Chapter 6 The Expansion New Membership Recruitment Area of Thai Maternal and Child Health Network under the Royal Patronage 6

Thrathip Kolatat, Chantima Charastong

At present, Thai Maternal and Child Health Network Board of Committee under the Royal Patronage has established project purposes that meet the principle objective, which is to lower the rate of preterm births. However, the board’s reexamination of the issue reveals the aforementioned strategy can be elevated to be policy-level strategy, the process of which includes setting up the clear strategic targets and public services, as well as considering the differences between service areas. It has also been suggested that personnel in those areas should be the ones coming up with action plans, to successfully reach the ultimate outcome1. Having studied the fundamental patterns of Thai Maternal and Child Health Network’s project management according to national context, the board has established an expansion model, which foresees the project expanding into various other areas, being carried out in a direction towards the expected outcome.

Establishing a strategy map in each area begins with strengthening work forces in the provincial level. Since the public health system is directed by Office of Provincial Chief Medical Officer, which provides management and supports to community and district health promotion hospitals, not the general and regional hospitals. Thus, if there is to be an integration of both health promotion and treatment, an operational conference is essential. The conference would allow idea sharing and discussion between the multidisciplinary involved, namely obstetricians, pediatricians, general practitioners, registered nurses (from prenatal clinics, delivery rooms, emergency rooms, neonatal intensive care unit, neonatal wards and follow-up clinics, etc.), as well as public health technical officers, social medicine officers from community hospitals, general hospitals and regional hospitals.

Fig. 1-2 Workshop for strategy map development of TMCHN project.

Thai Maternal and Child Health Network Project under the Patronage of HRH Princess Srirasmi, the Royal Consort of HRH Crown Prince Maha Vajiralongkorn 21 There are two stages to establish the provincial strategy map of TMCHN project: 1. Preparation stage 1.1 Consult the Ministry of Public Health’s Inspector General. 1.2 Present proposal to the Permanent Secretary of Ministry of Public Health. 1.3 Coordinate with the Provincial Chief Medical Officer. 1.4 Select strategy map-making coordinators. 1.5 Arrange for strategy map development workshop and appoint the attendees. 1.6 Prepare the program and handout for the presentation titled “Progress and Outcome of Thai Maternal and Child Health Network’s Areal Development Project and Strategy Map-Making”. 1.7 Conduct survey on preterm births in a given area in order to acquire the following types of facts, which would reflect the balance between demand and supply: 1.7.1 Prevalence of preterm births. 1.7.2 Level of severity and consequences. 1.7.3 Causes of preterm births. 1.7.4 Quantity and quality of neonatal care. 1.7.5 Bed management in neonatal intensive care unit and neonatal unit including the referral systems.

2. Mapping stage The strategy map-development team would gather information, and then analyze the situation of problems. A representative among conference attendees would be assigned to present his or her information, keeping involved parties notified. Subsequently, the information would be summarized and the key points are used to establish goals in the strategy map. The mapping stage is divided into two parts2:

Part 1 Gap assessment - which is done by analyzing the SIPOC (Supplies, inputs, process, outputs and customers) summary (Diagram 1) and stakeholders at pre-pregnancy period all the way until the postnatal period. Then a gap is summarized to appoint stakeholders or patients, and goals of projects in a given area. Goals and stakeholders written in Thai Maternal and Child Network project’s strategy would be selected to finally include in the provincial strategic map.

Stakeholders

Customer of Partners Customers/ output Suppliers/ Input Customer

Other agencies

Ministries/ Health Systems Primary health care Sub Contractor Customers Agencies Network unit

Input Process Output

Diagram 1 The SIPOC model.

22 Thai Maternal and Child Health Network Project under the Patronage of HRH Princess Srirasmi, the Royal Consort of HRH Crown Prince Maha Vajiralongkorn Part 2 Create the strategy map by following these steps:

1. Establish dimensions and perspectives. 2. Determine and summarize the stakeholders or clients. 3. Set up goals, classified by dimensions and stakeholders, by considering the results from the gap assessment. 4. Draw the cause-effect connections between each goal. Having created the strategy map, the next step is to establish indicators and activities that would meet the goals. A workshop program has also been initiated in the hope of receiving the most efficient results. To achieve this goal, the strategy map would be created according to a given circumstantial context; hence preterm birth problems in each area would be solved more efficiently. Hospitals and health centers that have joined Thai Maternal and Child Health Network between 2008 and 2014 are as follows: Period 1 1. The metropolitan areas and perimeters ƒƒ Hospitals in the Bangkok metropolitan areas and perimeters i.e. Bhumibol Adulyadej Hospital Rajavithi Hospital Nopparat Rajathanee Hospital Hospital Siriraj Hospital Phramongkutklao Hospital Klang Hospital Taksin Hospital Police General Hospital Lerdsin Hospital Nong Chok Hospital Ramathibodi Hospital Rachapiphat Hospital Lat Krabang Hospital Sirindhorn Hospital Nopparat Rajathanee Hospital Somdej Phrapinklao Hospital LuangporThaweesakChutinutharo-Uthit Hospital Queen Sirikit National Institute of Child Health Charoenkrung Pracharak Hospital

ƒƒ 68 other public health centers. 2. Regional Health Care Areas 15, 16*: Chiengmai, Chiang Rai, Lamphun and provinces (*renamed as Regional Health Care Area 1) Chiang Rai Prachanukroh Hospital Maharaj Nakorn Chiengmai Hospital Lamphun Hospital

3. Regional Health Care Areas 10, 12*: KhonKaen, MahaSarakham, Udon Thani and Nong Khai provinces (*renamed as Regional Health Care Area 7, 8) Srinagarind Hospital 6th Region Health Promotion Center 6 Khonkaen Hospital Nong Khai Hospital Mahasarakham Hospital

4. Regional Care Areas 6, 8*: Nakhon Si Thammarat, Trang, Phatthalung and Songkhla provinces (*renamed as Regional Health Care Area 11, 12) Songklanagarind Hospital Maharaj Nakhon Si Thammarat Hospital Phatthalung Hospital

Thai Maternal and Child Health Network Project under the Patronage of HRH Princess Srirasmi, the Royal Consort of HRH Crown Prince Maha Vajiralongkorn 23 Period 2 In 2009 1. Regional Health Care Area 5*: Phetchaburi, Prachuap Khiri Khan provinces (*renamed as Regional Health Care Area 5) • Phrachomklao Hospital • Prachuap Khiri Khan Hospital In 2010 1. Regional Health Care Area 14*: (*renamed as Regional Health Care Area 9) • 2. Regional Health Care Area 6*: province (*renamed as Regional Health Care Area 11) • In 2011 1. Regional Health Care Area 8*: Naradhiwas, Pattani and Yala provinces (*renamed as Regional Health Care Area 12) • Naradhiwas Rajanagarindra Hospital • Pattani Hospital • Yala Hospital In 2012 1. Regional Health Care Area 12*: Kalasin and Roi Et provinces (*renamed as Regional Health Care Area 7) • Kalasin Hospital • Roi Et Hospital

References

1. Prombutr W. Conference Material: Strategic Action Process presented in 2008’s First Official Discussion on the Development of Maternal and Child Health Network for Children, Youth and Family under the Patronage of HRH Princess Srirasmi the Royal Consort of HRH Prince Maha Vajiralongkorn. Scheme’s Flagship Area; Wednesday, July 9, 2008. Faculty of Medicine Siriraj Hospital. Photocopied document, 2008.

2. Productivity Institute and Sri Pathum University (Bang Khen). Workshop Material from Thai Maternal and Child Health Network’s 1st Strategy Map Gap Assessment and Establishment of Indicators for Thai Maternal and Child Health Network for Children, Youth and Family under the Patronage of HRH Princess Srirasmi the Royal Consort of HRH Prince Maha Vajiralongkorn. 1/2008: September 1, 2008. Faculty of Medicine Siriraj Hospital, Mahidol University. Photocopied document, 2008.

24 Thai Maternal and Child Health Network Project under the Patronage of HRH Princess Srirasmi, the Royal Consort of HRH Crown Prince Maha Vajiralongkorn