Abstract
The transfer of sub-district health promoting hospitals to provincial administrative organizations is
a form of decentralization that affects health services for people in the area. This mixed methods study
aimed to analyze situations of health workforce management and to develop policy recommendations
for health workforce management at primary care units under provincial administrative organizations in
response to pandemic. Qualitative data was collected from 64 people who are directors of the public
health division, provincial administrative organizations and medical and public health staffs of health
promoting hospitals by using interview guidelines. Quantitative data was collected among 410 service
users of the sub-district health promoting hospitals using validated questionnaire asking demographic
data and service satisfaction during the COVID-19 pandemic (Cronbach’s alpha 0.92). Demographic and
service satisfaction data were analyzed using frequency, percentage, mean, and standard deviation.
Qualitative data from interviews were analyzed using content analysis and then policy recommendations were developed. The results revealed that policy recommendations for directors of public health,
provincial administrative organizations include 1) establish a workforce with expertise and a sufficient number to cope with the pandemic, 2) define clear roles of the workforce during an epidemic,
3) develop expertise in epidemiological investigations for health workforce in the public health division,
and health promotion hospitals, 4) support health promotion hospitals with adequate facilities, isolation rooms, medicines and medical supplies to ensure operational safety, 5) organize a care system
and provide welfare for health workforce working during the pandemic, and 6) establish measures and
guidelines to support the operation of health workforce during an epidemic. Policy recommendations
for directors of health promoting hospitals include 1) mobilize a sufficient health workforce for the
pandemic, 2) manage missions in the epidemic effectively, 3) prepare facilities and emergency equipment
storage to be ready for use in the event of an epidemic, and 4) organize the care and supply of health
workforce during an epidemic.
