Abstract
Over the past 10 years, the Ministry of Public Health (MOPH) has transferred her seven responsibilities
and more than 30 health centres to local governments. The ministry faced both successful and failed
experiences. It was necessary for the ministry to review what should be the appropriate roles and options
for decentralization. This study was a qualitative research. It aimed at analyzing appropriate roles of the MOPH and her
sub-organizations together with the National Health Security Office (NHSO) in linking disease prevention
and health promotion in local areas and the overall system governance. Research methodology used
both literature review and brain storming as well as in-depth interview. The interviewees included 22
experts who were representatives from the MOPH, non-governmental organization, local government
and the NHSO. The gathered data was analyzed by using content analysis and the results were presented
by thematic analysis.
Results of the study showed that public health, disease prevention and health promotion were direct
responsibilities of the local government for improving the quality of life of local people and these roles
ought to be transferred to local authorities. But the prevention of serious disease epidemic should be
remained the command of the MOPH at the central level. Other ministerial sub-organizations together
with NHSO should play supportive roles of the health policies issued by the MOPH. Local government
could be an arm-length extension of the MOPH to bring policies into practice. Options for decentralization
should encourage stakeholders’ participation in disease prevention and health promotion. The area
health model became a more preferable solution because it could help align the fragmented health system
and create better networking governance.
