Achieving Universal Coverage in Thailand: What Lessons Do We Learn?
28 Pages Posted: 24 Mar 2008
Date Written: 03/2007
This paper reviews the policy process of achieving universal coverage of health care (UC) in Thailand and critically assess how the reform achieve policy objectives of improving equity and efficiency of the health care system with sustainable health care finance.
Findings from the study indicate that bureaucrat-led reformists played an important role in bridging researchers and policy makers. While agenda setting was vested in the political leadership and commitment to achieve universal coverage, the system design and monitoring and evaluation were guided by researchers; and successful policy implementation was based on the health system capacity. Evidence played a strong foundation of the health sector reform.
Several lessons were drawn. First, the strength of health care infrastructure and geographical distribution of well-functioning primary care services in rural and urban areas serves as a strong basis for success in the smooth implementation of the UC policy. The availability of qualified human resources for health at district and provincial health facilities is also a key factor enabling the capacity of the health care system to provide essential health services to the whole population, and cope with the increasing demand for health care. Second, financial feasibility of the country influenced by a long period of internal peace and the economic growth, coupled with appropriate health financing arrangements of the UC scheme, makes a possibility to implement the UC policy. Third, relevant knowledge and evidence for policy formulation and implementation, and skills in the estimate of budget requirement was acquired through the establishment of effective knowledge management mechanisms and sufficient long term investment in human resources in health system research and international linkage to keep abreast. Also, the national capacity to coordinate data producers (i.e. the National Statistical Office) and data users (i.e. the MOPH), and ability of researchers to communicate with health care reformists and policy makers support the conception of "The triangle that moves the mountain".
Keywords: universal coverage, health sector reform, health equity, health financing arrangement
JEL Classification: I18
Suggested Citation: Suggested Citation