Questions/Answers

This project aims to enhance the integration of local government agencies under the principles of "Participatory Governance", which covers dimensions of the quality of life (health, social environment, relationship and economy) in the southern border provinces. Notably, situations of serious conflicts and insurgency in those areas considerably influenced people's security and mentality. It then appears that every governmental organizations tried to solve the problems for local people. However, each agency worked separately and merely respond to their own policies, resulting in duplication of efforts across the institutions. Consequently, government agencies became untrustworthy to people and made them unhappy. According to a random survey, 90 percent of the population in NongChik district was less happy than people in general. Furthermore, the survey reported low level of quality of life in certain aspects. Nevertheless, the inter-agency collaboration among public sectors has been established since 2014 in order to proactively conduct home visits for local people, and gain more access to the unprivileged. The collaborative integration concentrated on the improvement of the quality of people’s lives through public participation and NongChik District Health Board (DHB), following the concept of “area-based, people-centered approach”.

The integration of over a hundred public institutions in the district aims to improve the quality of life and well-being for people living in the southern border areas. It is therefore essential to develop both vertical and horizontal collaboration among agencies to change their mindsets, reduce duplication of efforts and create mutual understanding. Such cooperation with well-balanced management results in an increase of public trust in government agencies. In addition, public organizations can participate in planning, implementation, following-up, and evaluation of practical strategies to cooperatively develop basic infrastructures in the community, including human resources, finance, and working processes.

The integration of government agencies, the private sector, and the general public under the civil state policy has been continuously conducted in the local areas. Such integration accords with the 2030 agenda for sustainable development in terms of Goal 3 (Good health and well-being) in section 3.8 (supporting healthcare services and better quality of life and well-being). The collaboration also corresponds to Goal 10 (Reduced inequalities) in section 10.3 (ensuring equal opportunity and eliminating inequalities of outcome). The result is that local people were encouraged to get into self-care, which achieved the goals of Thailand Healthy Lifestyle Strategy.

In the region where armed attacks occur regularly, local government institutions used to work separately to merely achieve their own goals. Additionally, complicated systems of official agencies and duplication of efforts caused problems to people and had drawbacks on the development of community well-being. In order to create a sustainable system for people, all public-sector institutions have to strengthen cooperative synergies and expand the organizational network through the concept of participatory governance in responding to social problems. It is undoubtedly crucial to integrate internal policies, human resources, budgets, and logistics management from each institution to support the inter-agency network to perform proactive operations. Furthermore, the reduction of conflicts among agencies results in organizational culture that helps improve and develop the quality of life for people on the basis of social and community contexts. Hence, the public integration primarily focuses on holistic approaches to promoting preventive healthcare, based on information and demands of stakeholders which have been gathered through SWOT analysis from the civil society forum, home visits and morning talks.

As there was no project manager to integrate local government organizations in the past, public health staff began to play a crucial role in project management. At the outset, the staff liaised with the community to make people trust in government officials. Then, over a hundred local institutions have been assigned particular roles to perform cooperative operations in improving the quality of people’s lives based on their problems and demands. As a consequence, the project results in the absence of conflicts and a decline in duplication of efforts since each organization is responsible for work assigned properly by the staff.

The project manager is the center to connect every local government institutions to collaboratively design space management and analyze the situation, covering all dimensions in a healthcare framework, including (1) health problems; (2) social environment; (3) relationship; and (4) income. The problem-solving techniques are flexible, based on individuals under the concept of “area-based, people-centered approach”. This framework leads to a concrete system to enhance quality of people’s lives, especially both government officials who offer and local people who receive public services are proud of themselves. This positive outcome makes them full of invaluable happiness among the unrest circumstances.

The application and exchange of information among public-sector organizations can develop a high-performance working system to improve the quality of life for the local people, which aims to maximize work productivity to the district, provincial, and national levels, such as the distribution of instructors to discuss the topic of “The roles of District Health Board and the development of quality of life in the community”; and to publish journal articles in the Journal of the Association of Researchers, Journal of the Psychiatric Association of Thailand, and Nursing Journal of The Ministry of Public Health.

The most significant outcome from the integration of local government agencies is the sustainable governance system. The project manager could develop real connections with various organizations and understand their roles, leading to a public network that jointly optimizes existing resources (human resources, budgets and logistics). The inter-agency collaboration created organizational culture that helps develop public service systems and enhance public participation in sustainable governance. For example, public participation is included in the strategic plan 1(the promotion of preventive healthcare). The indicator is the percentage of quality of District Health Board in the promotion of public participation.

The importance of public service development via social participation is that local people have better and more sustainable quality of life. The principles are as follows: (1) Customer Focus– the orientation of government organizations to serve people with what they need is necessary. All agencies are open-minded to listen to the poor and the unprivileged, and make them gain access to public services without posing any problems to the community; (2) Integration– the collaboration of local government systems makes local people trust in more than 100 public agencies and participate in their cooperative activities. All government organizations are fully integrated to work as a united team and reduce duplication of efforts between institutions; (3) Community Participation– every government sector has developed both vertical and horizontal collaboration to improve the quality of people’s lives; (4) Appreciation– the public-sector organizations appreciate comments and recommendations from each other in order to create network culture that maximizes happiness, civic pride, and social relationships in the community; (5) Resource Sharing and Human Development– the inter-agency synergies allow government organizations to cooperatively think, plan, perform, evaluate, and analyze their healthcare operations based on CQI and PDCA cycles; and (6) Essential Care– local people can practice self-healthcare.

Yes

The evaluation of the project demonstrates the following results: (1) According to feedback conversations with local people, it was found that they felt happier and more secured when government officials paid them home visits. Overall, local people were satisfied with more accessible healthcare from government institutions; (2) Self-evaluation questionnaires were distributed to assess and develop the level of public participation; (3) NongChik Hospital was selected to be an exemplary model for other government agencies at the international level; (4) NongChik District Health Board was awarded with various prizes, such as the National Award for the Best DHB.

The indicators for project evaluation are as follows: (1) the evaluation of public participation employed the UCCARE criteria, including Unity Team; Customer Focus; Community Participation; Appreciation; Resource Sharing and Human Development; and Essential Care. The maximum score for each criterion is worth; the overall score must be at least 3; (2) the evaluation of the quality of life for NongChik people employed the World Health Organization Quality of Life Brief – Thai, which categorizes the quality of life into three levels including low, moderate, and high; and (3) Thai Mental Health Indicator (THI-15).

The impacts of the project which complies with the concept of “area-based, people-centered approach” are as follows: (1) 57 percent of the local people are happier than people in general; (2) Prior to the project, NongChik people had suffered from low quality of life in some aspects while they had high quality of life in all aspects after joining the project; (3) There is no conflict of interest within government institutions as they avoid duplication of efforts in collaborative operations. In 2018, Thailand conducts a self-evaluation of public-sector integration, and scores 4.75 out of 5 following the UCCARE criteria.

The impact of the collaboration of over a hundred government agencies results in the public network that can be divided into three circles, including: (1) outer circle–the persons or organizations that make public donation and liaise with the private sector, such as private companies and stores; (2) middle circle– the primary stakeholders that directly involve in the project especially government institutions, such as NongChik district office, the district unit under the Ministry of Social Development and Human Security, military agencies, security units, and healthcare organizations; and (3) inner circle–persons or organizations that cooperate with government agencies for better outcomes, namely community leaders, village health volunteers, and village sages. The integration of three circles complies with the King Bhumibol’s philosophy of sufficiency economy, including the principles of understanding, reaching out, and developing. The collaborative synergies enhance equality for each government agency to improve the quality of people’s lives. A clear assignment of responsibilities allows good connections and systems for the institutions in all dimensions. Furthermore, the cooperation reduces suspicions in organizational contexts. Every member of the network gives moral support to each other and strengthens social relationships to increase the capacity of individuals to work as a team.

When government officials undertake fieldwork in the local area, it is vital that they are equipped with technically creative and academic skills in operations management. There are provable criteria to cooperate with each organization to improve the quality of people’s lives. Notably, this is not the case that government agencies merely put on an act for their own benefits. Actually, they are trustworthy and service-minded to conduct home visits and acknowledge social problems in the community where the unrest circumstances exist. As a consequence, the community gains invaluable happiness and sustainable development from the integration of local public-sector institutions.