Abstract
Summary Report Objectives Part 1 : To evaluate the operations of Provincial Administrative
Organizations (PAOs) in terms of whether they have carried out their missions in accordance with the transfer
criteria specified by the Announcement of the Committee. The evaluation includes assessing the results of
these operations, identifying strengths and weaknesses (or opportunities and obstacles), and providing
recommendations for future improvement and development. Part 2: Overall Status of the Primary Health
Care (PHC) system, with PHC units (PCUs) as the main service providers in the area, after they have been
transferred to the PAOs. This includes identifying any changes, the overall status of the system, strengths
and weaknesses that need enhancement or improvement, and suggestions for future development. Part 3:
To evaluate the Six+One Key Components of the PHC System, focusing on the status after the transfer. This
involves identifying strengths and weaknesses of each component and providing recommendations for
strengthening and developing these components in the future. Methodology The evaluation uses a "mixedmethods research" approach: Qualitative Study: Conducted in collaboration with the Health Systems
Research Institute (HSRI), selecting 3 2 PCUs across 8 provinces in 4 regions of the country. Quantitative
Study: Utilizing a survey method, questionnaires were distributed to the entire population (3,263 SHPHs, 49
PAOs, and 49 Provincial Public Health Offices). Responses were received from 35 PAOs, 35 Provincial Public
Health Offices, and 450 PCUs. The responses were statistically validated at a 95% confidence level.
The evaluation results are divided into 3 parts as follows.
Part 1: The results of the evaluation of the progress of the PAOs operations, whether they have
complied with the transfer criteria according to the announcement of the committee or not, that is, the
progress in establishment and operation. In terms of organizational structure, it was found that every
province has already been established. The establishment of the Public Health Division in the PAOs found
that all PAOs have implemented "Already completed" in 4 activities, progress in personnel operations The
acceptance of voluntary personnel transfers to all PAOs has been completed. Progress in operations
regarding budget, finance and accounting found that all Provincial Administrative Organizations have
performed "successfully" in 4 activities. Progress in operations in supervision, monitoring and evaluation was
found that after the transfer of 5-6 This month, the PAOs was unable to complete a complete performance
evaluation, but the PAOs took care by appointing a sub-committee. Including the evaluation cycle being
clearly defined.
Part 2 Results of the overall assessment of the primary care system; The evaluation results found
that after the transfer, the overall structure of the primary health system remained the same (as before the
transfer); and the overall status of the primary health system was found to be in comparison of services
between before the transfer and after the transfer. It was found that most of them remain the same.
Part 3 Results of the evaluation of 7 main parts. The results of the evaluation found that 1) Primary
health service provision of the Subdistrict Health Promotion Hospital (SHPHs). It can be concluded that the
models and characteristics of most services Still using the same format according to the criteria of the star rated SHPHs. 2) Manpower management. It was found that after the transfer of the number of manpower
of the SHPHs, the manpower increased from before the transfer by an average of 0.74 people per hospital.
3) Information system management, found that for the most part, information system management remains
the same as before the transfer. 4) Management of medicines, medical supplies, and medical equipment.
It was found that after the transfer to the PAOs, overall medicine management medical supplies and
medical equipment of the SHPHs (93.75 percent) remain the same. 5) Management of the financial system
and budget found that after the transfer the characteristics have changed as follows: (1 ) Lump sum
payments per capita from NHSO account for 36 percent of total income. (2) Income from subsidies according
to the size has been additionally allocated according to the transfer criteria. The proportion is 40 percent,
(3) additional subsidies from the PAO, an average of 3 percent, (4) Subsidies from the local health insurance
fund, 6 percent, (5) Depreciation money, 5 percent, and (6) Income other 10 percent 6) Primary health
system governance found that after the transfer It is likely that the primary health system of the PAO and
the Provincial Public Health Office will be separated from each other. If there is no proper integration, which
both the Provincial Public Health Office and the PAO agree that There should be a unified national health
care system developed according to the principles of the primary health system and 7) Public participation.
It was found that after the transfer the results and impact on the people in various services at the SHPHs
remain mostly the same as before the transfer. People are more satisfied. and have confidence in the
services of the SHPHs.
