Abstract
The research for “The Development of Indicators of Good Governance Management of the Provincial Public Health Office" was commissioned to The Center for Applied Economics Research, Kasetsart University by The Health Systems Research Institute. The objective of this research are to study a conceptual framework for a theory concerning good governance of the health system management in local areas, to develop good governance indicators regarding the
provincial public health office management which can then be implemented as a tool to evaluate and further develop the organization’s effective governance and also evaluate the level of good governance management of the provincial public health offices in the four pilot provinces: Chiangmai, Krabi, Cholburi, and Nakorn Pathom.
In the process of working on a conceptual framework and a theory concerning good
governance of the units handling health systems in the local areas, the research team has looked at extensive literature on good governance. They also arranged meetings with administrators, academics, and health personnel from the provincial public health offices. The meetings were designed to brainstorm opinions and come up with an understanding for setting up the conceptual framework on good governance of the administrative agencies handling health systems in the local area.
The conclusions for an indicator framework of good governance management are
comprised from the following ten principles: The Principles of Rule of Law (L), Ethics (E), Transparency (T), Participation (P), Accountability (A), Value for Money (V), Human Resources Development (H), Knowledge Management (KM), Management (M), and Information Technology and Communication (IT).
In the development of indicators measuring good governance management of the
provincial public health offices, the research team designed three sets of questionnaires based upon these principles. The first set of questionnaires was evaluated by internal officials within the agencies and consisted of fifty indicators. The second set was evaluated by officials with specific functions and contained eleven indicators. Finally, the third set was evaluated by related agencies and consisted of thirty-seven indicators. A range of scores were numerically assigned from 1 to 5 to evaluate good governance: 1 being the lowest, 2 low, 3 moderate, 4 high, and 5 being very high.
The findings based on the evaluations concerning management of the provincial public health office, as evaluated by the internal officials of the four provincial public health offices, revealed high levels of good governance management. The scores were 3.72, 3.43, 3.54 and 3.70 respectively. There was an especially remarkable score shown in the Principle of Information Technology and Communication. This may be due to the agencies having a data based system
and connecting the databases which helps reduce their workload and gives people the opportunity to share their opinions via the website.
The Principle of Value for Money found that their budget corresponded with the strategic plan that audited and evaluated evaluation results. It was found to improve internal management including financial support from external sources.
As for the Principle of Rule of Law, the regulation was found to be disseminated to
employees and freedom given to service recipients.
The questionnaire results indicate three principles that need to be developed: the
Principle of Management, the Principle of Knowledge Management, and the Principle of Human Resource Development. The Principle of Management could be defined as ‘incomplete’ in terms of people’s assessment. One possible cause was an institution research study that was conducted, but the results of which were not applied to their full potential, and there was no evaluation of administrative leadership. Based on the Principle of Knowledge Management, the culture of learning was shown to be lacking amongst working groups. Results indicated that continuity was deficient in the development of personnel ability. With the Principle of Human Resource Development, it was found that contingency plans
for the rationing of the workforce in some working groups were lacking.
The evaluation results for good governance management of the provincial public health offices by the agencies related to the provincial public health office of Chiangmai, Cholburi, and Nakorn Pathom revealed that good governance management was moderate. The scores were 3.36, 3.32, and 3.26 respectively.
For the Krabi provincial public health office, good governance management was rated as high, with a score of 3.61. For all four provincial public health offices, the Principle of Transparency was found to have the most significant rating. This could be due to opportunities for those concerned to give their opinions and listen to feedback from external parties; including activities to promote people’s participation. The three principles that needed to be developed were: the Principle of Management, the Principle of Human Resource Development, and the Principle of Participation. For the Principle of Management it was found that the provincial public health offices did not make a survey suitable to meet the needs and satisfaction of concerned offices. The evaluation results were not used to improve the work process and be transparent. Based on the Principle of Human Resource Development, the officials were found to have unity only among the working groups; the survey results indicated that individuals performed their work independently rather than as a group. For the Principle of Participation, there was an indication of inadequate consideration for the opinions of outside agencies and the public sectors concerned. The comparative results of the evaluation of the level of good governance management of the provincial public health offices by internal officials and related offices indicated a very significant difference for the Chiangmai and Nakorn Pathom provincial public health offices. As for the evaluation of the offices in Krabi and Cholburi, there were no significant differences. However, the distinguished principles and those needing development based on the evaluation of both the internal offices in the provincial public health offices and those related
offices, followed the same direction.
