Abstract
The objectives of this mixed method study were: (1) to study situation of public health operation of
sub district administration organizations in Nakhon Si Thammarat ; (2) to study role, working process
and outputs of the sub district administration organizations related to development of public health activities; and (3) to identify conditional factors that influenced or hindered implementation of projects for
health development under the sub district administration organizations.
The population of the first phase study was 81 sub district administration organizations in Nakhon
Si Thammarat Province. The data analysis was performed using descriptive statistic. In the second phase
Thakuen sub district administration organization was selected as a case study among sub district administration
organizations and followed by the analysis using content analysis method.
The result of the first phase study showed that most sub district administration organizations were
in medium size. Most of the public health officers were untitled personnel of the manager offices (43.2%),
followed by community health development workers (35.8%). In terms of health projects, the most common
type was those for prevention and control of dengue fever (92.6%). The most successful projects were
those concerning surveillance and solving of problems of malnutrition, supporting to health centers for
their curative care services and supplying of essential drugs to community centers for primary health
care. All successful health projects (100%) were found to have promoting factors as cooperation of the
various organizations in the community such as community health volunteers and health clubs (80.25%).
The main obstacles were lack of knowledgeable, human resources and funding.
The results of the second phase of the study showed that the beginning point of public health development
by the sub district administration organizations was when they enrolled in local community health
fund. The working process was jointly carried out by sub-district administration organizations, local health
centers, community health volunteers, and health clubs. The main factors for successful health development
were team leadership, team working, strong community health volunteers and general public involvement.
Enabling factors are public-mind consciousness and open-mindedness of the public health
staff. The problems and obstacles were lack of experience in community health fund and the indifference
in health by some groups of the people.
