Abstract:
This mixed methods research aims to investigate the evaluation of the Disease-Free Childcare Center Standard, and the factors associated with the evaluation process in Health Region 1. The quantitative phase involved 347 childcare providers responsible for implementing the disease-free center initiative at local administrative organization. Participants were selected using quota sampling. Data collection tools included: the questionnaire on factors influencing the standard, based on a comprehensive review of relevant literature and previous studies ; and the 2013 evaluation form for Disease-Free Childcare Centers issued by the Department of Disease Control, Ministry of Public Health. Data analysis employed descriptive statistics and chi-square tests. The qualitative phase involved purposively selected childcare providers from both centers that passed and those that failed the evaluation criteria. Data were collected using a structured in-depth interview protocol and analyzed through inductive thematic analysis. The results revealed that 298 early childhood development centers met the evaluation criteria for Disease-Free Childcare Centers, accounting for 85.9% of the total. When examined across the four evaluation domains, the results showed that: Domain 1 (Management and Administration) was met by 228 centers (65.7%) ; Domain 2 (Personnel Management) by 258 centers (74.3%) ; Domain 3 (Infrastructure, Sanitation, and Environmental Hygiene) by 325 centers (93.7%) ; and Domain 4 (Materials and Equipment) by 313 centers (90.2%). Regarding individual factors, prior experience in communicable disease training and prior experience with center evaluation or supervision were significantly associated with the evaluation outcomes of the Disease-Free Childcare Centers (p = 0.011 and 0.007, respectively). As for supporting factors, adequate provision of disease prevention and control equipment, sufficient educational materials for disease prevention, annual budget allocation, and adequacy of the allocated operational budget were all significantly associated with positive evaluation outcomes (p =0.027, 0.016, 0.049, and 0.002, respectively).The findings from this study can be used to inform recommendations for relevant agencies, such as local administrative organizations and public health authorities, to prioritize the development of systematic plans and programs focused on disease prevention and control within early childhood development centers. It is essential to establish clear operational guidelines, including regular meetings to develop communicable disease prevention strategies, implementation of practices aligned with the Disease-Free Childcare Center standards, promotion of annual health screenings for staff, and appropriate staffing ratios based on the number of children under care. In addition, continuous and equitable support should be provided to enhance the knowledge and competencies of teachers and caregivers in communicable disease prevention. Such efforts would contribute to reducing disease transmission risks and improving public confidence in the quality of early childhood care services. Regular monitoring and evaluation of program implementation, accompanied by constructive feedback for improvement, are also critical. Moreover, sustained support from local networks through the provision of educational materials, disease control equipment, and adequate financial resources is vital to ensure the long-term sustainability and enhancement of standards in Disease-Free Childcare Centers.