Abstract
The main objective of this study was to determine the people’s perspectives and expectations on devolution of health promoting hospital to local administration organization. The alternative aims of this study to impact of devolution of health promoting hospital to local administration organization, health database management system, problem and obstacles on devolution. Conceptual framework based on system theory and six building blocks. The study design was conducted Mixed methods. Study areas were regional health 1 and 4. Data collection method both questionnaire and in-depth interviews from health promoting hospitals both devolution and not devolution. Study subjects composed of 3 groups: 1) executives in the area, including both ministry of public health and local administrative organizations (n=48), 2) Officer of health promoting hospitals (n=104), and 3) people in each area (n=3,912). Results found that people whose experiences services of all 46 health promoting hospitals had perspectives and expectations do not difference between devolution and non-devolution. They would doctor home visit, drug quality, receipt drug from health promoting hospitals and do not need got drug at hospital, laboratory in community, and staff enough to services. Although, the satisfaction of people towards the service of between health promoting hospitals that devolution was higher than non-devolution with statistical significance (P value <0.05). Impact of health promoting hospitals devolution found that local administrative organizations were affected in terms of personnel that were not transfers as well, budget issue was not clear to use, and issue of the land and buildings that need process with another organization, and including health database management system, referring, there were no clear guideline. Problems and obstacles encountered in operation due to unclear communication, distrustfulness, untrustworthiness, and the recently started responsible office for public health in local administrative organizations make the devolution are many obstacles to implementation. Therefore, clarifying communication and trustfulness between the Ministry of Public Health and local administrative organizations will make the transfer. able to meet the expectations of the people.
