Results of developing a model for promoting the quality and standards of primary healthcare services in primary care units and their networks in Nong Khai Province. Results of developing a model for promoting the quality and standards of primary healthcare services in primary care units and their networks in Nong Khai Province.

Abstract

            This study employed participatory action research based on the PAOR cycle (Plan, Act, Observe, Reflect) of Kemmis and McTaggart, integrated with a mixed-methods approach. The objectives were: 1) to examine the situation, problems, and needs related to improving the quality and standards of primary health care services in Nong Khai Province; 2) to develop a model for promoting quality and standards of service delivery among primary care units and primary care networks in Nong Khai Province; and 3) to evaluate the outcomes of implementing the developed model. The study was conducted in three phases: 1) situational analysis and problem identification using 20 key informants; 2) model development verified by 5 experts; and 3) model implementation and evaluation. Data collection instruments included in-depth interview guides, a model appropriateness assessment form, field notes, lesson-learned recording forms, a self-assessment form based on the 2025–2027 Primary Health Care Service Standards, and a satisfaction questionnaire. Data were analyzed using descriptive statistics, paired t-tests, and content analysis.

           Findings: After completing two rounds of the PAOR cycle, the overall self-assessment scores increased significantly (p < .05), particularly in the areas of infection prevention and control, and laboratory systems. The proportion of service units meeting the standard criteria increased to 96.30%. Practitioners reported greater confidence in performing duties according to the standard criteria (M = 4.90, S.D. = 0.30) and high satisfaction with the support provided by the mentoring team (M = 4.85, S.D. = 0.36). The findings suggest that an empowerment-based participatory process can help cultivate a culture of continuous learning and teamwork among health personnel, thereby further enhancing the quality and standards of primary health care service delivery.

Keywords: primary health care, participatory action research, service quality standards