Capacity Building for District Health Networking to Achieve a Health Promoting District: Case Study of Nai Muang Sub-District, Sawan Khalok District, Sukhothai Province

Abstract

The purpose of the qualitative research was to explore and retrieve lessons learned from health care services and care management among bed-bound elderly of Nai Maung Sub-District, Sawan Khalok District, Sukhothai Province. Key informants were administrator and professional nurses of the Sawan Khalok hospital, head of the Primary Care Unit, the Mayor of the Sub-district municipality and municipal staff, community leaders, village health volunteers, community people, and caregivers; a total of 45 informants. Question guidelines to be used for data collection were validated by experts. Data were collected from secondary sources, by in-depth interview, focus group discussions, participatory observation, and field notes. A content analysis approach was used in the analysis of the collected data, and conclusion drawn, lessons learned and themes developed. The input aspects included utilizing social capital, and the potential of district health networks to engage in care management of bed-bound elderly. The process aspects were 1) integration between community health plans and planning of district health networks 2) focus on people building and teams working in care management 3) linkages with levels of care 4) care management 5) community resource utilization and administration. The output aspects include 1) bed-bound elderly received holistic care, palliative care, and no abandon elderly 2) using local wisdom to promote health 3) having satisfaction on home health care, and ensuring unseen cases of bed-bound elderly can access to health care services 4) welfare receiving correct welfare allowances for the bed-bound elderly, and for equipment support 5) renovating housing and environment to enhance health 6) having pride in working and 7) having happiness. Factors of success were 1) participation and collaboration between stakeholders and health service networks 2) leadership, 3) interaction and good relationships 4) having a caring mind 5) seamless coordination between participating parties 6) a variety of budgetary sources and 7) data sharing. The findings were that care management of bed-bound elderly, focusing on social capital and health service network capacity, can effectively drive service development for the future.