Abstract
The regulations emphasize enhancing the role of village health volunteers (VHVs) in
promoting community health, especially among vulnerable groups. VHVs are encouraged to
develop skills and knowledge to become community health leaders and managers, with their
roles linked to Subdistrict Health Promoting Hospitals (SHPH). The regulations also outline how
VHVs should adapt to future public health trends in Thailand.
However, the decentralization of local administration may impact the roles of VHVs.
This research project aims to align VHV services with the evolving public health system after
the transfer of SHPHs to Provincial Administrative Organizations (PAOs). The study employs
qualitative research techniques to gather detailed insights and perspectives from senior
executives and experts, focusing on the transfer of public health responsibilities to local
administrative organizations in Kanchanaburi Province.
The research objectives of this study were: 1) To identify and explain the knowledge
and capabilities of VHVs before and after the transfer, and the challenges faced in transferring
SHPHs in Tha Muang District to the administration of Kanchanaburi PAO; 2) To develop the
roles of VHVs to enhance health services and community development following the transfer
of SHPHs to Kanchanaburi PAO; and 3) To develop policy recommendations for VHVs to
promote disease prevention behaviors in areas where SHPHs have been transferred to
Kanchanaburi PAO.
According to the first objective, the primary roles of VHVs remain unchanged, but
changes in local health organizations affect their work. VHVs need to develop technology skills
for recording and reporting work results and require additional training. There is also a need
for clarity regarding benefits and compensation to reduce confusion and enhance
understanding of the system changes. Coordination must pass through PAOs and district health
organizations, but VHVs continue to work with SHPH staff, with increased workloads to align
their work with policies and agreements. While these changes may complicate their work,
support and supervision are crucial for effective community health services.
Furthermore, there is a disparity in the capabilities and knowledge of VHVs, which may lead
to inconsistencies in local health management. Skills needing improvement include using
tools, accurate data recording, and IT proficiency, especially among the elderly. Addressing
unequal abilities and knowledge levels among VHVs is a challenge. Additionally, promoting
acceptance and understanding of VHVs' roles within the community is essential, as some
communities may not see VHV services as necessary or may lack prior experience with them.
Building trust and understanding of VHVs' roles is crucial for improving local health services.
For the last objective, collaboration between local agencies is vital for developing and
supporting VHVs' work. Integrated work and cooperation between agencies should be
encouraged to build ongoing positive relationships. Joint policies between PAOs and Provincial
Health Offices (PHOs) and collaborative work plans should be established for clear task
assignments. Emphasizing inter-agency cooperation and continuous data collection support is
important. Creating forums for knowledge exchange to maintain VHV engagement and
involving local leaders in VHV work are also necessary. Enhancing VHVs' public health work
capacity, allocating budgets for further education at various levels to standardize knowledge
and skills, supporting work tools, providing welfare, and setting criteria for admission,
resignation, and compensation are key to improving VHVs and supporting community work at
various local levels.
