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Location Thailand ASEAN
Flag
Coat of Arms
Government Monarchy under the constitution (1). , and. Democracy with a parliament (2).
King His Majesty King Bhumibol Adulyadej the Great Pr York microscopy.
Chancellor Yingluck Shinawatra.
King
Country Background of Thailand
6/07/12 2
Thailand profile- Southeast Asia
Region- GDP per capita USD 4,608- Population of 64 million- Population growth rate 0.5%- Infant mortality rate: 11.8/1,000 live birth- Life expectancy
-Male 69.6-Female 76.9
A Journey towards Health Systems Reform in Thailand
PHC/HFA (1980)Quality of Life Concept based on Basic Minimum Needs (2007)
National Health Act
(2001) Thai Health Promotion Foundation Act - Sin Tax
(2002) National Health Security Act
(1997)Economic crisis and political reform with People Constitution
(1990) Economic led Growth Policy causes social inequity, Deteriorated natural resources
(2000) Health System Reform Office
(2007)Constitutionreplacing an interimconstitution by an army-led coup
(1992) Health System Research Institute Act
(2001) IHPP under MOU of MoPH & HSRI
(2010)National Refrom Committee
• Propose health policies and strategies
Network of members and communities
• Management of the Health Promotion Fund
• Management of the NationalHealth Security Fund
• Health related operation
Local Administrative Organizations
• National HealthStatute
Other Networks
• Creationof knowledge
สช. ปรบัปรุง พ.ย.
50
• Health Assembly
Parliament
CabinetNESAC NESDB
HSRI
Ministry of Public Health and other
ministries relevant to health
THF
NHSO
อปท.Regional Agencies
NHC/NHCO
Web of the Health Systems Mechanism
Professionaland AcademicNetwork
Press and medianetworks
HA
National Health Commission Office
Mr. Techid ChawbangpomExpert of social networking
National Health Commission, Thailand
Essence of the National Health Act
• New Definition of Health Health is Well-Being
• New Governance Body beyond Public Health Ministry: National Health Commission
• New Tools for Policy Process: Health Statute, Health Assembly, HIA,
National Health Commission
NHC
NHCO
EB
• Chair : PM• Vice : MoPH
Minister
MoPH
Cabinet
MoPHMoPHOtherMinistry
NESDB Etc
Tools• Health Statute (HS)• Health Impact Assessment (HIA)• Health Assembly (HA)• Health Station, TV and Radio on line
Wellbeing
Healthy Public Policy
National Health Commission (NHC)
People participation at all levels
10 Dissemination of health information 3 Health security and protection
7 Promotion of Local health wisdom
5 Prevention and control of health threatening factors
8 Consumer protection
11 Formation and development of health personnel
1 Philosophy and basic concepts of health system
Statute on National Health System
2 Desirable health system and its and goal
4 Health promotion
6 Public health services and quality control
9 Generation and dissemination of health knowledge
12 Health financing
5
Health Impact Assessment (HIA)
• Maximize positive impacts and minimize negative impacts on people health
• Support the decision making at policies, programs or projects• Learning process of the society as a whole
“a process in which the relevant public and State agencies exchange their knowledge and cordially learn from each other through a participatory and systematically organized forum, leading to recommendations on Healthy Public Policies or Public Healthiness.”
Definition of Health Assembly
“The Triangle that Moves the Mountain” Strategy
Knowledge (K)
Social (S)
Political Involvement (P)
NHA
4
Three Health Assembly Models under the Same Principles
Models1. National Health Assembly (NHA)2. Area-based Health Assembly
(AHA)3. Issue –based Health Assembly
(IHA)
NHA
IHAAHAPrinciples1. Involvement of Stakeholders2. Systematic Management3. Learning and sharing
System and Mechanism of Health Assembly
National Health
Commission(NHC)
National Health Assembly’s Organizing Committee( NHAOC )
NHCO
National Health
Assembly
Principles and Procedures of Organizing NHA
Linked
Mechanism for technical
Support
Area based Health
Assembly
Issue based Health
Assembly
Private/Civil society Political
/Gov.
Academic/Professional
Multi Sectoral
Mechanism
Principles and Procedures of Organizing Area based HA and Issued based HA
Put proposal to practice
• Cabinet
• Parliament /Political sector
• State agencies
• Local administrative organization
• Local communities
• Academic profession organization
• Private /Business / or other orgs.
Put proposal to practice
National Health Assembly is a year-long process
Call for agenda
Agenda
selection Drafting
technical and
resolution
Stakeholder
constituency
consultationRevise
document
Circulate for
constituency
consultation National
Health Assembly
Submit to
Cabinet Implementation
6/07/12 Thai Health Systems and National Health Assembly
14
2 dimensions, 4 values, 5 strategies
6/07/12 Thai Health Systems and National Health Assembly
15
Participatory healthy public policy
Social empowerment
Participatory Democracy
Interactive Learning
through action
Participatory healthy
public policy
process
Social Movement
5 StrategiesIncrease participation from all 3 sectors and build
ownershipDevelop the Assembly System that are systematic
with clear pattern but with flexibilityUse inclusive approach to involve all stakeholdersSupport downstream process to bring policy to
implementationLink National Health Assembly to Thailand Reform
Assembly and Assembly at International level
6/07/12 Thai Health Systems and National Health Assembly
16
26
Needs of People
Government Sector State Policy
Civil SocietySector
Conceptual Idea of Health Assembly on the Development of Healthy Public Policy
Participatory Policy Formulating
Knowledge Sector
Politic/Government Sector
Civil Social Sector
Health Assembly
ExampleCase learning
to public development in Thailand
The Enhancement of Local Disaster Management
to Public Policy Development in Thailand
Scopes of Presentation• Disaster situation and the 2011
flood situation in Thailand • Roles of civil society organizations
and local communities in disaster management
• Movement of participatory public policy development
• Contents of Thai NHA Resolution on disaster management with local communities as the focal point
Disaster Situations in Thailand (year 1989-2010)
Disasters Numbers(times)
PeopleInjured
Peoplekilled
Cost(million US)
Flood 213 7,896 2,938 3,735.1Landslide 9 > 500 541 66. 2Storm 36,024 1,367 842 163.0Fire 46,986 3,775 1,639 916.7Tsunami 1 11,775 5,401 225.8
83,233 > 25,313
11,361 5,040.8
Department of the Disaster Prevention and Mitigation, Ministry of Interior
Flood Situation in Thailand, 2011• July 2011- January 2012 • Covered 65 provinces, 684
districts, with 4,086,138 households and 13,595, 192 people affected.
• Houses : whole houses 2,329; partially damaged 96, 833
• Damaged agricultural areas 11.20 million Rais; 13,961 roads; 777 drainage ditches; 724 bridges/bridge-necks; 231,919 fish/shrimp/clam farms.
• 813people were killed and 3 were lost.
• The World Bank approximated damage cost at 45,000 million baht.
Importance Causes• Communities’ lack of disaster
planning• Lack of effective warning
system and lack of accessible communication system
• People’s lack of knowledge about disaster prevention.
Songkla Partner Against Disasters
• Damage (2010) : 16 districts, 12 municipalities, 119 sub-districts, 1,049 villages/communities, 269,233 households, 802,247 people
• Activities: Providing horizontal warning system – focus
on networking Setting up database in both risk and safe
areas Encouraging communities to be alerted and
self-dependent during disasters
Examples of community roles:
Nakhon Sawan Community Network• Damage : 4 sub-districts, 59
communities, 18, 464 households, 72, 331people
• Activities: – Setting up 11 relief shelters– Sacrificing some houses to safe
the communities – Setting up Disaster Fund
Examples of community roles:
Nakornpathom People Network
• Damage : 7 districts, 102 sub-districts, 905 villages, 85,381 households, 230,165 people
• Activities:Setting up relief shelters in temples,
schools and government offices Setting up the shared kitchen Recovering the indigenous orange,
Nakornchaisri, orchards
Examples of community roles:
National Health Assemblyin National Health Act, 2007
a process in which the relevant public and State agencies exchange their knowledge and cordially learn from each other through a participatory and systematically organized forum, leading to recommendations on Healthy Public Policies or Public Healthiness.
Timeline- Development of public policies on community-
centered disaster management
The 14-province Southern Health Assembly Network in
proposed to enclose the issue in the agenda of The 4th NHA
(May 2011)Songkla Partner
Against Disasters
The agenda was announced in The 4th NHA &
academic team working on development of policy recommendation was set
up
Forum on Lessons learned
from flood management(Jan 2012)
The 4th National Health Assembly (NHA) (2-4 Feb
2012)
The Cabinet approved on NHA’s Resolution
and assigned departments to act on accordingly (May
2012)
Flood Oct-Dec
2011
Resolutions• Revise the Disaster Prevention
and Mitigation Plans• Provide local community
network’s preparation planning• Set up national fund• set up fund and collaborative
mechanism in local level• Support knowledge management
Resolutions• Provide frequency bands for TV,
radio broadcast • Encourage development of diverse
volunteer networks• Set up area based health assembly
to address disasters in the areas. • Prepare learning curriculums in
every class level
Lessons Learn• The power of local communities and civil
society networks is crucial in dealing with disasters in Thailand in 2011
• Working experiences of local communities and civil society networks are important sources for development of the policy recommendation
• the Thai NHA, founded in accordance with the national Health Act, is a tool used for participatory development of healthy public policies, which is recognized by all sectors including the government
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