SERVICE-SYSTEM OUTCOMES OF A VOLUNTEER DENTIST PROGRAM IN KOH MAK, TRAT PROVINCE: AN ANALYSIS USING THE 1A4C CONCEPT

Abstract

This study aimed to analyze the service-system outcomes of a volunteer dentist program in Koh Mak, Trat Province, through the 1A4C concept, comprising Accessibility, Continuity, Comprehensiveness, Coordination, and Community Participation. A mixed-methods research design was employed, involving stakeholders related to the volunteer dental activities. Eight operational stakeholder groups participated in the study, with a total of 71 informants. Qualitative data were analyzed using content analysis and thematic analysis, and the identified outcomes were categorized according to the five components of the 1A4C framework. The findings showed that the volunteer dentist activities generated outcomes across multiple stakeholder groups and levels of the service system. Community members experienced reduced travel burdens and expenses associated with receiving dental services. Primary care teams had increased availability of dental services and reduced referral burdens. Schools demonstrated outcomes related to oral health promotion, while local businesses experienced reduced costs associated with replacement labor. Dental departments of hospitals in the province experienced reduced burdens in receiving referrals from Koh Mak, while the Provincial Public Health Office experienced a reduced burden in organizing personnel rotation. In addition, volunteer dental personnel reported positive experiences from working in the area. When the identified outcomes were analyzed according to the 1A4C concept, they covered all five dimensions: Accessibility, Continuity, Comprehensiveness, Coordination, and Community Participation, with Coordination and Accessibility emerging as the most prominent dimensions. These findings suggest that the volunteer dentist activities generated outcomes not only for service users but also for the broader dental health service system by reducing barriers to access, strengthening service linkages, facilitating resource coordination, and engaging local partners. The analysis of outcomes from multiple stakeholder groups using the 1A4C concept provides a foundation for assessing social impacts and further developing the study toward a Social Return on Investment (SROI) evaluation.

Keywords: 1A4C; Accessibility; Volunteer Dentist; Island Area; Dental Health Service System