The Development of Local Health Assurance Funds in Fao Rai District, Nong Khai Province

Abstract

The development of local health assurance funds focuses on the participation of community people
and local governments in improving quality to health services and health service management which will lead
to the development of popular-based health system. This action research aimed at studying the
implementation of local health assurance funds. There were four phases following the spiral action research
process, namely planning, action, observation, and reflection. A total of 49 samples were purposively which
comprised of broad of local administration organization, local administration’s members, community leaders,
sub-district health personnel, health volunteers, and community people representatives. Quantitative data
collection was collected using the reliability of 0.92 questionnaires. Qualitative data were collected by research
assistant during October 2008 to April 2009 ,interviewing the participants during meetings, group discussions,
A-I-C participatory workshops, fieldtrip, learning and sharing knowledge activities, and through followed-up
assessments. Percentage, mean, standard deviation and paired t-test were employed for data analysis.
The findings revealed that, after the experiment, the results of development of local health assurance
funds were increased in all aspect, overall, at 0.05 level of significance. That is, before the experiment, the
development of plans, service provision, and financial allocation were at moderate level. Whereas after the
experiment, the results showed that some aspects were at high level ( X = 2.48 ,S.D.= 0.22). These include
supervision and follow-up, monitoring and evaluation, service provision and planning, was at high level ( X=
2.68 ,S.D.= 0.26, X = 2.65 ,S.D.= 0.34 andX = 2.64 ,S.D.= 0.27). However, some aspects were perceived of
local health funds operation appeared to have some management problems such as financial and accounting
management, internet or online information reports and financial support from communities was at high level
( X = 2.50 ,S.D.= 0.37 ,X = 2.44 ,S.D.= 0.31, X = 2.31 ,S.D.= 0.34 and X = 1.99 ,S.D.= 0.51)
In conclusion, the application of A-I-C participatory technique, including participatory planning,
fieldtrips for learning and sharing knowledge, and supervision and follow-up assessment, as a mechanism to
improve local health assurance funds implementation throughout this study. The results revealed that some
aspects have positively changed. Therefore, implementing local health assurance funds through A-I-C
participatory technique is recommended and should be expanded community-wide.