricultural group. Their expectations with regard to technology transfer, community business development for production, processing and marketing, plant and animal breeding modification were at a moderate level. However, those expectations with regard to technology support, soil, water and environmental resource development were at a high level. As for problems, operational guidelines and suggestions, the respondents revealed that there were many problems, such as quality of soil, lack of rain and irrigation, plant and animal breeds, organic fertilizer, labor, knowledge of breed selection, products, markets, investment and governmental support. Agricultural institutes played only a minor role in agricultural occupation development. It was suggested that group members be allowed to participate, to submit their opinions, to plan and to make decisions.

Keywords : expectation of the agriculturists, sustainable occupational agricultural development, preservation protection of natural resources, environmental preservation, reduction of chemical agricultural inputs, food safety
(Published in Journal of Health Systems Research Vol.3 No.1 Jan.-Mar.2009)

Title : Experience with Public Health Decentralization : The Health Center Transfer Model Researchers : Jaruayporn Srisasalux* Charay Vichathai* Rampai Kaewvichian *Health Systems Research Institute Bureau of Policy & Strategy, Ministry of Public Health Abstract Public health decentralization has been a national agenda and compliant with the 1997 Constitution of Thailand. In principle, the central administration of Ministry of Public Health was responsible for decentralizing its part of public health programs and resources to local administrative organizations according to Decentralization Plan for Local Administration. The Ministry of Public Health established the Office for Supporting Public Health Decentralization so that it could act as a policy coordinator and a preparation facilitator for transferring public health programs and activities to local administrative organizations. In 2007, the Ministry of Public Health initiated a pilot project to transfer 22 health centers to 19 local administrative organizations in 16 provinces. The individual experiences of this project indicate that community participation was necessary. Other important factors on part of local administrative organizations were their supplementary budgets for public health activities & investment, shortened command-control line, clearer pathway of health personnel positions and leadership of community development. Good relationship between health centers and local administrative organizations were undeniably helpful for the transferring processes. Lesson learned from this project were if the transferring would carry out for more health centers, communication of the transfer vision, processes, advantages, precaution and possible contingencies and solutions should be thoroughly made from policy to implementation level. Human resources for transferred public health programs must be carefully planned. Administrative & Consultative Office at provincial level should be established to help solve out administrative inquiries and provide technical consultation from the starting point to monitoring and continuous evaluations. Then, the lessons learned and application from local levels would help support the better development. Keywords: decentralization, public health, health center transfer
(Published in Journal of Health Systems Research Vol.3 No.1 Jan.-Mar.2009)