Thailand: Thailand Health Profile

The MOPH is authorized and responsible for the strengthening of the public health and hygiene, preventing and controlling diseases and recovering the energy-level of the population. It has established its goals and a 3-year strategy for pursuing the goals so that the subordinating agencies adhere to the principal goals and their strategy is in operation according to estimates of the public health budget required for achieving the goals.

 

The followings are the target of MOPH’s policies:

 

The middle-term goals of the MOPH’s services are following:

 

The MOPH’s strategies in pursuing the goals according to the policies are:

 

The devising of the public health strategic plan: The strategic plan is very important for the result-oriented management (or Management by Objectives). Therefore, the strategic plan will be designed carefully in order to conform to the desired goal and the strategy of achieving the goal of the superior operation unit, so as to achieve the goal successfully.

The organizational structure at the central level of the MOPH consists mainly of the Office of Permanent Secretary of MOPH and 3 task clusters, described below:

 

 

The organizational structure of the regional agencies which are under the administration of the Office of Permanent Secretary of MOPH, consist of Provincial Public Health Offices, hospitals, Ampur Public Health Offices, the PCUs and the community clinics. The above agencies are the major healthcare service providers who help the people promote health, control and prevent diseases, and provide medical treatment and recover health. They utilize the knowledge and technology that have been developed and transferred from the technical Department and adjust and apply them appropriately according to the specific requirements of their regions. The organizational relationship between the technical Department at the centre and the regional public health operation agencies is basically staff relationship in which the centre provides support to the regional agencies, but does not command.

 

For healthcare at the primary level, there are the PCUs providing the services within the scope of Tambol and village. They are responsible for arranging a suitable aggregate of health services for the rural people in their responsibility areas which normally have 1,000 – 5,000 people. There are fulltime public health personnel stationed at the public health units such as Sanitation Officers, Midwife Nurses and Technical Nurses. In addition, Dental Officers, Technical Nurses and Public Health Officers are also working there. Ampur Public Health Offices are responsible for the assistance, supports, supervision, monitoring and appraisal of their accomplishments.

 

On the aspect of decentralization of the authority of the public health administration, the Constitution of the Kingdom, 1997, the section 78 stipulates that the government is to decentralize its authority to empower the regional authorities to make them self-reliant and make their own decisions regarding the regional affairs through the legislation of acts, plan and procedure of achieving the goal of the decentralization within 4 years (2001-04). In case the regional organizations are not ready to assume their new role within 4 years, the decentralization period is expanded to 10 years (2001-10). The regional organizations are stipulated to prepare themselves for the decentralization while the central government is stipulated to provide administrative assistance, and intellectual and technical supports for decentralization purpose. The Steering Committee of the Decentralization has also been established for the purpose of forming the policy and procedure of the decentralization. The Steering Committee has so far drafted up two major plans:

 

 

The MOPH, in an effort to actualize the decentralization of the public health administrative authority to regional organizations, has designated the Regional Health Committees in 43 provinces. These regional committees are responsible for the coordination in forming policy, drafting plans of regional public health development, plans of resource requirement, and also planning budgeting and personnel. They are also responsible for defining the criteria and allocating the resources, supervising and inspecting and defining the criteria for appraising the outcomes of the regional public health administration. Currently, the committees are in the process of determining the forms and procedure of operation.

In the result-based management - Management by Objectives (MBO), the devising of the public health strategic plan will be according to the target areas and to cover all age and gender groups in order to improve the people’s health. One of the outstanding public health strategies is the Healthy Thailand strategy by the MOPH as the overall goal of the public health directing the health endeavours throughout the country. The policy of Healthy Thailand of the year 2004 concentrates on 5 health aspects - exercise, diet, emotion, disease reduction and environment according to different age groups and regions through holding appropriate activities. All related activities and plans governing them will be integrated so that the implementation of the plans can be achieved.

Public health bodies: In addition to the Ministry of Public Health, other important public health bodies in Thailand include the Health System Research Institute (HSRI), Thai Health Promotion Foundation (“ThaiHealth”), National Health Security Office (NHSO) , National Health Commission Office (NHCO), and the Emergency Medical Institute of Thailand (EMIT). Epidemiological transition: Thailand is witnessing both demographic and epidemiologic transitions.

The total fertility rate (TFR) has dropped from 2.4 in 1990 to 1.6 in 2006 with an estimated population growth rate of 0.7% for the period 2004-2015. HIV/AIDS, tuberculosis, malaria and emerging pathogens remain important and compounded with emerging drug resistance particularly among mobile/border populations. Noncommunicable diseases (NCDs) are equally important as lifestyles change and the population ages. These include chronic diseases such as cardiovascular diseases and diabetes as well as those associated with the risk factors of smoking, unsafe use of alcohol, inactivity, unhealthy diet and environmental degradation. Injuries, particularly those related to road traffic accidents, represent one of the highest causes of morbidity and mortality in Thailand and extract a high economic toll on the country.

Many current public health challenges require multi-sectoral and multi-stakeholder collaboration as well as efforts to address their social determinants. Health systems: The national health budget increased from 5.8% of total government spending in 1993 to 11.3% in 2006. About 60% of all health expenditure comes from government sources. In 2001 the government introduced the Universal Health Care (UC) policy (the “30-Baht scheme”), in 2002 universal health care coverage, and in 2007 universal coverage without pay. Issues remain concerning health service quality, sustainability, and adequate health personnel. Public and national self-reliance in health: While the Ninth Health Development Plan emphasized a life-cycle health approach, promoting healthy lifestyles, improving the quality of health care, disease prevention and control, and preparing for the need of an ageing population, the Tenth Plan emphasizes public and national self-reliance in health and quality of services.

Roles in Regional and sub-regional cooperation in health development: Thailand is an emerging development partner and active in a number of regional and sub-regional cooperative initiatives. There are 35 WHO Collaborating Centers in Thailand which together with other Centers of Excellence are organized into a network (called NEW-CCET).