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This study explores how transformational leadership, employee commitment, and job satisfaction affect the operational effectiveness of village health volunteers.

February 8, 2026Open Access

Assessing the operational effectiveness of village health volunteers in Thailand: A structural equation modeling analysis

Key Points

This study explores how transformational leadership, employee commitment, and job satisfaction affect the operational effectiveness of village health volunteers.
Mixed-methods design incorporating quantitative and qualitative data
Quantitative data collected from 280 village health volunteers in Thailand
Qualitative insights gathered through focus group discussions
Structural Equation Modeling utilized to analyze relationships among key variables
Transformational leadership significantly predicts employee commitment (β=0.80, P<0.001)
Job satisfaction is also significantly predicted by transformational leadership (β=0.65, P<0.001)
Operational effectiveness is influenced by employee commitment (β=0.49, P<0.001) and job satisfaction (β=0.13, P=0.04)
68.0% of the variance in operational effectiveness can be explained by these variables

Abstract

Background: Village health volunteers (VHVs) play an essential role in Thailand’s primary healthcare system by promoting health, preventing diseases, and ensuring community well-being. However, their operational effectiveness is influenced by several key factors, including transformational leadership, employee commitment, and job satisfaction. This study investigates these relationships and their implications for sustainable community health systems. Methods: A mixed-methods approach was utilized, combining quantitative data from 280 VHVs across Thailand’s lower central region with qualitative insights gained from focus group discussions (FGDs). Structural Equation Modeling was employed to evaluate the relationships among transformational leadership, employee commitment, job satisfaction, and operational effectiveness. Results: The findings reveal that transformational leadership significantly predicted employee commitment (β=0.80, P<0.001) and job satisfaction (β=0.65, P<0.001). Operational effectiveness was significantly predicted by employee commitment (β=0.49, P<0.001), transformational leadership (β=0.26, P<0.001), and job satisfaction (β=0.13, P=0.04). Together, these variables explained 68.0% of the variance in operational effectiveness. A new model termed T-E-J Performance (where T=Transformational Leadership, E=Employee Commitment, and J=Job Satisfaction) has been developed to guide strategic improvements. Conclusion: To sustain effective community health programs, it is vital to enhance leadership capabilities, improve job satisfaction, and foster commitment among VHVs. These findings offer actionable insights for policymakers to create leadership training programs, enhance incentives, and implement strategies for workforce retention. Strengthening VHV systems can significantly contribute to sustainable healthcare delivery and health equity in Thailand.

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