Abstract
This research aimed to study the policy proposal for monitoring and evaluation of the Sub-district Health Promoting Hospital (SDHP) where have been transferred to Mahasarakham Provincial Administrative Organization (MPAO). The mixed methods research was conducted in 2 phases. Phase 1 was a survey in 500 samples and phase 2 was action research. The target samples were the stakeholders from 175 settings of Health Center in Honor of His Majesty the King’s 60th Birthday Nawamintrachini (HCN) and the SDHP. Data was collected by questionnaires, focus group discussion and commenting record. The results reveled factor affected the health service following the six building blocks of health system framework. The factors related the health services significantly were married status (p-value<0.001), work position (p-value=0.019), committee (p-value=0.023), and information sources (p-value=0.024). The factors affected the monitoring and evaluation of the HCN and the SDHP who transferred to the MPAO statistically significant were transferring (p-value=0.027), personal transferred status (p-value=0.006), gender (p-value=0.014), married status (p-value<0.001), education (p-value=0.0043), work position (p-value<0.001), work type (p-value<0.001), and training experiences (p-value=0.001). The comparing between a transferred group and a non-transferred group found the statistically significant difference (p-value<0.001) in the improved health, the responsiveness and the improved efficiency. The policy proposals will be implemented in 4 domains. First, the improved health domain should involve all stakeholders participate in the evaluation. The format depends on each district and should have a sharing forum. The first phase should evaluate the people impacts rather than outputs, according to the changes of health service system. Second, the responsiveness domain should select the indicators which can be performed under the situation of transferring to the MPAO. Third, the social and financial risk protection domain should monitor and evaluate the health impacts covering manpower, materials and network coordination. The facilities should be flexible for good health services. Lastly, the improved efficiency domain should increase the human resources for the effective coordination and performance. The assessors for the monitoring and evaluation should be the delegates of the health networks of the Ministry of Public Health, Provincial Administrative Organization, and stakeholders. The manual should be development for assessing guideline and improving performance.
