Abstract
This study employs both qualitative and quantitative methods. It aims to understand the process of the transfer system of a public health center (PHC) to Local Government Organization (LGO). Specifically, the study focuses on the process of setting up the transfer mechanism, monitors the product and output, analyzes and summarizes lessons learned, as well as provides policy recommendations relating to the mechanism and structure for transferring the PHC to the LGO. The research duration is from September 2007 to October 2008.
Research results confirm that those PHC under study followed the mechanism and process of the transfer system to LGO. 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: these are (๑) the whole transfer of PHC and personel, (๒) the whole transfer of PHC and parts of personel, (๓) the transfer of some PHC with all personel of those PHC, (๔) the transfer som PHC with parts of personel, of which the majority of the PHC employed the second type. Different types impacted the management of works, budget, personnel and materials differently. Relating to the output, we have learnt that ideas and paradigms of the public health decentralization to local areas were significant and made the transfer system efficient through generating people’s participation and coordinating with the network of public health consistently. 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 works, and improved policy, strategy and planning for public health and environment activities parallel to the development of infrastructure. Also, we have discovered some problems relating to the management of works, budget, personnel, property, material, medicine and medical supplies following the imprecision of rules and regulations from the Ministry of Public Health and the Ministry of Interior. Factors contributed to the success of the transfer included cooperation, leadership ability, having organizational vision and ability for management of the LGO.
Recommendations for transferring the PHC to the LGO are in the following. At the policy level, the national decentralization committee should have a clear integrated policy and establish a national coordinating body to be responsible for making the public known of the value, idea and benefit of the public health decentralization. At the provincial and district level, 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 PHC to the LGO smoothly and communicate with all concerned parties efficiently. During and after the transfer, it is significant to promote a sharing of experience, information and reflection of the transfer. At the community level, we suggest that the LGO and the PHC should abide by the principle of people’s participation starting from local public organizations to local civil societies in decision making for the transfer of the PHC to the LGO and the support for community health development planning.
