Implementation of "Sustainable and Strengthening Disease-Control District" Policy in 7-Province Areas of Upper Southern Thailand, Fiscal Year 2555

Abstract

This evaluation research intended to: 1) analyze the content extent of "sustainable and strengthening disease-control district" policy in terms of validity, coverage, relevance, flexibility and feasibility. 2) examine the processes and procedures of policy implementation, and 3) evaluate the outcomes following the policy implementation in fiscal year 2012. The study areas encompassed seven provinces of upper southern region including Chumporn, Nakhon Si Thammarat, Suratthani, Krabi, Ranong, Phang-nga, Phuket. Data collection was carried out from November 2011 to July 2012. The entire 147 respondents from the government, local governments, and public sectors involving in implementing the policy at the provincial, district, and subdistrict levels were recruited to our study. Instruments applied were close- and open-ended questionnaires, query evaluation forms for assessing the system management mechanism of the province and the qualification of district by the 5 areas, relevant reports or documents regarding policy implementation. Data were analyzed using descriptive statistics and qualitative content. Research results of policy content analysis showed that the validity was at a high level while the coverage, relevance, flexibility and feasibility all were at the highest level. For the processes and procedures of downstream policy implementation, the evaluation revealed most implementers convey the policy by a conference and the convey messages were clear, comprehensive, and overspread. However, the strategies to convey were somewhat different among areas. Findings of an evaluation of two-year policy implementation impact showed all 7 provinces (100%) achieved two key performance indicators: 1) meet the provincial system management mechanism for the 5 components and 2) meet the 60% of qualified districts with the five areas. Of all 74 districts in the region, 69 districts (93.24%) met the criteria of qualified district. Important factors in the overall success of their driven policies included clear policy, efficient resource management and effective area-based responses, well support by leaders at all levels, continued supervision, monitoring and evaluation, best coordination, and strengthening networks and teams. The policy recommendations of this study were are: 1) to continue this policy implement by creating the Road map to guide the actors in gearing up the policy to the sub-district level, 2) to make an agreement of cooperation with the relevant ministries, and 3) to publicize widely. Recommendation from the assessment was is to evaluate the implementation of this policy in the coming years for the sake of the development plan and the achievement of the ultimate goal of policy "an effective, efficient, timely mechanism and system of diseases and health threats surveillance, prevention and control.