กระบวนการกำหนดนโยบายหลักประกันสุขภาพแห่งชาติในพื้นที่แขวงกาวิละ เทศบาลนครเชียงใหม่

Abstract

The study “Policy Formulation Process of Nation Health Security for Kavila Subdistrict, Chiang Mai City Municipality” aimed to investigate the roles of Chiang Mai City Municipality in policy formulation process of National Health Security and study the participation of the local people in specifying their needs in the National Health Security policy. In addition, the study was based on different principles including policy network, public policy, public participation, and policy formulation, in the analysis and description of the policy formulation process of National Health Security. The data revealed that Chiang Mai City Municipality initiated the implementation of the National Health Security in the area. Since the Municipality had previously conducted activities related to health, they could establish health security funds at the local level. However, it was found that format, regulation management, and increasing of health service coverage relied on the integration of the Municipality and local people. The operations from only one party would not achieve the goals of the National Health Security Act. Furthermore, the interviews indicated that the Municipality, comprising of the administrators and officials, followed the regulations of the National Health Security fund management. That is there were representatives from the local communities in the board committee, there were seminars to educate the health volunteers about the principles and regulations, the projects were advertised, all the processes were successful, and the result from the evaluation was at an A level. Nevertheless, the data from the interviews suggested the differences and conflicts among communities. Some communities who could operate according to the regulations and were financially supported to continue their operations were satisfied with the Municipality. On the other hand, some communities thought that the Municipality’s regulations were complicated and difficult to implement. Consequently, they were not financially supported to continue their operations. This caused the lack of participation among local people, communities, and the Chiang Mai City Municipality in activities which could contribute to the services which would suit the needs of the communities. Therefore, it can be concluded that the policy formulation process of the National Health Security has not been highly successful; that is, it was moderately successful. This indicated that there was a lack of the participation between the Municipality and the communities. Furthermore, it can be suggested that in terms of the communities, they should be aware of the rights according to the Health Service Act.The community leaders and related persons in the project should also try to understand the Fund’s regulations for the health benefits of the communities to receive the service from the National Health Security Office. In terms of the Municipality, they should try to improve the evaluation to encourage the community leaders, who were lack of the knowledge of the process, to have more participation with the Municipality. This would help achieve the objectives of the Municipality’s health policy to provide opportunities for all communities to improve the living quality of the people since this was the role of the Municipality according to the National Health Security policy.