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Public Health Situation in ThailandBy

Choen KrainaraSuleeporn Boonbongkarn

Chaba SrisunoJirapa Sophon

Regional and Rural Development Planning Field of StudySchool of Environment, Resources and Development

Asian Institute of Technology (AIT)2008

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Distribution of Health Resources

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Ratio of High-Cost Medical Technologies

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Numbers of Patients

No. Disease Death rate No. of Patients

1 Cancer 47,000 4,000,000

2 Heart disease 45,000 3,000,000

3 Coronary artery disease

21,000 2,000,000

4 Diabetes 15,000 12,000,000

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Research Projects on Health System

Reforms

Research Projects on Diseases and Health

Problems

- Anti-AIDS Traditional Medicine

- National Newborn Screening Project

- Research Package on Diseases and Health Problems

Health Research

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Health Education

Formal

• 12 medical universities

and public health

colleges, nurse colleges

• Standard Medical

Treatment Curriculums

Informal

• Traditional and

alternative medical

treatment

• Preventing rather

than curing

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The National Health Policy (the 9th Plan Period, 2002-2006)

Image of Desirable Thai Society and Health

Development Concept: People-centred and self-Sufficiency Economy

To create a proactive health system

Objectives of Health Development

Development

of management

system for

health

Development of

health security

and service

quality

Development of basic

factors for good health

and health promotion

Development of

people ‘s health behaviour

Development of

health knowledge and

technology

Management of

human resources

for health

Development of

country ‘s competitiveness

in health

To create a health security system

To enhance knowledge and

technology for health development

To strengthen self-care and health

promotion

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Targets and Situations under the National Health

Development Plan during the 9th Plan Period, 2002-2006

Health impactReduction

of health problems

Health

promotion

Health

care accessibility

• Reduce infant mortality rate to not exceeding 15 per 1,000 live births

• Reduce maternal mortality to not exceeding 18 per 100,000 live births

• Increase life expectancy at birth - Female, to 77 years - Male, to 72 years

Etc.

• Reduce malnutrition among children aged 0-5 years to not exceeding 7%

• Reduce HIV infection prevalence rate

- in conscripts to not exceeding 1%

- in women of reproductive age to not exceeding 1%

• Reduce mortality rate due to cancer tonot exceeding 40 per 100,000 population

Etc.

All citizens have health security

• At least 80% of children aged 0-5years have growth development accordingto their age• At least 60% of the people exercise regularly•Reduce smoking rate among people age 15 years and above to not exceeding 21%

The

universal

coverage of

Healthcare scheme

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Decentralization Situation

• Until December 2004, there was not much progress in decentralization of the health sector.

• Factors hamper the decentralization include:

• Limited budget

• Ineffective cooperation

• Inadequate human resource

Policy on Decentralization

Proposed New Decentralized Health System

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Proportion of National Health Budget by

Major Type of Programme (2002-2004):

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Thai Health Care system

• Improvement of overall Thai people’s health situation

• Promotion of an equal access to healthcare

Success

Strengths

• Professional experts

• Advanced medical technologies such as health facilities

and equipments

• Effective vaccination and epidemic disease control

• Alternative medical treatment

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Health Index of Thai

People by Region

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• Inequities of Medical and Health Services

– Inequities in Resources Allocation

– Inequities in Access to Health care

– Inequities in Health Status

– Inequities in Bearing Healthcare Cost

• Problems of Health Services System Efficiency

– Problems of Health Services Efficiency

– Problems of Investment in Hospital Beds

– Problems of the Quality of Service System

Health Care systemProblems

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Health Care system

•Centralization of budget and organization

• Lack of both physicians and medical

technologies in micro-level

• Lack of accessibility to health care services

Weaknesses

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Impacts of The Universal Coverage of Healthcare

Positive Negative

• People have more health security

especially poor people who don’t have

any health insurance.

• Promote an equal health budget

allocation.

• Promote an equal right to access the

health services.

• Major public health budget was used

for the universal coverage than other

programs

• Ineffective health budget allocation to

public health centers : Doctors move to private hospitals.

• Impact on long-term economic

viability of health care centers

• Due to the limited national budget,

lower health service quality.

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Other relevent issue:

• Exercising Compulsory Licensing (CL)

• Ethical issues of doctors and drug companies

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Recommendations

1. Decrease an inequality of health service and health care

2. Decrease an inefficiency of resource allocation

3. Promote alternative treatment and preventive measures

4. Take a long term look at the subsidy of health care plan for example 30 baht health scheme and universal health coverage scheme

5. Promote decentralization

6. Learn more about drug patent and study more about important drugs for poor people

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“…All Thai people have an

equal right to access the

quality health services…”

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Expatriates Living in Thailand

Our local website in

English

Chinese (Simplified)

Chinese

(Traditional)

Japanese

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Thankyou