Management Guidelines for Developing Primary Health Care Standards in Subdistrict Health Promoting Hospitals under Provincial Administrative Organizations

Abstract

This descriptive qualitative study aimed to develop management guidelines for improving the quality and standardization of services provided by Subdistrict Health Promoting Hospitals (SHPHs) under PAOs. The study was conducted in 8 provinces across 4 regions of Thailand between August and December 2024. Key informants involved in primary healthcare services were purposively selected and categorized into 5 groups: SHPH practitioners, local administrative executives, service recipients, District Public Health Offices, and Provincial Public Health Offices. A total of 352 participants were recruited. Data collection proceeded until data saturation was achieved. The study ensured trustworthiness. Data were analyzed using thematic analysis.

The findings identified 4 key components for participatory primary healthcare development: 1) Health Workforce: Workforce allocation should match workload demands, supported by academic and clinical consultation systems; 2) Health Financing: Clear budget planning should reduce duplication and support shared health goals; 3) Medical Supplies and Infrastructure: Medicines and medical supplies should be systematically planned, monitored, and evaluated; 4) Leadership and Governance: Collaboration among PAOs, public health agencies, SHPHs, and communities should promote standardized health promotion and disease prevention services. The study proposed a prototype framework for sustainable and standardized SHPH management under PAOs. Key recommendations include establishing an MOU between the Ministry of Public Health and the Ministry of Interior, area-based health committees, and integrated interministerial information systems.