Proactive Health Promotion at the subdistrict level: Thailand’s New Public Health Management Policy

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Health center in Thailand, what does it look like?

     Thailand is an Asian country with a population of 60 million, 70% of whom reside in the rural area. Rural public health services continued to expand during the past half century, from one hospital in each province to more than 700 district hospitals covering the total district area nationwide. [1]

     National health status has been improved.[2] The pattern of illnesses has shifted from infectious disease to chronic non-communicable diseases.[3] Increasing number of patients in remote communities require continuous health care. With the aim to emphasize on health promotion, the ministry of public health has launched a project, on which $160 million would be spent to upgrade subdistrict health centers nationwide to health promotion hospitals.[4] [5]

       New buildings are constructed; ambulances/medical equipments are purchased. Personnel in health centers are assigned with new tasks/responsibilities. Villagers can more easily access to new patient-friendly “hospital”. As a part of this initiative, financial aid is offered to booster their moral of village health volunteers. The Thai Rural Doctors Society has initially raised concern on corruption issue during procurement in this project. Finally after thoroughly reviewed, it was approved and already implemented.

      The initiative sounds beneficial to everyone. However, policy which includes long-term human resource development plan is needed to ensure sufficient personnel for health services delivery throughout the country. Purchasing more equipments, constructing more buildings, or just changing the name from health center to hospital would mean nothing if the quality of care is not improved. [6]

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4 Responses to “Proactive Health Promotion at the subdistrict level: Thailand’s New Public Health Management Policy”

  1. phenpan Says:

    As a doctor in Thailand and do have experience in cataract ambulatory surgery in the rural area, this post is really be a big problem. So many people in that area have difficulty assessing to health personnel due to poor transportation and low socioeconomic status. This policy would improve quality of health in some part but as the author mentions, the instrument will not be worth without sufficient health personnels. Many health personnels don’t have good motivation to stay in rural area. Furthermore the health promotion policy seems to be good but with poor education in health promotion among health personnels make this difficult to work. Another problem that should concern is the difference in culture which may not response to health promotion policy from the government. The good understand to people in that area would help.

  2. healthpolicyjunkie Says:

    This is a very insightful blog post. All too frequently policies create new infrastructure without considering future ramifications. Many public health people are able to “catch the vision” of what needs to happen in the future (i.e. creating incentive programs in Thailand to attract health professionals to stay local). Unfortunately lawmakers and the public often have limited vision when it comes to championing and (most importantly) funding initiatives. How can we as public health practitioners help lawmakers/public “catch the vision” so to speak?

  3. mervynong Says:

    The government in Thailand appears to be making an effort to improve access to health care especially in the rural areas. It is comforting to note that they are acknowledging the issue and are acting on it. This is a good start and it is hoped that the momentum can be sustained. With the instability that has occurred in the past, there would be numerous parties who have lost faith in the government. The government needs to regain the people’s trust. The new prime minister is aware of this.

    “Prime Minister Abhisit also mentioned that, aside from that the government has to monitor, evaluate and improve the quality of health care system, the issue of good governance is very important to every agencies. The distribution of health care specialists needs professional management to carry it out, laying a strategy from the beginning, which is producing human resources, to localized health care system that local agencies can have more role in. The government believes that this solution is the most realistic and sustainable.”

  4. What is Child Anxiety Says:

    What is Child Anxiety…

    […]Proactive Health Promotion at the subdistrict level: Thailand’s New Public Health Management Policy « SBFPHC Policy Advocacy[…]…

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