Abstract
This research is an evaluation of the 10th Participatory Health Region implementation using the principles of the CIPP model for collecting data from the Committee for Public Health Region 10 and stakeholders from 5 provinces. Data were collected by analyzing secondary data, in-depth interviews, focus groups, self-administered questionnaires, and practice observations. The obtained data were analyzed using content analysis together with descriptive statistics and synthesis content. This study has 4 objectives which are: 1) To assess the governance care in the area, 2) To evaluate the implementation of the 10th Participatory Health Region on issues related to governance results in health region 10, 3) To evaluate the performance of the health region committee, according to their mission by focusing on a leverage for reform issue, including solid waste problem, road traffic accident, food safety (organic farming) and early childhood development problems, 4) To assess the value of the health region committee's operations in 5 areas: co-ordinate, co-sharing, co-direction, co-integration, co-power and resource and synthesize policy proposals for implementation of the Health Region and the central government. The study indicated that every committee understands the context, roles, duties, and goals of Public Health Region 10, but it takes 1-2 years to adjust to the concept before being able to understand the roles and responsibilities. The board has a total of 44 people and is acquired through the recruitment method and selection is from 3 organizations which are government agencies, private organizations, and civil society. The number of the board who can carry out the tasks by attending the meeting regularly and able to work according to their roles and responsibilities, approximately 20 people only. More than half of the board came from Ubon Ratchathani province, which was not distributed in other provinces in the area of public health region 10. All agencies of the committee - especially the government sector - provide good support regarding the approval of personnel to attend meetings and become a part of the working committee on the local reform agenda. And also for support meeting places for the board. As for the budget and resources, there is very little support. Since this committee is responsible for the coordination of various networks, a budget is not available for operating projects or activities but only for coordination purposes. The budget received is one million baht per year which is not enough when there must be site visits in the area to support the leverage for reform issue. The performance evaluation of the board passed as planned but still did not reach the desired outcome as there is no clear goal and indicator of the success of the plan. The most obvious output was the leverage for reform issue of 4 issues, namely road traffic accidents, solid waste management, early childhood development and food safety/organic farming. All issues were met according to the plan, namely the operational committee for these issues is appointed in each province. There is a direction and working with other agencies in the area. Lessons are learned for each issue and lead to setting a target group for further expansion in other areas. Assessment of the operational value of the board found that coordinated and co-integration tasks had an average of 3.6 points, while the co-power and resource missions were of lower average value at 3.1 points. The performance evaluation of the health region 10 committees using the principles of the CIPP model found that despite efforts to use the 5 principles for coordination, it still had a lack of alignment and focus on driving work to lead to concrete changes, especially in terms of monitoring and evaluation. If it is necessary to continue this board, there should be confidence in the ideology of continuity and sustainability of cooperation from partners in the regional health network in the following areas: 1) Creating commitment and seriousness at every level - particularly from the central part - since the board has a loose mechanism and lack of common goal and pride in the organization. 2) Developing mechanisms to guide and experiment with systematic operations in area 3) Increase clarity in supporting management systems, both in terms of strengthening the secretarial team and the exchange of knowledge management to be continuous and sustainable. 4) There should be a form of learning for systematic management from foreign countries or agencies in Thailand. For example, the Sub-district Health Insurance Subcommittee of the National Health Security Office that has been in operation for over 15 years would benefit the administration of the board in the future. 5) In terms of structure, there should be a clear workplace in the health district committee for more concrete coordination. 6) In terms of the policy, the district health region committee is necessary to work with various mechanisms that existing in the areas such as the District Quality of Life Development Committee, the Provincial Elderly Committee, etc. It should create a chain of driving mechanisms in both operational planning and indicators including the knowledge management and sharing mechanisms. This will help to support solving various problems under the 5 key components of the board and will be a big improvement. The study has some limitations. The main informant is the health region 10 committee which is the main stakeholder of the area. Second is data from the secretarial team tends to give positive information to the research team. Information from non-committee members and working groups in the 10th health committee, in particular from relevant government agencies and people involved in the target areas in each agenda are small in number and therefore availability of some information is limited.
