In the context of transfer of Sub-District Health Promotion Hospital (SDH) to Provincial Administrative Organization (PAO), there are certainly many more issues to be explored and considered to find joint solutions on an ongoing basis. . But there is another big issue that is equally important to work on. That's the thing “Monitoring, Monitoring and Evaluation”
“The Coverage” had the opportunity to discuss this issue Dr. Subakit Sirilak Health Systems Research Institute (HSRI), Health Systems Research Institute (HSRI), Health Systems Research Institute Director, HSRI acknowledges as a supporting institution for health systems research. Concerns are raised about monitoring and evaluation of primary health care services in the converted Sub-District Health Development Hospitals.
This is because monitoring and evaluation of work performance can be very important. But at the moment no mechanism or tool is efficient enough to be used.
Big problem 'Provincial Administrative Organization Public Health Division' Not enough people.
The Director of HSRI explains the principles of work supervision and monitoring which consists of 3 methods: 1. Follow-up and supervision from reports or report monitoring Reports on program implementation such as how to deliver public health services What is the state of public health? As the data comes in, it is analyzed centrally.
2. Monitoring by meeting or monitoring by meeting Many organizations hold meetings and necessary information is conveyed. If there are problems with this, they can ask and exchange questions and 3. Observation and observation by observation or Field monitoring This is the nature of a field visit
The Point of Problem First, the structure of the Public Health Office was that the District Public Health Office (PMO) and Provincial Public Health Office (PHO) under the Ministry of Public Health (MOPH) were the supervisors to supervise and monitor the work. To be consistent with the management plan and to have systems and procedures in place to adequately supervise and monitor the Sub-District Health Promotion Hospital under its jurisdiction with a team of staff.
However, when it is transferred to the provincial administrative system, it is the main institution to be monitored and monitored Provincial Administrative Organization Public Health Division With approximately 7-8 staff members, supervising and following up the transferred Sub-District Health Promotion Hospitals will not be sufficient and will have an impact on the overall health goals of the country.
Dr. Subakit said that in the past, the Public Health Division staff of the provincial administration had about 7-8 staff at each location. Being responsible for taking care of the health system in the area may not have directly taken care of public health before but when it comes to taking on the responsibility of supervision and monitoring, you may not be prepared. Monitoring and surveillance especially through surveillance. Not enough manpower
“If there is not enough monitoring and surveillance, we can get incomplete information about health services for the public. This will have an impact on further research, including information that has already been processed by the Sub-District Health Development Hospital to improve the health system of the country. There will be no analysis of whether the operation was carried out as planned or not. And what are the obstacles? Are there?” He gave a picture of that.
So this has become another problem for HSRI, which has to support research and research until it has empirical evidence. There are any processes or methods that can be used as tools to effectively manage the issues of supervision, monitoring and evaluation.
“On the other hand, the Public Health Division of the Provincial Administration should train officials to supervise and monitor the work of Sub-District Health Promotion Hospitals. If there are any issues, they will be resolved immediately,” the NRCT director added.
Key solution relationships. 'Provincial Administrative Organisation – Provincial Public Health Office'
Personally, if there is a good relationship between the provincial administration and the provincial public health office, Dr. Subakit believes. A provincial governing body that can come together and work together as a network can request cooperation to become a health board. The duties of the Provincial Public Health Office are not to command or direct. But Sub-District Health Promotion Hospital will provide educational support to function properly. This will enable effective tracking and monitoring, including the collective storage of service information.
“Continue to work together as a trusting network of collaboration between the two organizations. So, this may be the best mechanism at this time. But research should have a long-term perspective. Or there is a role model in some areas with an oversight system. “Strong and effective monitoring and evaluation so that other provincial administrative bodies can further study or adapt,” he said.
There is also research from Chulalongkorn University, said Dr Subakit. Reflects and emphasizes the relationship between provincial administrative bodies and provincial public health offices, which are important to the primary care system. If the relationship between them is not good, it will cause problems in monitoring and monitoring the work of sub-district health promotion hospitals, which according to HSRI's research, some relocated sub-district health promotion hospitals have reduced services.
Therefore, it will allow relevant agencies to be confident that there will be follow-up and accurate information if an effective monitoring mechanism is in place. If there is close monitoring and rigorous monitoring it will effectively reflect the health service information of the Sub-District Health Development Hospitals. But on the other hand, if there is no supervision and follow-up it will cause problems in the overall picture of primary care work across the country.
“I think management policies should depend on strong supervision and follow-up. This will strengthen the transformation of sub-district health development hospitals. And ensure that health services are provided to the people. It is people-centered and effective and really achieved the goal,” said the NRCT director.
Join solving research stock indicators – Find a way
On the one hand, Dr. Subakit sees that HSRI should try to conduct research on its own to uncover the issues of the situation for shifting Sub-District Health Development Hospitals. If it is set as an 'indicator' of transfers, it will have 2 parts. : 1. National core indicators so that indicators can be set for each region accordingly.To lead towards the goal 2. Regional indicators are determined as per the requirement of the region This is consistent with the principles of decentralization
However, no matter how the indicators are set, if there is no mechanism for tracking and monitoring it is impossible to know whether the operation went as planned.
“Monitoring, monitoring and evaluation is a very important mechanism. But today no single mechanism is found to be strong enough. This research may help to know if there is a system or what mechanism exists for effective monitoring, monitoring and evaluation? Used to transfer sub-district health development hospitals to provincial management systems, ” asserted Dr. Subakit.
At the same time, another aspect is complicated. That is, the supervision and monitoring of sub-district health promotion hospitals in areas where their work has not been transferred to the provincial administrative system, he considers another issue that requires research on how to manage them. But in principle, if the provincial public health office and the provincial administrative body have a good relationship, collaborate as a network or alliance. This should solve the problem of surveillance monitoring.
“Policy requires local governments to scale up and be efficient in managing the entire system. Because in the future, medical supplies and drug storage will need to be managed and fully understood. Sub-district health development hospitals should be ready to scale up so that they are not trapped in providing public health services. ,” concluded Dr. Sukith.
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