Outcomes and Management of Chronic Non-communicable Disease by the Health System of Panom District, Surat Thani Province

Abstract

This qualitative research aims to study the outcomes and management of chronic
non-communicable diseases (e.g., diabetes, hypertension) of Phanom District, Surat Thani
Province, Thailand. The data were collected using documents review (2012-14), in-depth
interviews and groups interviews with managers and relevant staff at the provincial, district
and sub-district levels as well as the clients. The preliminary findings were presented to
stakeholders at a workshop to solicit input and validation. The formulation of policy and
measures to address the challenge of non-communicable disease (NCD) is primarily a
function of national agencies such as the Ministry of Public Health (MOPH), the National
Health Security Office (NHSO) and the Thai Health Promotion Foundation (THPF). The
MOPH and NHSO develop the strategies and project plans. The NHSO focuses on
implementation systems, evaluation and financial support in accordance with quality
standards of management. The THPF supports disease prevention activities at the subregional
and provincial levels, stratified by departmental specialties and sectional roles and
responsibilities. The disease control sector manages projects on treatment, health education
and behavior change interventions to reduce NCD. The health promotion sector manages
the DPAC clinic activity. These two sectors operate somewhat independently of each other.
At the sub-provincial level, the district health system consists of the Phanom Community
Hospital, the District Health Office (DHO) and Tambon health promotion hospitals (THPH) in
the districts. The district health system work corporately with partners such as local
administration organization, other ministry offices, communities, and civil society groups.
The wide range of activities to address the NCD challenge have been organized by the
district health system under the PHANOM Project strategy. Oversight is provided by the NCD
CUP Board which also issues guidelines for action plan evaluation and surveillance. Case
management of the NCD Clinic already meets quality standards; thus, the focus of the
district is on NCD prevention and control, with challenges indicators, targets and intensified
implementation.