Implementation of Non- Communicable Disease Prevention and Control in Local Administrative Organizations, Samut Prakan Province

Abstract

Objective: 1) To study the situation of the operation of prevention and control of non-communicable diseases in local administrative organizations in Samut Prakan Province and  2) To develop guidelines for the operation of prevention and control of non-communicable diseases in local administrative organizations in Samut Prakan Province.

Materials & methods: The research design is mixed method research consisting of Quantitative Research and qualitative research in the form of Action Research, which consists of Phase  1: Planning, Phase 2: Action, Phase 3: Observing, and Phase 4: Reflecting.

The population and samples used in the quantitative research were executives of local administrative organizations, directors/heads of public health and environment divisions of municipalities, persons responsible for prevention and control of non-communicable diseases of local administrative organizations, and relevant persons from all 49 local administrative organizations, 1 person per organization, totaling 49 persons. The quantitative instruments used were the survey on the implementation of prevention and control of non-communicable diseases in local administrative organizations in Samut Prakan Province. The qualitative research instruments (action research) were the focus group discussion form and the in-depth interview form and non - participant observation form.

Results: The results of the study found 1) The overall situation of the operation of prevention and control of non-communicable diseases of local administrative organizations in Samut Prakan Province was at a moderate level, with an average of 2.24. The highest performance results were in the areas of operation planning, operation strategies, and resources, followed by participation in the operation, organizational structure and management, prevention and control of non-communicable diseases in the area of ​​responsibility, and supervision, monitoring, and evaluation of the operation and work standards. The main obstacles were insufficient staff for the operation, frequent transfers and changes of work locations, no non-communicable disease situation in the area of responsibility, and low public cooperation in screening for diabetes and high blood pressure. 2) Developing guidelines for the prevention and control of non-communicable diseases in local administrative organizations that are clear and appropriate for the context of Samut Prakan Province, where the urban area and local administrative organizations have one of the highest incomes in the country. It is considered that they have the potential to manage the prevention and control of non-communicable diseases in the area. In terms of organizational structure and management, the organizational structure must be reviewed, personnel must be adequately managed, and clear work assignments must be issued. The health insurance fund at the local level must be managed to maximize the benefits of the people. In terms of planning, strategies, and operational resources, there must be a database system for planning operations and solving public health problems at the local level in collaboration with local public health service facilities.

Conclusions: Local administrative organizations in Samut Prakan Province, which is an urban area, have high potential, especially in terms of budget, which has one of the highest incomes in the country. More than 90 percent of them participate in the local health insurance fund, including many public health centers that can be models. The operation of prevention and control of non-communicable diseases (NCDs), especially diabetes and hypertension, which are the leading causes of many other non-communicable diseases, if the structure is organized, the number of personnel is sufficient and appropriate, the work is clearly assigned, there is a disease situation database system, and the operation is integrated with the sub-district health promotion hospitals in the area and Village Health Volunteer (VHV) in the area. There is a clear and continuous monitoring system, the operation of prevention and control of non-communicable diseases of local administrative organizations will be effective, and the people will benefit the most.