Oral health care system after decentralized the Sub-district health center to local authority: a case study of Sun-Nameng sub-district, Chiang Mai Province

Abstract

The objective of this report was to describe oral health care system,

achievement and success factors of Sun-Nameng sub-district after the decentralization to local administrative authority since 18 October, 2008. The law and policy of decentralization, and oral service activities in Sun-Nameng sub-district were reviewed. The 15 key informants related to the decentralization were interviewed. It was found that in the year 2017, 0.52% (51 out of 9,762) of sub-district health centers were decentralized to local administrative authorities. After being decentralized, the service system was improved in various areas, such as providing routine health care service by volunteer physician, 24-hour emergency service, preventive and promotive activities, as well as oral care services. The local administrative authority supported budget for 2 dental nurses as permanent staffs that collaborated with dentist for dental care , provided room and facilities, dental unit, and dental materials. The oral activities could meet the MOPH indicators for pregnancy women, children, elderly group and general population in the sub-district. The data from Health Data Center (HDC) from the year 2014 to 2018 showed that number of dental service increased 133.3%. The success factors of oral care services after being decentralized included a clear direction and support from local administrative authority, the support from district hospital, and the perception that oral care activities can help local administrative authority gaining credibility and acceptance from the people in the sub-district, which people health was a main objective.