Measures and process of network management of alcohol abuse in high-risk provinces: success or failure

Abstract

This research had the objective to study measures and procedures in addressing alcohol abuse through a network of provinces which high prevalence of alcohol abuse. As well as to study the success and failure of management of such programs. The researcher applied mixed methods for data collection, including both qualitative and quantitative methods. The methods include in-depth interviews with 55 key informants, focus group discussions with 13 persons from two groups, review of existing documents, and survey research with interviews of 1,600 samples from 784 households in four provinces: Lampang, Sisaket, Kamphaengphet, and Chaiyaphum. Data were processed using analytic induction and descriptive statistics. The data were verified using data triangulation.

This study found that all four study provinces implemented public campaigns as their principal intervention. Measures that are considered best practices were only implemented as secondary approaches. The public campaigns themselves were not very effective or efficient and, thus, the goals were not achieved. Plus, the program did not fully address the context of the problem

This study of the process of networking of four provinces to address alcohol abuse found that Sisaket had the highest capacity to respond, followed by Lampang, Kamphaengphet and Chaiyaphum. The most important factor behind successful action

of the network was having a lead agency. This had a reinforcing effect on other components. Conversely, lack of leadership led to poor performance of the network. Also, lack of network unity was also a factor behind lack of success. That said, there were limitations of participation, exchange and sharing of resources, institutional support, and external environment factors which impeded achievement of the network.

When looking at success or failure of the network to reduce risk of alcohol abuse, none of the four provinces was able to have clear impact on this variable. Thus, overall, as a network, it has to be concluded that the program was not successful as envisioned. Part of this shortfall may be that the network implementers have a limited view of what success means, or they focused too much on process and outputs, rather than outcomes and impact.

The findings of this study are consistent with the concept of the Logic Model. The four provinces in the network chose to emphasize interventions that were less efficient and effective than what has been the experience of best practice efforts elsewhere. The provinces did not take full advantage of the potential of the network to achieve synergies of collaboration. Thus, the risk environment for alcohol abuse in the four provinces as a whole was not significantly reduced.

Based on the findings of this study, it is recommended that provinces with higher prevalence of alcohol abuse should implement best practice interventions as their principal strategy. Public campaigns can be used as reinforcing or support measures. The Sisaket model of an Alcohol Dependence Rehabilitation Center should be replicated in other provinces. There should be a network of volunteers and campaigners to monitor dangers from alcohol abuse, as implemented in Kamphaengphet. There should be replication of the “Prasat Model” of Surin Province which involves setting up community-based check points. Ultimately, there should be more advocacy to increase the priority of the province to address alcohol abuse and invite civil society to play a more significant role in the response. There needs to be increased trust and shared values in the network which are regularly reinforced. There also needs to be a uniform definition of success which focuses more on outcomes and impact to reduce and eliminate alcohol abuse.