Abstract
Surge events cause strain on health services. The health workforce is, therefore, the front-line health personnel who are essential in responding to a pandemic situation. This study aimed to 1) analyze situations of health workforce management in responding to a pandemic in primary care units under the context of transferring health promoting hospitals to provincial administrative organization; 2) explore problems and obstacles/challenges and methods of resolving them for health workforce management in primary care units; 3) describe health service satisfaction among recipients of health promoting hospitals transferred to provincial administrative organization; and 4) propose policy recommendations for health workforce management in responding to a pandemic in primary care units under the context of transferring health promoting hospitals to provincial administrative organization. This was a descriptive study using both quantitative and qualitative approaches. The sample in the quantitative method were 410 people who received services from health promoting hospitals which were then transferred to provincial administrative organization. There were 64 participants for the qualitative portion of the study including directors of public health divisions, medical and public health staff working at health promoting hospitals, and public health volunteers. The quantitative instruments included questionnaires on the service satisfaction from health promoting hospitals and the service satisfaction from the pandemic with the reliability of 95 and .92, respectively. The qualitative instruments were comprised of interview questions related to the Corona Virus 2019 pandemic as well as problems and obstacles and methods of resolving them for health workforce management in primary care units. They were checked for their comprehensiveness, clarity, appropriateness, and question sequence by five experts in qualitative research and health workforce management. Data were analyzed by using descriptive statistics and thematic analysis. The results revealed that: 1. The health promoting hospitals which transferred to the provincial administrative organization did not analyze or do staff planning in response to the pandemic. However, they recruited staff to work during the pandemic, assigned staff to assist other units, communicated and commanded work duties, delegated jobs during the pandemic, supported staff to participate in trainings, allocated facilities and resources for work during the pandemic, and took care of staff when they had been infected. 2. The problems and obstacles and methods of resolving them for health workforce management of health promoting hospitals which were transferred to provincial administrative organization in the dimension of recruitment and allocation included 1) staff shortages, which were resolved by adjusting roles and duties to aid each other for all jobs, 2) unclear policies and work guidelines, which were resolved by communicating with each other for better understanding, and 3) incomplete routine work, which was resolved by managing and prioritizing jobs; in the dimension of training included 1) insufficient training and lack of work knowledge, which were resolved by self-study, and 2) lack of cooperation and trust of people, which were resolved by using laws and assistance from village leaders; in the dimension of system and environment management included 1) inadequate drugs and medicine, materials, and work support, which were resolved by using personal budgets or self-production, and 2) lack of morale at work, which was resolved by supporting and seeking advice from each other. 3. Service satisfaction among recipients of health promoting hospitals transferred to provincial administrative organization was found to be satisfactory overall, and for each dimension, at a high level. The highest average score was for the service satisfaction of location dimension, followed by the service satisfaction of staff dimension, the service satisfaction of quality service dimension, the service satisfaction of convenience dimension, and the service satisfaction of service support dimension, respectively. Service satisfaction from the pandemic overall, and for each item was at a high level. The highest average score was for using campaign or enforcement to use a facemask for 100% in participating in all public activities, followed by notifying the pandemic situation and guidelines to the public thoroughly, mandating handwashing and measuring body temperature clearly before entering markets or public events in communities to protect the disease spreading, and appropriately suggesting to the public to postpone or avoid large events which have a high risk of disease spreading, respectively. 4. Policy recommendations for health workforce management in responding to the pandemic in primary care units under the context of transferring health promoting hospitals to provincial administrative organization in the dimension of workforce planning includes the public health division under the provincial administrative organization has workforce specialized in epidemics to deal with the pandemic; in the dimension of recruitment and allocation include 1) CUP Split and the health promoting hospitals foster the staff during the pandemic, 2) The public health division under the provincial administrative organization defines the role of workforce in the CUP Split and health promotion hospitals when there is an epidemic, and 3)CUP Split and health promotion hospitals manages missions in the epidemic effectively; in the dimension of training includes the public health division under the provincial administrative organization develops expertise in epidemiological investigations for workforce in the public health division, CUP Split, and health promotion hospitals; in the dimension of system and environment management include 1) The public health division under the provincial administrative organization supports the CUP Split and health promotion hospitals with adequate facilities, isolation rooms, medicines and medical supplies to ensure operational safety, 2) CUP Split and health promotion hospitals prepare facilities and emergency equipment storage to be ready for use in the event of an epidemic, 3) The public health division under the provincial administrative organization organizes the care and supply of the workforce during an epidemic, 4) CUP Split and health promotion hospitals takes care of the workforce during an epidemic, 5) The public health division under the provincial administrative organization establishes management measures and guidelines to support the operation of workforce during an epidemic, and 6) The provincial administrative organization has a platform for recording and monitoring an epidemic.
