Abstract
The transfer of sub-district health promoting hospitals to provincial administrative organizations alters the roles of provincial health office and district health office. This study aimed to investigate optimal roles of provincial and district health offices after the transfer and synthesize policy suggestions. Mixed methods were used. The qualitative data were gathered through semi-structured interviews and focus groups. The participants from 8 provinces, representing each region, covered experts, administrators of Ministry of Public Health, policy makers, chiefs of provincial and district health offices, and district chiefs officers. The quantitative data were collected using questionnaire. The data were analyzed with descriptive statistics. Policy suggestions were synthesized from the analysis of qualitative and quantitative data, and connoisseur meeting. The findings revealed that the roles of both offices remained the same as before with some new operations to solve the consequences of the transfer. 1) In transition phase: the provincial health offices operated as the prior roles following the 2019 Primary Care System Act, and advised district health offices for readiness preparation transitioning the district health offices’ competencies to be the academic offices. However, the roles of district health office by the ministerial regulations should be modified. 2) At completion phase; the provincial health offices operated as the prior roles with some role changes according to the modified roles of the district health offices. These modified roles involved upgrading the district health offices to be the academic offices with enhanced regulator’s competencies, and quality accreditation of primary care settings. The district health offices’ modified roles included consultants and the evidence-based information providers, regulators of primary care service quality and improving health consumer protection system.
