1 hsro, thailand national health system reform : toward healthy thailand

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Page 1: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

1HSRO, Thailand

National Health S ystem Reform : to

ward healthy Thailand

Page 2: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

2

The Old Health Paradigm

HSRO, Thailand

Focus on

• biomedical• cure diseases

Page 3: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

3HSRO, Thailand

Page 4: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

4

Changing of the Pattern & of Health Problems

HSRO, Thailand

• CD. NCD. & newemerging dis.

Page 5: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

5

Increasing of Social pathology

• Biosocial related

HSRO, Thailand

Page 6: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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More problems in Health Care Systems• Equity

HSRO, Thailand

• Quality• Efficiency

Page 7: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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• Philosophy & Directions & Strategies of NHS : not clear• No National mechanism to oversee NHS.

HSRO, Thailand

Page 8: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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(Biosoc ial Health

Systems)

(Biomedical Health

Systems)

HSRO, Thailand

Page 9: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

9Dynamics

Individual Environment

Health Care systems

Security

Economic/politicalPhysical/biological

Cultural/religious

Technological

Genetic

Behavior

Health

SpiritualCommunicationand transportation

Population/educational

Quality/efficiencyPublic/private

Equity/coverageTypes and levels

of services

Health and Relating / Contributing Factors

Wibulpolprasert, S.

Belief system

Life style

HSRO, Thailand

Page 10: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

10HSRO, Thailand

*HSRO was set up under HSRI

HSRO*

Partnershipbuilding

Knowledgegeneration

DraftingThe NH Act

Publiccommunication

NHSRC HSRI BoardTechnicalAdvices

HSRI

MoPH

Page 11: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

11Prawase Wasi HSRO, Thailand

Political linkage

Knowledge generationSocial movement

The that moves the mountain

Page 12: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

12

Framework for National Health System Reform

Building Health EQE/Holistic/Evidence-based Participatory/Transparency Consumer Focused

Legislative framework National Health Committee

Knowledge ManagementPanership BuildingPublic CommunicationManagement

Chair by PM 3 years mandate

Civic involvement Wisdom Partnership Public hearing/education/ relation

NHSRC

Strategies

National Health Act

Desirable Health System

HSRO, Thailand

Page 13: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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The New Strategy of New Health Systems

focus on ill - health

(disease oriented)

focus on good - health

(well beingoriented)

Shift to

HSRO, Thailand

Page 14: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

14HSRO, Thailand

Health: A complete, holistic and balanced state of physical, mental, spiritual and social being.

Spiritual : A thorough understanding of the root causes of all worldly tribulations, which lead to total empathy and tolerance to all.

(Draft of the National Health Bill)

Page 15: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

15

National Health Bill drafting

Process = Social movement(interactive learning through action)

Result =

• Direction of NHS.+

• Dynamic mechanism to oversee NHS.

Health Constitution

HSRO, Thailand

Page 16: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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Goals of NHSRGoals of NHSR “ “ To achieve a desirable national HS in To achieve a desirable national HS in

which ‘health promotion takes a more which ‘health promotion takes a more precedent role than its curative precedent role than its curative counterpart’, and is based on counterpart’, and is based on

the concept of the concept of ““sufficient healthsufficient health ”, ”,inviting the people to take part inviting the people to take part

in being an active partner in being an active partner in their HS for in their HS for

sustainable sustainable healthhealth””

HSRO, Thailand

Page 17: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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Good health/well-being approach

Right, Duty and Health Security

National H. Commission, Health Assembly

• Policy & Strategy • Consumer Protection• Health Promotion • Knowledge Creativity and KM.• Health Threatening Prevention & Control • Information & Communication• Health Care System & QC. • HRH.• Local Wisdom in Health • Health Financing

• Policy & Strategy • Consumer Protection• Health Promotion • Knowledge Creativity and KM.• Health Threatening Prevention & Control • Information & Communication• Health Care System & QC. • HRH.• Local Wisdom in Health • Health Financing

Contents of NH.BillContents of NH.BillContents of NH.BillContents of NH.Bill

HSRO, Thailand

Page 18: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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Health Assembly (HA)(local area specific HA, issue specific HA, national HA)

to create participatory healthy public policyto encourage social interactive learning through actionto generate knowledge related to health & well - being

Page 19: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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Success of Health Systems Reform in Thailand

HFA

AFH

National Health Bill (draft)• As the principle decree for

Health Systems (Health Constitution)

• As a mechanism for participatory public policy formulation

National Health Security Act (2002)• Reform of health care

financing system to achieve universal coverage

Thai Health Promotion Foundation Act (2001)• Utilization of the 2%

“sin tax” to facilitate sustainable health promotion in all dimensions (physical, mental, social and spiritual)

1

3

2

MoPH

People & Social Academics &

Professional Sectors

Other gov. sectors

HSRO, Thailand

Page 20: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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Lessons learned

1. Health paradigm shift

Health asabsence of

disease

Health aswell-being

HSRO, Thailand

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21

Total health systemsTotal health systems

Public healthPublic healthsystemssystems

Health CareHealth Caresystemssystems

Page 22: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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Lessons learned (cont.)

2. Provide opportunity and means for all sectors to participate

All for Health (interactive

learning through action)

Health for

All

HSRO, Thailand

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Lessons learned (cont.)

3. An essential mechanism

• Strategic management

• Create collaboration

• Encourage participatory learning process through collaborative practice

• Knowledge management

HSRO, Thailand

Page 24: 1 HSRO, Thailand National Health System Reform : toward healthy Thailand

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9P.O. Box , Talad Kwan, Non 9P.O. Box , Talad Kwan, Non 11 0 0 2 11 0 0 2 ,, Thai l and Thai l and

- - -. 6 6 2 5 9 0 2 3 0 - - -. 6 6 2 5 9 0 2 3 044

- -. 6 6 2 5 9 0 2 3 1 - -. 6 6 2 5 9 0 2 3 111e-mail: [email protected]: [email protected] page: home page: http://www.hsro.or.thhttp://www.hsro.or.th

National Health National Health System Reform OfficeSystem Reform Office