Assessment of community health fund, Public Health Region 11, to support the next phase of policy making: รายงานฉบับสมบูรณ์ การประเมินนโยบายกองทุนหลักประกันสุขภาพในระดับท้องถิ่น เขตสุขภาพที่ 11 เพื่อสนับสนุนการดำเนินนโยบายในระยะถัดไป

The implementation of decentralization concept under Thai health policy follows the National Health Security Act B.E. 2545 (2002) and Determining Plans and Process of Decentralization to Local Government Organization Act, B.E.2542 (1999). Community health funds (CHF) have been set up by National Health Security Office (NHSO), Ministry of Public Health, and Department of Local Administration, Ministry of Interior at the subdistrict level, emphasizing on participatory process. CHF primarily aims to support health-related activities done by communities and organizations based on community demand and readiness. CHF can be used for health promotion, prevention, rehabilitation, and proactive primary healthcare. This study was a mixed-methods study conducted in the Public Health Region 11 (upper southern Thailand). First, tertiary data from NHSO region 11 was analyzed to provide an overview of the regional situation. Afterwards, interviews were conducted; interviewees included NHSO region 11 personnel and subjects from 10 subdistricts (6 subjects for each subdistricts: 3 CHF committee and 3 non-CHF committee). We were able to complete 57 of 60 planned interviews from the subdistricts. Among 10 subdistricts, 5 were selected from the eastern coast; other 5 were selected from the western coast with mixing between good and bad performance CHF of those subdistricts. Two subjects from a provincial state audit office were also interviewed. Moreover, a population survey was conducted in those 10 subdistricts. The sample size was 350 (35 subjects from each subdistrict). Subjects were residents of each subdistrict aged 18 years and above who did not work with SAO or public health centers/hospitals. Preliminary results were presented to stakeholders including NHSO, SAO, community members, public health officers, and HSRI on 28th June 2018. Discussion during the presentation were recorded, analyzed, and included in the final report