Community

RESEARCH
REPORT NRCT
Models of Health Service Rendered by Local Administrative Organizations after

the Transfer of Health Centers to the Local Authorities
Authors
Dr.Bang-on Thepthien
Ms. Piyachatr Tragoolvongse
Ms. Parinda Tasee
= Models of Health Service Rendered by Local Administrative

Organizations after the Transfer of Health Centers to the Local Authorities / .
. ; , 2554.
314
1. - - - - - - 2. - . 3. 4. I.
II. III. .
IV. Models of Health Service Rendered by Local Administrative Organizations after the Transfer
of Health Centers to the Local Authorities
WC503.6 831 2554

73170
02-4419870, 02-4419040 3 45, 54
02-4419044 www.aihd.mahidol.ac.th

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Contracting Unit for Primary Care
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Models of Health Service Rendered by Local

Administrative Organizations after the Transfer of
Health Centers to the Local Authorities

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Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ofHealthCenterstotheLocal Authorities
ASEAN Institute for Health Development, Mahidol University
Abstract
The research for Models of Health Service Rendered by Local Administrative
Organization after the Transfer of Health Centers to the Local Authorities The objective of this
research are to study on The Good Governance Management of the local authorities on health
service and challenges after health center was transferred from Ministry of Public Health. This
qualitative research used 1) formal interview with health personnels, executive board and
member of sub-district administration organization at BaanProk district, Samutsongkram
Province, villagers, at Moo1 (Baan-lad-juan) and Moo 4 (Baan-suan-pa) 2) Non-participatory
observation, 3) Community mapping and 4) Field note. All the research methods are for
answer all research question.
In 2550, the BaanProk Sub-district health center was transferred to BaanProk Tambon
Administration Organization. In term of health service there have strengths such as the health
personals work citizen center and work more closely to the villagers, the better accessibilities
of the villagers to health service, health service management by the local Administration
Organization is more flexible and freedom in term of Policy making, Human resource and
Financing.
From the improvement of the proactive management of Baanprok health centre which
is effect to increase the number of accessibility to health service in the community. The most
common of techniques have been used such as home health care, chronic disease screening
ageing care etc. From the study found beginning of self reliance and health service
satisfaction are showed. Also it show less expectation from the medical doctor service as they
know it is the limitation of the health centre. The people in the Baanprok area realize that the
health decentralization is very important. If the heath center can function for primary care
under the support of the government by people centered very effectively. The clear picture for
self reliance in the community will be reflected.

The most important challenge that found in this study is the limitation of the community
participation. Most of the local people engage their own health service activities only in
practically such as to be the health volunteers, community meeting and to be the committee in
village funds. For well being and sustainability development of community health, the
government should consider to establish mechanisms for increase public participation and
health advocacy in planning and decision making process that effect health in the community.
In the other hand the considering for local administration readiness in good governance and
political condition that relate to health service are also very important. Both of their capacity,
local people and local administration are very important for impact of health decentralization.
After transferring the health center, the health personnel have to play in the different
role of health service management by follow to Ministry of Interior role, example of financing,
budget planning, people participation, to be the committee on project presenting, purchasing.
It will be their responsibility to contribute key elements of good governance undertaken of
local government. So the decentralization and mission transfer greatly affect the livelihood and
future of health personnel. Thus, the operation in this aspect has to be carried out carefully
and clearly to ensure that, after the transfer, their rights and dignity will not diminish.
According to the health center transferring to the local government is aimed to empower the
villagers for self reliance and participate in term of policy making, management and financing.
Also the health personnel have to highly level of responsibility and accountability.
1 :
(INTRODUCTION)

2

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HIV/AIDS

(Pierret, J,
Radley, A,.(ed). 1993 ,2547 :41 - 56)
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(medical sociology)
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. 1970
Berkanovic (1972) Gallapher (1976), Gerson (1976) Gerhardt (1978) A lonzo
(1984) (
,2547 :33) (deviance)

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(actors)

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(medicocentic)

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treatment)

(Pierret, J, Radley, A,.(ed). World Of illeness. 1993, Routledge New York. : 9)
..1970
(ordinary people)
20

(the patients point of view) (the lay

perspective)
(contents) (notions)
(beliefs)
(cognitive bits of
information)

(Chrisman 1977 ; Helman 1978 ;
Pill Stott 1982 ;Blaxter 1983 ; DHoutaud Field 1984, Radley ed.,1993)

(Herzlich1973)
(social representations of health and illness)

- (Blaxtes
Paterson 1982 ; Williams 1981, 1983 1990 ; Cornwell 1984 ; Crawford 1984 ; Calnan
1987, Redly ed., :10)
(Backett
1990)
(Edinburgh)

(new health consciousness) (Crawford 1980,
Radley, ed., 1993) (health behavior)
(health promotion) life style

21
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(preventive behaviors) (behaviors for health)
(Anderson et.al., 1988)

( ,2547 :34)

/ Black Report
(Townsend Davidson 1982, Blaxter Peterson 1982 ; Cornwell 1984, Calnan
Johnson 1985, Calnan 1987) (Macintyre 1986 : 393)
social patterning

(correlate)
(occupational class)
The Health and Life-Style Survey
9,003 ..1984 1985

(multidimensional)
(objective) (subjective)
22

(Blaxter, 1990 ; 4 ,2547 :35)

1.
2.
3. /
4.

( Cornwell
(1984) Williams (1990) ( ,2547 : 36)
(interpretive approach) Calnan
(1987)

(Calnan 1987 : 8, , 2547 : 36)

(illness) (health)
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Auge (1984)

(Eventful)

()

(Pierret,
Adley (ed) 1993 : 12)

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( , 2547 : 36)

() (value)
(new health and fitness consciousness)
(healthiest) (duty to be healthy) (Zola 1977,
Crawford 1977 1980 ; Renoud 1981 ; Herzlich Pieret 1987,
, 2547 : 36) (bodyism) (selfdevelopment) (pleasure) (hedonism)

Crawford (1984)

(American health consumerism)

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()
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(internalized) (Crawfor 1984 : 97, , 2547 : 38)
(

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Auge event
( , 2547 : 38)

25
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(social
representation) ()
()
( )
(Herzlich, 1984 ; 77)
Calnan (1985)

(Calnan 1985 : 90)
(elements)

Fitzpatrick (1984)

(Fitzpatrick 1984: 19,
, 2547 : 38)
26


(reservoir of signs)
Herzlick
(terms)

(signifies)
(Herzlick 1984 a, , 2547 : 39) Pierret
( Constructing discourses about health and their social determinant)
(survey)

(
WHO ; Stacey 1976 Anderson 1984)

( , 2547 : 40)

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8 - 10
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(Community)
1.
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2.
3. (Risk group)
(Epidemiology)

(participation) (World
Health Organization-WHO) 3 (World Health Organization, 1991)
- (participation as contribution)
(labour) (cash) (material)
- (participation as organization)
-
(participation
as
empowerment)
Oakley P. Marsden D. ( Oakley P. and Marsden D., 1983)
3
1. Participation must be active:
participation involvement
2. Participation involves choices:

3. Choice must have the possibility of being effective:

29
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Hollnsteiner (Hollnsteiner M.R.,

1982) UNICEF

active
5 (Rifkin S. B., 1990)
1
2
3
4
5
1 2 passive

passive active
involvement
active involvement

passive ( 1 2)
(Non-government organization- NGOs)
active

30

(empower people)
(sustainable
development)
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( , 2541)
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(Cohen, M.J. and Uphoff, N.T., 1977)
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2. (implementation)

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4. (evaluation)
(working definition) /

(partnership)
(local self-reliance)
31
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1.

(sponsored or induced participation)
WHO Community Participation, Health and
Development: The Primary Health Care Approach. (United Nation, 1983)
3
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(self-sustaining)

1.2
(sponsored or induced participation)

1.3 (compulsory participation)

2.
2
32

2.1
2.2

- (community assessment)
- (definition of problem)
- (setting priorities)
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- (implementation)
- (monitoring and
evaluation)

5
1. /

passive participation
2. /
active
participation
3. /

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1.

2. (knowledge)
3.

34

4.
5.

1. /
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(Allan Pred and M.J. Watts, 1991
, 2549)
(James C. Scott, 1991 , 2549)
Asian
Medical Systems: A Comparative Study) (Charles Leslie, 1976)
.. 1976

..
42

1980

( , 2549)
(system centered approach) (actor
centered approach) (Symbol)
(Senses and Sensory experience)

(object of inquiry)

(Reflexivity)
(reflexivity)
(George E. Marcus and Michael M.J., ,
2549)

(Ethnographic representation)

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(James Clifford and George E. Marcus, 1986 , 2549)
5. (Decentralization)
(Decentralization)
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: Hakkinen, Gudfinnsdottir and Unde 1995; Hjortsberg and Ghatnekar 2001; Lingren 1995;
Hakansson and Nordling 1997; Hakkinen 1995; Rissanen and Hakkinen 1999; Koivusalo 1999;
Gudfinndottir and Gunnarsson 1995. (2544)
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794
8,100
180
143
486
359
241
2,488
* : ( 30 2552)

6

/
6

3 4

2
1
5

3
96

1 5
6 11
89
87 1 1
6 7 - 8 11

4.6
97
(..)
3

4 .. () 18

.. 2549 -2551

42

11

7
5 12 .
7
4 /
15 19 4
98

2552 (
29 2552)
2551
2552
()
869,997.12
1,203,154.03

12,531,957.69
11,423,647.18
4,152,167
9,177,412.41
NA
12,979,818.14
17,554,121.81
34,784,031.76
.
-

1-5 3,492
5

1. 2
2. 2
3. 1

5

5
99
417 461,000
3 36 284

-

23

300
11 87
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
100

101
102

103
104

105
5
:
1 4
(Key Infromances persons) 1
1 () 23
4 19

() 41-74 60
10 1
1
2 2
1 ()
1
4
1
1

6

1

80

2
5.1 1 ()

44
50
52
52
52
52
53
55
55
10
57
11
59
12
62
13
63
14
64
15
67
16
70
108
.4
.4
.4
.4
.4
.6
.2
.7
.4
..1
. 4
.4
.4
.4

:
1 4
5.1 1 () ()

17
70
18
73
19
74
20
41
21
52
22
60
23
74
.4
.2
.6
.6
.4
.4
1 1
44 4
200-300

4
()

10
3

2 6 1

3 14

109
5

17.00-18.00 .

() 1
U
U =c
= z 44
ego
U= c

-
( 40 ) 2-3
120,000
(
)

110

:
1 4

2 1
50
30,000

( )
6 ( ) 2
2 52
2-3

2 8.00 .
17.00 .

2
-

111
() 1
U =
U= c
z 50
ego
c

2-3
1

/

3 1
52 4

80-100

112

:
1 4

500

5
2
13 1
30 3
()
3
120

11
4-5
17.00 18.00 .

113
() 1
U =
z 52
ego
U= c
U= c= c
U= c
U= c
U U
c c
c c
( 2-3 )
( 10 )

30
3

2

2

114

:
1 4

-
( )
()

4 1
55 4
500
3-4 ()
() 6
5
5

()

1

( 5)

115

2-3

() 1
U = z 52
ego
U= c
c
U = c
U= c

() 5-6

500
( 5 )

116

:
1 4
1
2

1

5 1
52 7
()
200
4
10.00 .
10

3
2 3
-
-
117
() 1
U = z 52
ego
U =c
U
U
c U

5

-

118

:
1 4
6 1
52

4
3,000 3
20,000 7,000

3
3
3

119

9.00-10.00 .

() 1
U = z 52
ego
U
120

:
1 4
7 1
() 1
U = z 53
ego
c

4 2
4-5
1
( 2552)
-
2

/

3

121

2 2
/

()

(
)

/
2-3
30 ()

100
122

:
1 4

.3

1

1 1,000
400-500

1520

60

()
2
2

2-3
123

2

8 1
55 2
65 6,000
3

2 10
3
-

() 2-3
10

1 -
2
124

:
1 4

() 1
U = z 55
ego
Uc
U= c
Uc
()
2
( 179)
()

2
3-4

()

125

2

-

9 1
() 1
U = z 55
ego
c
58 3
.. 2519

( 2) ..
2516 Early Retine .. 2543
15

126

:
1 4

()

(/.)

()
Vote
( 500 ) 2

127

()

280 ( .. 2552)

()

(
)
128

:
1 4

4 8

(
)
129
10 1
57
100-150 7

-

-
-
-

() 1
U =c
U= 6
z 57
ego
c
U c c U
130

:
1 4
1

-

()
11 1
() 1
U = z 59
ego
c
131

: 3

5,000 4
4

:
:

:

:

132

:
1 4
12 1
() 1
U = z 62
ego
U
62 1
5 3
( )

()

( ) 5 ()

6

() (
133
11 )

134

:
1 4

100% -

20 ( )

135
13 1
() 1
6 = z 63
ego
U =c
U=c
U= c
U
c
: 12
3 2 1
.
.

1,000
5
:

:

:
136

:
1 4
:
14 1
64
15 70-100
3 10
3
()

1

6.00 .
()
8.00 . 3
137

10
() 1
6 = z 64
eg
U= c
U
U= c
c
U=c
U=c
U= 6= c
c U
( : 1 1
) 2

138

:
1 4

() (
) 1

2
15 1
() 1
ego
z 67
()
U= c
c
67
35 1 ()

CP

() ( 60 )
139
( 4-5 )
200-500

5
7-8
2
/

()

140

:
1 4

4-5

141
16 1
() 1
6 = z 70
ego
U =c
U= c
U U
Uc c
U =c
U= c
U c U
U
:

5 2 3

:
:

:
142

:
1 4

:
17 1
() 1
6 = z 70
ego
U= c
c
U =c
U
U=c
U= c
UU c
U =c
U= c
UU c
c c
U= c
UU c
U= c
c
U =c
U =c
U
:

14

143
:

:

:
:

()
.. 2550-2551

:
18 1
73

144

:
1 4
9 2
3
6 4
7 3 4

() 1
73 S = c
eg
6
U= c
U =c
U=c
U= c c U = c U=c
c
U c U
U U c
cU
145
1

Check
()

19 1
() 1
U z74
ego
U =c
U =c
U =c
U = c
c U
U U
c c
: 3
1
250 3,000 4
2 2
146

:
1 4
:

100
:
3

:

147
20 1
41 6
250

4 2
12 6 2 11
72
5-6

(
-
10,000 2
5
-

10
10

2

20
148

:
1 4
5 40

() 1
6 = c
41 S c
ego
U
/

()

-

2

149
2
21 1
52 6
20,000
40,000
3
2 15
2

2 (.2-3) 2

7.30 .
17.00 18.00 . 2
3
150

:
1 4
() 1
52 S c
ego
c
151
22 1
() 1
60 S = c
ego
U = c
c
U= c
U
U=c
6
5-6

06.00 17.00 . 1
( )

2 05.30 .

60

()
152

:
1 4

60
60

2-3
-
(
) ()
100 ( 2 ) ()

7

( )

153
23 1
() 1
74 S = c
ego
c
U= c
U=c
74
20 10 (2529) 2

4 71
49
3 2 ( 2-3)

2-3

154

:
1 4

-

6 7 11

155

,
(DM+HT)

-
156

:
1 4
157
158

:
1 4
159
160

:
1 4
(Key Informances persons) 4

4 () 23
7 16

() 26-80 60
4 4
3 4

70
3
1
1 1
() 2

4

4

4
161

5.3 4 ()

26
37
41
42
42
44
46
46
46
10
48
11
48
12
50
13
54
14
55
15
58
16
65
17
42
18
19
20
162
42
43
45
/.
.6
.3
.6
.4
.3
.6
.3
.4
.6
.7
.4
.4
.4
.4
.4
.3
.6
.6

:
1 4
5.3 4 ()

21
61

22
80

23
80

.4
.4
.4
1 4
( )
26 200
() -

2-3
3

1 3

- 6
1 (14 )
() 1 1 3
8 - 1
() (
)
163
() 1

8.00-17.00 .
100 200 /
15.00-17.00 .

() 4
U = c
U
U = 6 = z226
ego
U
U U
8

3 2 3
3
6
() (
) 3

164

:
1 4
2 4
2
2
6 74 72 37
. 3 5-6 44 .6
2 2
BBP -

10 2
( 4 )
20-30 64

2

165
4
13

-

8
5-6
() 4
U = c
U= c
U = z 37
ego
c c
U U

-

500
166

:
1 4

- ( )

3 4
41
7 6 210

51
20

3 2
3 ()

6.00-17.00 .

167

3

5-8
() 4
U = z 41
ego
8-9
-

/
()
-

168

:
1 4
4 4
42
4
300 (.)
3
(12 ) 13
100,000
2-3 6 ( 1 )
()
20
(
)

7.00 . ()

() 4
U = z 42
ego
U= c
169

1
10
6

1

( )

( )
170

:
1 4
5 4
() 4
U = z 42
ego
U
3 2
()

2-3

1

() (
5 3 )
2
2

4-5

171

2 ()

172

:
1 4
6 4
() 4
U = z 44
eg
U
()
4 2 3
10
AIA 8.00-20.00 .
2 (/) 15,000

2-3
200,000
3 10

24
173
10

- OT
OT

(45 )

17-18

( 3 )
1

174

:
1 4
7 4
46
3

10 2
5

2 10

()
- 12 -
()

Bakery

5.3019.30 .
(9.30-12.00) 2

-

175
() 4
46 z
ego
4

6
(
)

176

:
1 4
8 4
46

3
8
2
2

( )

7.00 .
9.00 . 10.00 .
15.00-16.00 .

-

177
() 4
U = z 46
ego
U= c
U

5 5 1

10

-
178

:
1 4
9 4
46 7

200
5 order

8.00-12.00 .
() 3
7

3 1 1
1
2 5 4 1

6
500 300

3
179
() 4
U = z 46
ego
U = c
U= c
c
U
2
4 1

( )

20

180

:
1 4
10 4
48

2 ( 5,000 )
3 (
)
1 SLE
1
SLE
-
8.00 . 12.00-14.00 .

3
3
5
()
()

3

() 4
U = z 48
ego
c
U=c
181

() 1

2

-
3-4

182

:
1 4

11 4
() 4
U = z 48
ego
U = c
U= c
43 2
7

1

183

()

( 1 )
1 ( 17 )
(10-15 )
184

:
1 4
12 4
() 4
U = z 50
ego
U= c
U c
U
c c
:

9

:

: .
185
: 3
8
:

2 ()

:
3 1
13 4
() 4
U = z 54
ego
c
54

2 2
2
7-8
186

:
1 4
31

1
(4 )

600
600
600

1,804

600 600

/
20 ( 4 )

()

187
() ()

(
) ()
3 ()
1

30 ()

5
()
10

( 1 5)

14 4
55
order 100
188

:
1 4
(2 )
2
3 () 2 (
)
10 2

6 - 2
-
() 2

2 ()
75
() 4
U
U= c
U
= z 55
ego
U =c
U
189
3
()
3-4
2
( ) ( 1 )
10 3-4

() 4

2
( )

190

:
1 4
15 4
58
4 9 2 (
) 5-6
57 10 30
3 21

Order

( 6 )

2

191
() 4
U = z 58
ego
U

10
-

192

:
1 4
16 4
() 4
U = z 65
ego
c
U= c
c
U=c
U=c
U U
U U
: 10
5 2 3

:
:
30 1 5 2
2
193
:

()

:
17 4
42 ()
6,800
() 6,700 1 3
2
700,000
()
5
()

3

- ( 800,000
) ()

194

:
1 4

-

() 4
42 S = c
ego
U

7-8
2-3

()
()

195
18 4
42 6

2 50-60 3
8.30-12.00 . 3 ( )
3 10
( 3 )

250
15.00-18.00 .
1 ( 6-7 1213 ) 2

)

37 4
(20.00-21.00 .)
3
196

:
1 4
2 2

30
20

(1 10 ) 9
5 1

(
) EM
() 4
42 S = c
ego
c
U

2 3
197

6

-

5

2

(
)

198

:
1 4

() 30
10 ( 1 = 3 )

4

19 4
43 6
1 43 .2

17 7 ()
20
20,000
()

199

2 6
8.00-13.00 .
17.00-20.00 .
21.00 .

() 4
U = z 43
ego
U =c
U

(
)

( )

2-3 ()

200

:
1 4

(
)

()

20 4
() 4
U
c
c
45
S = c
ego
c
45
36,000 7 36
() 3 2 1
51 91
4-5 10
45

201
(
)

6.00 .

(
)

Paracetamol

202

:
1 4

60-70 %

-

203
21 4
() 4
61 S = c
ego
c
U= c
c U
Uc
c

30 3
1 2 2
3 2
2

(-)

() 1 3
2,000

500

()
100

204

:
1 4
1

3

22 4
() 4
80 S = c
ego
c
U =c
c
205

30
3 2 1

2

1

2

(, )

206

:
1 4

30

()
23 4
() 4
80 S = c
ego
c
c
U
c
U

80

207

6 2 3

9 10

:

:
: 3

:

2-3
:
208

:
1 4
209
210

:
1 4
211
212

:
1 4
1 4
()

()

()
1 4
() -

213
5 4
200 1 300-500
6
7
8
9

10
( )

/ (Fast Track)

()

214

:
1 4

1 4
8 ( )

5.1

()
215

1

5.2
()
/
216

:
1 4

() -
()

1 1 4
(
)

1 4

(
)

(
)

217
1 4

(
)
(
)

(.)//
218

:
1 4
..
2550

(Special section)

3
(

)

/
219
5.3
()
()
()
(/)
1 4
1.

220

:
1 4
2. 1 4
3

3.
(
)

()
1 4
221
5.5 /
1
4
/

3
3
1.
2.
(health need)
3
3. /
4. ( )
5.
6.
3
3
7.
8.
222

6
:
I.

II.

III.

IV.

V.
VI.
-
- -

I. -

II.

III.

224


/

-

/
- -
225
226


/

/
3
()
.. 2540 5
227
1
2
3
4
5
()
528
80
193
323
257
()
546
86
234
337
285
()
1,074
166
427
660
542
338
39
97
161
119
2,869 35
800
.
10 (. 59 )

(Formal Interview)
(Key Information)

228

6.1
1
2
3
4
5
6
7
8
9
10
38
38
38
43
43
46
48
49
50
52
.
.4
.6
.6
.3
.7
.6
10
8 2
38-52

229
()
28 S
ego
U = c
U U U
c= c
c c
7 ()

31 2552

3
16 2
2
2 1
()
U = c
U= c
S 38
ego
c cU
230

6
2 2
(gender) -

(
)
()
4
2
115 16
.

()
38 S c
ego =
U U
4
2

2-3 (10 )
231
4 1 3

-

232

()
43 S = c
ego
U
3 1
1
3
3 2551 143

()
U= c
S43
ego
233
-

3 1 2
5

--

( )
5 10%
( 80 ) 60%

2

234

()
6 = c
46
ego S = c
3
- 7 4 3
4 2
81

4 4

4

235

()
6 = c
48 S = c
ego
4

- 5 4 1

(-)
20
()

2

236

()
49 S = c
ego
U= c
U
U= c U
c
U= c
U
2
4 4
3 4

4

/
237
()
U = c
U U
50
z c c c
ego

6 2
4 3

10

238

4

()
U = z 52
ego
c
4 2

2
10

239
240

241

//

242


(
)

243
244


2551 2 3

2551
1.
25.49
2.
17.65
3.
15.68
4.
13.73
5.
7.85
6.
13.72
7.
1.96
8.
3.92
: 3
64.06
11.79
11.45
9.23
1.31
1.08
0.60
0.48
2538 - 2544

80
( , 2550)

-

245

1 (
)

246


2 3
1.

2.
/

3.
247

1

(
)

(1)

3,500,000 ( 1,000,000
2,500,000 )
248

(2)

(
)

249

(
)
250

251
252

1.
2.

3.

4.
5.

6.
7.
1.
253
2.
3.

( .)

1. .. 2550
2.

3.

4.
5.
254

255
++++
/ +++++

passive participation
+++
+++
/

active participation
256

++++
++
++
4-5

(Change Agent)

(Change Agent)
257
4

/

/

(
.)

/

IT

258


3 (.. 2551 .. 2553)
16 1 45 35
5 3 2

259
2
2
2 24 100
5

260

261
(.)
2

3 (.. .2551-2553)

262


--

2 ()

5

263

5

1.

2.

3.
4.

5.

6.

264

7.

. 20
19 , . 13 7-8
()

100%
8.
9. 1

10.
11.

12.
265

Routine
.

/

266

267

1- 5 6 - 11

268

7

2540
4 (.. 25442547)

1)
2)

3)
1

(1)

(Health Need)

/ (customer focus)

.
.

/

()

270

,

2
2
(Self-Reliance vs. specialization)
271
7.1
(//)
272
1.
)
) (/)
) / ()
2.
)
)
)
)
3.
) (Health Need)
) (/)
( )
) (people center)
4.
) ( & )
) ( & )
)
(Self Reliance)
(Specializational)
)
(/)
( DM & HT, , pap Smears)

(Home Care)

(2)

2

1.
600
600
273
2.
/

(Self-Reliance)

()

7.2
(3) ()

274

CUP & PCU

7.3
.
/
Networking
1-5
275
(4)

1) 3
(One Stop Service)
2)

4
3) 4 6
-
4)
5)

6)
276

7)
Unit
8) /

7.4
(leadership)
/
(Good Government)
(Relationship)
(Community Participation)
( )
277
(5)
254

278

279
(6)

11 2
( )
1-5
6

11

.. 2537 (
3 .. 2543)
280

(Decentralization)

-
()
- (
)
- (
)
- -
-
-

-

-

281
(7)

3 4

(Unit )
(8)

(.)
(.)
2550 80(2)

282


281 - 290
2540

.. 2550

283
(Flexibility)
(Responsiveness) (Participation)
(.)
. 3 (1.) .
. accountability
.
(2.) . accountability

social capital
(3.) . Political
accountability

. respond

()
14,21
(CUP)
()

284

()

/ (
, 2551)
285
(9)

(
) /

3 4 structure design
zero based

mind set

privatize
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295
Models of Health Service Rendered by Local Administrative

Organizations after the Transfer of Health Centers to the Local Authorities
RESEARCHER
RESEARCHER
AIHD
ASEAN Institute for Health Development
MAHIDOL UNIVERSITY

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RESEARCH

Models of Health Service Rendered by Local Administrative Organizations after

= Models of Health Service Rendered by Local Administrative

Contracting Unit for Primary Care

Models of Health Service Rendered by Local

Health Centers to the Local Authorities

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

(Service Delivery Unit) 30

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

(the patients point of view) (the lay

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

(Blaxter, 1990 ; 4 ,2547 :35)

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Hollnsteiner (Hollnsteiner M.R.,

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

( 2530 ; Krech , Crutchfield and Ballachey ,1962)

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University

Modelsof HealthServiceRendered byLocalAdministrative Organizations aftertheTransfer

ASEAN Institute for Health Development, Mahidol University