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Public Health Situation in Thailand
                         By

                   Choen Krainara
              Suleeporn Boonbongkarn
                   Chaba Srisuno
                   Jirapa Sophon



Regional and Rural Development Planning Field of Study
  School of Environment, Resources and Development
          Asian Institute of Technology (AIT)
                          2008
                                                    1
Distribution of Health Resources




                                   2
Ratio of High-Cost Medical Technologies




                                          3
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 21,000       2,000,000
    disease
4   Diabetes        15,000       12,000,000

                                               4
Health Research


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
                                            5
Health Education

         Formal                    Informal
• 12 medical universities    • Traditional and
  and public health            alternative medical
  colleges, nurse colleges     treatment
• Standard Medical           • Preventing rather
  Treatment Curriculums        than curing


                                                     6
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


                           Objectives of Health Development


To create a proactive health system                     To create a health security system

 To strengthen self-care and health                         To enhance knowledge and
            promotion                                   technology for health development



Development          Development of          Development of basic        Development of
of management        health security         factors for good health     people ‘s health
system for           and service             and health promotion        behaviour
health               quality

       Development of                 Management of           Development of
       health knowledge and           human resources         country ‘s competitiveness
                                                                                      7
       technology                     for health              in health
Targets and Situations under the National Health
         Development Plan during the 9th Plan Period, 2002-2006
                              Reduction                 Health                   Health
   Health impact          of health problems          promotion             care accessibility

• Reduce infant           • Reduce malnutrition       • At least 80% of        All citizens have
mortality rate to not     among children aged         children aged 0-5        health security
exceeding 15 per 1,000    0-5 years to not            years have growth
live births               exceeding 7%                development
                                                      according                      The
                          • Reduce HIV infection
• Reduce maternal                                     to their age                universal
                          prevalence rate
mortality to not                                      • At least 60% of          coverage of
exceeding 18 per             - in conscripts to not   the people exercise        Healthcare
100,000 live births       exceeding 1%                regularly                    scheme
                                                      •Reduce smoking
                             - in women of
• Increase life                                       rate among people
                          reproductive age to not
expectancy at birth                                   age 15 years and
                          exceeding 1%
  - Female, to 77 years                               above to not
  - Male, to 72 years     • Reduce mortality rate     exceeding 21%
                          due to cancer tonot
          Etc.            exceeding 40 per
                          100,000 population
                                                                                            8
                                    Etc.
Policy on Decentralization

      Proposed New Decentralized Health System


   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
                                                        9
Proportion of National Health Budget by
Major Type of Programme (2002-2004):




                                          10
11
Thai Health Care system
 Success

 • Improvement of overall Thai people’s health situation
 • Promotion of an equal access to healthcare

 Strengths
• Professional experts
• Advanced medical technologies such as health facilities
and equipments
• Effective vaccination and epidemic disease control
• Alternative medical treatment
                                                           12
13
Health Index of Thai
 People by Region




                       14
15
Health Care system
 Problems

• 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   16
Health Care system
Weaknesses

     •Centralization of budget and organization

     • Lack of both physicians and medical
     technologies in micro-level

     • Lack of accessibility to health care services




                                                       17
Impacts of The Universal Coverage of Healthcare


              Positive                                 Negative
• People have more health security       • Major public health budget was used
especially poor people who don’t have    for the universal coverage than other
any health insurance.                    programs
• Promote an equal health budget         • Ineffective health budget allocation to
allocation.                              public health centers : Doctors move
• Promote an equal right to access the   to private hospitals.
health services.                         • Impact on long-term economic
                                         viability of health care centers
                                         • Due to the limited national budget,
                                         lower health service quality.




                                                                                18
Other relevent issue:

• Exercising Compulsory Licensing (CL)
• Ethical issues of doctors and drug companies




                                                 19
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

                                                 20
“…All Thai people have an
  equal right to access the
 quality health services…”



                              21
22
Expatriates Living in Thailand
         Our local website in
              English
              Chinese (Simplified)
              Chinese
(Traditional)
              Japanese




                                     23
Thank
 you




        24

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Public Health Situation in Thailand

  • 1. Public Health Situation in Thailand By Choen Krainara Suleeporn Boonbongkarn Chaba Srisuno Jirapa Sophon Regional and Rural Development Planning Field of Study School of Environment, Resources and Development Asian Institute of Technology (AIT) 2008 1
  • 3. Ratio of High-Cost Medical Technologies 3
  • 4. 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 21,000 2,000,000 disease 4 Diabetes 15,000 12,000,000 4
  • 5. Health Research 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 5
  • 6. Health Education Formal Informal • 12 medical universities • Traditional and and public health alternative medical colleges, nurse colleges treatment • Standard Medical • Preventing rather Treatment Curriculums than curing 6
  • 7. 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 Objectives of Health Development To create a proactive health system To create a health security system To strengthen self-care and health To enhance knowledge and promotion technology for health development Development Development of Development of basic Development of of management health security factors for good health people ‘s health system for and service and health promotion behaviour health quality Development of Management of Development of health knowledge and human resources country ‘s competitiveness 7 technology for health in health
  • 8. Targets and Situations under the National Health Development Plan during the 9th Plan Period, 2002-2006 Reduction Health Health Health impact of health problems promotion care accessibility • Reduce infant • Reduce malnutrition • At least 80% of All citizens have mortality rate to not among children aged children aged 0-5 health security exceeding 15 per 1,000 0-5 years to not years have growth live births exceeding 7% development according The • Reduce HIV infection • Reduce maternal to their age universal prevalence rate mortality to not • At least 60% of coverage of exceeding 18 per - in conscripts to not the people exercise Healthcare 100,000 live births exceeding 1% regularly scheme •Reduce smoking - in women of • Increase life rate among people reproductive age to not expectancy at birth age 15 years and exceeding 1% - Female, to 77 years above to not - Male, to 72 years • Reduce mortality rate exceeding 21% due to cancer tonot Etc. exceeding 40 per 100,000 population 8 Etc.
  • 9. Policy on Decentralization Proposed New Decentralized Health System 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 9
  • 10. Proportion of National Health Budget by Major Type of Programme (2002-2004): 10
  • 11. 11
  • 12. Thai Health Care system Success • Improvement of overall Thai people’s health situation • Promotion of an equal access to healthcare Strengths • Professional experts • Advanced medical technologies such as health facilities and equipments • Effective vaccination and epidemic disease control • Alternative medical treatment 12
  • 13. 13
  • 14. Health Index of Thai People by Region 14
  • 15. 15
  • 16. Health Care system Problems • 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 16
  • 17. Health Care system Weaknesses •Centralization of budget and organization • Lack of both physicians and medical technologies in micro-level • Lack of accessibility to health care services 17
  • 18. Impacts of The Universal Coverage of Healthcare Positive Negative • People have more health security • Major public health budget was used especially poor people who don’t have for the universal coverage than other any health insurance. programs • Promote an equal health budget • Ineffective health budget allocation to allocation. public health centers : Doctors move • Promote an equal right to access the to private hospitals. health services. • Impact on long-term economic viability of health care centers • Due to the limited national budget, lower health service quality. 18
  • 19. Other relevent issue: • Exercising Compulsory Licensing (CL) • Ethical issues of doctors and drug companies 19
  • 20. 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 20
  • 21. “…All Thai people have an equal right to access the quality health services…” 21
  • 22. 22
  • 23. Expatriates Living in Thailand Our local website in English Chinese (Simplified) Chinese (Traditional) Japanese 23
  • 24. Thank you 24