Abstract
The health promotion and disease prevention is the important issue in Ministry of Public Health that has been developed and progressed for a long time. While, the public health system changed from the Universal coverage insurance policy has also impact on changing in the heath promotion and disease prevention by taking the result of this budget allocation, health personnel allocation, managing administration, achievement evaluation. The purpose of research is for studying the impact of Universal coverage insurance policy on these health promotion and disease prevention aspects. Moreover, the result for the quality of health promotion activity in Universal coverage insurance policy by studying in four provinces, which are Surin, Phang-nga, Lumphun, and Nakonsawan emphases on the qualitative method collection from the central hospital, general hospital, and PCU/heath center. The result of the research found that there are various models of budget allocation in each province in 2002. Some problems in the system occur from them. Method in budget allocation was changed in each province in 2003 such as to setting the minimum budget that have to allocate to PCU/health centre. The directly budget allocation from provincial health office makes administration management in PCU/health centre more flexible in health promotion activity. The model of budget allocation that helps personnel expect should emphasis on making motivation in health promotion activity in the level of PCU. The budget allocation in paying out for handling project plan should make it well organizes, and must have strongly monitoring and evaluation unit in CUP level. The health personnel allocation to health center/PCU is not successful in attempting to have doctor or nurse in PCU. Perhaps, the cause is the salary budget allocation changed from capitation, which included salary in CUP level in 2002 to included salary in provincial level in 2003. The CUP’s board system also has a problem about personnel administration, health officer especially, in PCU or health centre have the confusion about the line of command and direction of policy, which do not go in the same way. The health officer is not sure in doing their activities. However, the Universal coverage insurance policy has not impact on number of health promotion activity, but the impact of quality cannot summarize.This research allots the health promotion and disease prevention activity analysis into 2 groups.The group that has policy and method after having the Universal coverage insurance policy such as family folder, and health examination in risk group.The group that has policy and obvious method before having the Universal coverage insurance policy such as home visit, mother and child care, EPI program, and family planning activity, and health promotion in community. It found that there are the factors, which has impact on the quality and quantity of health promotion activity after the Universal coverage insurance policy in service provider aspect; example of, the budget allocation form, consistency and supporting factor, resource planning, participating setting same goal in the CUP, continuously monitoring demonstration, supervising, and evaluation, adjustment of attitude in health care personnel in new paradigm of health promotion, making relation with the health volunteer, and efficiency of health report systems.
