Participation in Community Health Assurance: A Case Study of Chana Hospital, Chana District, Songkla Province

Community participation is an essential strategy for improving community health in the context of Namkao Subdistrict, which has strong community organizations was considered suitable as a model for the development of a participatory community health fund at the subdistrict level. The study was divided into two periods: the first for formulating a model by collecting data about the existing social fund and the situation of organizations in the community, and the second for assessing the real operations of the Namkao community health fund and evaluating the administration processes designed. The results showed that all three sectors (community sector including groups of community savings organizations, health-care sector and subdistrict administrative organizations) agreed with establishing the fund. The contribution from the community sector is the key to community ownership of the fund. The community health fund board consisted of people from every sector. Approval for budgets of any projects is considered by its linkage to the Namkao health plan in that it would have a wider perspective of health than a bio-medical model. For the second step, the Namkao community health fund was established in 2007 ; a contribution was provided by the National Health Security Office, which funded 37.5 baht per capita every year (about 140,287 baht in 2007) , while the local government provided 100,000 baht, the community sector 14,000 baht and the health-care sector 100,000 baht. Currently, the community is developing a community health-plan for allocating budget to health-promoting projects. The participatory process is the core concept in establishing community health. A community health fund at the subdistrict level is an important participative strategy that can support real operations. This innovation promoted the concept of good health, which should not be limited to health organization staff only but a task shared by everyone.