Thailand’s public health decentralization policy: a case of pro-social rule breaking of thai local health staff

Abstract

This dissertation examines the pro-social rule breaking theory (Morrison, 2006) to understand the motivation and behavior of Thai local health staff over rule breaking for local people/patients' benefit. This theory demonstrates why local staff tend to use their discretion to accomplish their jobs for the local people's benefit, although their discretions may contrast with the rules, especially the central administration’s rules and procedures. The factors behind local staff rule-breaking consists of three levels of analysis within the local workplaces: individual, relational, and organizational factors (Dahling et al., 2012; Vadera et al., 2013; Fleming, 2019).

Finally, the results of the research analysis demonstrated that pro-social rule breaking behaviors are positive with local health staff conscientiousness and educational background. So, the research suggests that conscientiousness is the only factor that can convince Thai local health staff to break the rules, while other factors have no significant relationship with pro-social rule breaking behaviors.