Municipal Public health services Management

Abstract

This research aimed to 1)study the level of public health service administration of municipalities, the potential of municipalities, government policy, situation environment, and people's participation in public health service administration of municipalities; 2) examine causal factors influencing public health service administration of municipalities; and 3) propose guidelines for public health service administration of municipalities. A mixed research method was utilized in this study .For quantitative research, the sample consisted of (1) Mayor/Deputy Mayor, (2) Municipal Clerk/Deputy Municipal Clerk, (3) Director of Medical Division/Director of Public Health Division, (4)Hospital Director/Head of Health Service Center, and (5) Doctors/professional nurses of municipalities from sub-district municipalities, town municipalities, and city municipalities, amounting to 375 samples. A questionnaire was used to collect data. For qualitative research, in-depth interviews were conducted with the informants comprising (1) the mayor, (2) the municipal secretary, and (3) the directors of the municipalities’ public health/medical divisions. The purposive sampling method was used to choose 3 persons from each municipality, amounting to 18 persons and 2 representatives from the NHSO to obtain complete relevant information. Hence, the total sample consisted of 20 interviewees.

The results found that 1) the level of administration of municipalities’ public health services was at the highest level with an average of 4.44, followed by the potential of municipalities with an average of 4.24, while government policy, situation environment, and people's participation were at a high level with mean values of 3.70 3.91 and 4.16 respectively; 2) the causal factor that most influenced public health service administration of the municipalities was the municipality's potential with the direct, indirect, and total effects equal to 0.93, 0.06, and 0.99, respectively, followed by government policy, public participation. and situation environment with the total effects of 0.39, 0.17, and 0.04, respectively; and
3) municipalities should establish primary and secondary missions since they are spatially related while the Ministry of Health should provide missions at the advanced secondary level and tertiary level as well as academic support missions to reduce duplication. In addition, government should decentralize powers and set clear missions, roles, duties and powers of municipalities and increase the size of municipalities to have a large enough population to carry out public health missions at the economies of scale level and to increase capacity of municipalities.