Abstract
Background: The deep southern border provinces consist of Pattani, Yala, Narathiwat and 4 districts of Songkhla province--Nathawi, Chana Thepha and Sabayoi, which are the diverse areas of life under the framework of beliefs, religions, cultures, and other traditional ethnic groups. Besides, there has been a situation of unrest and violence for more than 15 years, affecting health service systems, quality and accessibility. This research is a descriptive study aimed to explore the feasibility of applying the multicultural health service standards for the three levels of health services in those areas to meet the spiritual needs, religions, cultures and customs of each ethnic group or focus on the culture of the sub-groups, contributing to health equity. Methods: The study consisted of 2 phases between June 2018 - November 2019: phase 1, the draft criteria were developed in 5 steps. First, documentary research was reviewed and synthesized to provide a general understanding of the multicultural health service standards in other countries. Second, the survey was conducted to draw the opinions of people in the area by using questionnaires. Third, the focus group discussion was performed between the recipients and health service providers. Fourth, in-depth interviewing was a loosely structured interview among the service management team such as the hospital director, head of district public health, and the local government organizations. Fifth, the content of the standards was screened and standardized by experts such as provincial public health doctors in Delphi techniques. A total number of 5,555 people were given information in these processes. Phase 2, a feasibility study of using standards was launched in the pilot areas with 3 steps: (1) the standards were approved by policymakers to consider into action, (2) the standards were implemented in pilot hospitals, and (3) an evaluation and monitoring was then proceeded to announce as a policy. Results: The multicultural health service standards were finally drafted and organized into 7 main criteria and 47 sub-criteria. The standards were then implemented in 4 hospitals in study areas and 1 hospital in the other area that has a similar context. The parallel evaluation during the trial period revealed that the customers’ opinions for the service quality were 88.6-99.4%. They knew, needed and satisfied this service that was 34.3%, 99.2%, and 97.1% respectively. While the health care providers know about this service 100% and need it 85.0%. The outcomes also provided 97.9% of the concrete model and 98.6% having good management for customer complaints. Suggestion and conclusion: The feasibility study of the multicultural health service standards utilization in the Southern border provinces has contributed to familiar and acceptance among recipients and health service providers. Therefore, this is an opportunity for the Ministry of public health and local administrative organizations to promoting as a policy to apply in all health services and in communities for better service accessibility in the long run.
