An Evaluation of Health Mission Transferred to Local Government Organizations in Regional Health 3
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Abstract
Background: Health care decentralization was expected to change in improving health system quality. In Regional Health 3, the health care mission of six health centers were transferred to local governance organizations. Many existing studies explore the effect of the health mission transfer but the focus on health service dimension did not cover the six components of health system recommended by the World Health Organization (WHO).
Objectives: To examine the level of performance of transferred healthcare services mission and compare their level of performance from each other and to study the effectiveness of management after the health mission transfer according to the WHO’s health system components.
Materials and methods: The mixed methods were used to collect the data. The research instruments were composed of the questionnaire and semi-structural in-depth interview. Descriptive statistics and content analysis were used to analyze the data.
Results: The study found that the health centers had a high level of performance on both overall health system and each of 6 components according to the WHO’s health system components. There were significant differences in overall health performance according to the WHO’s health system components among gender, age and the number of service usage at p value <0.05. However, the level of education, medicare benefits scheme and the health centers had no difference in overall health performance. For the effectiveness of management, it was found that the health service system, budget system and better relationship were good after the health mission transfer. On the other hand, human resource management, health informatics quality, as well as drugs and medical supplies were still limited and operating similar to the health center under the Ministry of Public Health.
Conclusions: Health mission transferred to local government organizations in Regional Health 3 was better able to respond to the people’s health needs. However, some of the WHO’s health system components need to improve.
Keywords: evaluation; health mission transfer; the health center; local governance administrations
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References
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