Mechanisms for driving the implementation of community-based health public policy to build the strong communities, Thaweewatthana district, Bangkok

Abstract

This study aims (1) to study and assess level of community engagement and compare between urban and suburban communities (2) to study the implementation of community-based health public policy Thaweewatthana district, Bangkok (3) to propose guidelines to drive community-based health public policy Thaweewatthana district, Bangkok. A convergent Mixed Methods Design, quantitative part recruited in a sample of 120 inhabitants; which included the community presidents, secretary of the community committee, health volunteers, government officials from the Public Health Center, the community development and social welfare department of Thaweewatthana district, office. A self-administered questionnaire was used to collect data with validity of 0.87 and internal reliability of 0.89. Descriptive data were analyzed using t-test. In regarding to qualitative research, an in-depth interview was conducted with community presidents and health volunteers with structure interview guidelines.

The results showed that: (1) Assessment of the strong communities in 9 dimensions ranked from the highest to the lowest as followings: community leaders, mentor relationship building, organizational structure, participation, management, problem assessment, discretion to find causes and approaches, linking with third parties and organizations and resource mobilization. Suburban communities scored higher in all dimensions. The dimensions of participation, resource mobilization, connection with people and external organizations, discretion to find causes and solutions and management were significantly higher than urban communities (P<0.05). (2) The most of them had structural components of the community-based health public policy but a small component, A horizontal network structure between multilateral non-mandate power structures and the establishment of MOUs between stakeholders. In regarding to social capital and process, it has a strong point that executives of departments shared goal of working for the health of the people. The weaknesses pointed out that stakeholders have ownership of the processes and outcomes and have to support budget and resources from network partners. Positive factor was the awareness and interests in the health of the people. Negative factor was the lack of budget support, awareness and understanding of the implementation. (3) Mechanisms for driving is beginning to develop the potential of community leaders, community learning, to development strong community potential, finding network partners, data collection design and analyzing the data, problem identifying and it determinant factors, project formulation, budget plan from the Thaweewatthana district, Health Security Fund.