ศักยภาพ การมีส่วนร่วมและปัจจัยที่มีความสัมพันธ์กับความสามารถของอาสาสมัครสาธารณสุขประจำหมู่บ้านในการจัดการสุขภาพชุมชนหลังการถ่ายโอนโรงพยาบาลส่งเสริมสุขภาพตำบลให้แก่องค์การบริหารส่วนจังหวัด

Chaweewan Sridawruang; Pennapa Sriring; Atcharawadee Sriyasak; Wuttikul Thanakanjanaphakdee; Chiraporn Worawong; Buppha Raksanam; Wanida Sripromsa; Manatsri Paibulsiri

Authors

Chaweewan Sridawruang Boromarajonani College of Nursing, Khon Kaen
Pennapa Sriring Sirindhorn College of Public Health, Khon Kaen
Atcharawadee Sriyasak Boromarajonani College of Nursing, Yala
Wuttikul Thanakanjanaphakdee Sirindhorn College of Public Health, Khon Kaen
Chiraporn Worawong Boromarajonani College of Nursing, Udonthani
Buppha Raksanam Sirindhorn College of Public Health, Trung
Wanida Sripromsa Boromarajonani College of Nursing, Udonthani
Manatsri Paibulsiri Faculty of Nursing, Pathumthani University

Keywords:

community health management capacity, participation, village health volunteers, devolution, sub-district health promoting hospital

Abstract

This cross-sectional analytical study aimed to investigate the capability, community participation and factors associated with the abilities of village health volunteers (VHVs) in community health management of devolved sub-district health promoting hospitals of provincial administrative organizations (PAOs). The questionnaire survey included 3 dimensions: first, the capabilities of VHVs measured in 3 domains; knowledge, attitudes, and behavioral skills in community health management. Second, the participation and third, the capabilities of VHVs in community health management; all were measured based on self-assessed questionnaire. The content validity verified by three experts was of 0.85, 0.92, 0.95, 0.92, and 0.94, respectively. The study was conducted between March 2023 and February 2024. Sample selection employed a multi-stage random sampling method. This study recruited 482 VHVs from across 10 provinces of 4 regions. Data were analyzed using a computer program. Multiple logistic regression was used to analyze the data. Adjusted odds ratios (Adj.OR), 95% confidence intervals (95% CI), and p-values were reported. Results: Most of the participants were VHVs of medium-sized health promoting hospitals (52.9%), were female (82.0%), with age range of 50-59 years (38.6%). The average duration of being a VHV was 16.38 ± 9.64 years, and 87.3% had training experience. Capacity of VHVs in community health management comprised knowledge, attitudes, and behavioral skills in managing community health in five areas: health planning, leadership and budget management, organizing health promotion activities and disease prevention in the community, evaluating community health management, and information technology for managing community health. The findings showed that most VHVs had a high level of knowledge, attitude, and behavior in community health management. Specifically, VHVs demonstrated a high level of knowledge (mean 28.16, SD=1.79). They also showed a positive attitude (mean 4.37, SD=0.49). The highest average was found in organizing health promotion activities. The lowest was the evaluation of community health management. There was a high level of community health management behavior (mean 4.31, SD=0.50). The highest mean was found in information technology for community health management. The lowest were in organizing health promotion activities and controlling them, prevent disease in the community. The community participation of VHVs in community health management was at a high level (91.9%, mean 4.27, SD=0.57). A multiple logistic regression analysis was conducted to identify factors associated with VHVs’ ability to manage community health at a high level. The analysis revealed five significant factors: 1. skill potential, 2. participation, 3. age group, 4. the duration of being VHV, 5. occupation.

References

Office of the Decentralization for Local Administration, Office of the Permanent Secretary to the Prime Minister. Handbook on the implementation of decentralization to local government organizations in accordance with the Decentralization to Local Government Organizations Act B.E. 2545 (2002). Bangkok: Office of the Decentralization for Local Administration; 2021. (in Thai)

Srisasakul J, Patcharanamul W. Evaluation of the transfer of primary care services to local administrative organizations and alternative decentralization models. Nonthaburi: Health Systems Research Institute, International Health Policy Program; 2018. (in Thai)

Thanomchaiyathawat B, Chukumnird S, Lillahkul N, Noin J, Ratchawan R, Junwin B, et al. Human resource management provided by the Queen Sirikit health centers and subdistrict health promotion hospitals transferred to the management of the provincial administrative organizations using the mechanism of the Primary Health System Act (B.E. 2562). Final report. Nonthaburi: Health System Research Institute; 2019. (in Thai)

Sarakshetrin A, Sriyasak A, Chantra R, Krirkgulthorn T, Nimwatanakul S, Chenktin T, et al. The proposed policy to human resource for health management during the transitional period of transfer health promotion hospital to provincial administrative organization. Final report. Nonthaburi: Health Systems Research Institute; 2022. (in Thai)

Department of Health Service Support. Handbook for village health volunteers and community health managers. Nonthaburi: Department of Health Service Support, Ministry of Public Health; 2013. (in Thai)

Rongmuang D, Sukrungreung I, Thongdee J, Dechavoot L, Suwannarat K, Sarakshetrin A, et al. Provision of services according to primary care service standards and certification of service standards of sub-district health-promoting hospitals under the provincial administrative organization. Final report. Nonthaburi: Health Systems Research Institute; 2022. (in Thai)

Daniel W, Cross C. Biostatistics: a foundation for analysis in the health sciences. 10th ed. New Jersey: John Wiley & Sons; 2013.

Soonthorn S, Sriyasak A, Leungratanamart L, Tongpeth J, Boonmee L. The development of the community health management models during the post-crisis of the COVID-19 pandemic for village health volunteers in the 5th and the 6th health regions. Final report. Nonthaburi: Health Systems Research Institute; 2022. (in Thai)

World Health Organization, UNICEF. Operational framework for primary health care transforming vision into action. Technical series on primary health care. Cairo. Switzerland: YAT Communication; 2022.

Thianjuruwatthana W, Nawsuwan K, Vachiraprapun S. Guidelines for development of quality village health volunteers (VHVs) to support the health workforce for the future health system. Journal of Health Science 2021;30(2):353-66. (in Thai)

Techathan C, Rattanapanna S, Jaitia S. Effect of empowerment program of the village health volunteers to implementation of community health education in Papai municipality, Sansai district, Chiang Mai province. College of Asian Scholar Journal 2019;9(1):17-24. (in Thai)

Thongchai C, Boonnjarut S. Capacity adaptation of village health volunteers under changing contexts in the semi-urban area of Ban Thabo, Chae Ramae sub-district, Ubon Ratchathani province. Area Based Development Research Journal 2017;9(3):206-20. (in Thai)

Choomee P, Udomkitpipat J. Knowledge of chronic diseases and competencies in providing services regarding chronic diseases in the community of village health volunteers in Surat Thani province. Journal of Legal Entity Management and Local Innovation 2021;7(4):277-93. (in Thai)

Tippetch P. Factors influencing village public health volunteers’ performance in Mab Pong sub-district, amphoe Panthong, Chonburi province (master’s thesis). Faculty of Public Administration, Burapha University; 2017. (in Thai)

Hnuploy K. Factors related to the work performance of volunteer village health workers in Phatthalung province (master’s thesis). Department of Health System Management, Graduate School, Thaksin University; 2010. (in Thai)

Ha N. Competencies development for village health volunteer of Muang district, Phuket province (master’s thesis). Department of Public Administration, Prince of Songkla University, Hat Yai, Thailand; 2019. (in Thai)

Charoenson P, Munsawaengsub C, Nanthamongkolchai S, Pitikultang S. Role of village health volunteers in family care team practice, Chanthaburi province. Proceedings of the 20th National Graduate Research Conference. Mar 15, 2019. Khon Kaen University. MM022; 2019. (in Thai)

Suwannakoot N, Nakrukamphonphatn S, Natason A, Lamduan W. Factors predicting to caring competency of older people among village health volunteers in Ubon Ratchathani province. Journal of Science and Technology Ubon Ratchathani Rajabhat University 2021;23(2):18-26. (in Thai)

Chuengsatiansap K. Health volunteers in the context of changes: potentials and development strategies. Final report. Nonthaburi: Health System Research Institute; 2016. (in Thai)