The Potential of the Local Health Fund for Health Promotion: A Case Study of Khlong Thom District, Krabi Province

Abstract

This qualitative research was a multiple case study that aimed to explain the potential of the local health fund for health promotion in Khlong Thom District, Krabi Province. Qualitative approaches were used to collect the data - documentary reviews, in-depth interviews, and focus group discussions, during June-July 2021. All thirty key informants were committees of the local health funds, consisted of nine executives of the local administrative organizations, nine staff of the local administrative organization who responsible for the local health fund work, ten directors of the health-promoting hospital, and a public health executive and a local health fund staff at the district level. Data have been verified the accuracy by using the triangulation method. Then, content analysis was used to analyze the data.

          The results revealed that during the fiscal year 2019-2021, the local health fund supported the projects focusing on the general people at risk and working-age groups while providing budget support to the organizations/groups of people/other agencies the most, followed by service units/service centers/public health agencies. For the management of health promotion and disease prevention in 6 components of the operation of the local health fund, namely 1) the potential of the local health fund committees which should be more developed, 2) Management of the local health fund which found the limitation on budget disbursement practice due to unclear guidelines, 3) Development of plans or projects which the district and fund committees jointly determined the direction and issues for propulsion, 4) Implementation of projects, plans to drive health promotion which operated at the district level by the district committees and at the sub-district level by the network mechanism of local health funds, 5) Reporting system of the local health fund which consistent with actual practice, and 6) Developing a monitoring and evaluation system to supervise its performance continuously and up to date. However, the district and local health fund should collaborate to determine the direction of health promotion and disease prevention so that the policy and practice will be implemented in the same way.