location: , 'Thailand year: 2001 source: HSRI

title: A survey of anemia prevalence and its causes of children 1 to 4 years at Krabi province

abstract: Iron deficiency anemia (IDA) affects human quality of life impaired learning process, working abilities and natural resistance. This impairment is irreversible in some age group although iron status becomes normal. The prevalence data of IDA among young children is rare in most developing countries and different from country to country due to nutrition, child rearing pattern and genetic background. There is a mixtures of hemoglobinopathy genes in Southern Thailand so solving of IDA problem in Southern Thailand suspected to be a complex situation. How big the IDA problem in young children in Southern Thailand is not know and the natural nature of the population due to hemoglobinopathies involve in solving the problem. The special study of the nature and predictors of anemia is needed for proper policy formulation of this public health problem in southern Thailand.                A  community  study was designed to establish the prevalence and predictors of iron deficiency anemia in the pre-school rural children of Krabi province in Southern Thailand. Participants aged 1-4 years were selected by two–stage cluster random sampling , firstly random sampling the villages until get 30 villages and secondly random sampling ten participants from all children of each selected village.Children with history of chronic illness, malaria, prematurity, blood dyscrasias , acute illness and/or cured less than 2 weeks, iron supplement therapy with or without past blood transfusion during last 3 months and second to third degree malnutrition were all excluded. Three hundreds children between ages 1-4 years were identified belonging to this population. All participants should had their consent forms signed by parents to participate in this survey before the study activities started. Venous blood was measured for levels of hemoglobin and serum ferritin. Stool was collected to perform occult blood test for silent GI bleeding identification and Kato’s thick smear for hookworm ova identification. All of them had a full blood count, serum ferritin, hookworm ova and occult blood estimation performed. Data of sociodemographic characteristics (income, religion, parents’ education andoccupation) and child rearing was interviewed. Results: 28% of the sample are anemic (hemoglobin less than 11 gm/dl). The prevalence was highest among 2 years old children. Male among aged 1-3 years is found more anemic than  girl. The anemic prevalence reduced when children grew up. The severity of anemia is moderate. Iron deficiency  (serum ferritin less than 12 microgram/L) was found in 24.3% of this population, 53.6% of anemic children were (IDA), 46.4% were non IDA. Mean hemoglobin of the anemic children is 9.3 ( 1.3 gm./dl. The prevalence of IDA was significantly lower when the children ages increased (p = 0.006 ). There is no significant difference between both sexes. Muslim children had significantly higher IDA than Buddhist children ( p = 0.001 ). Hookworm and silent bleeding were not the IDA causes among this group ( Odds ratio 1.995%  CI = 0.0 - 21.6 ). This study is a new study of IDA prevalence among young children in Southern Thailand. Its finding confirmed that anemia and IDA is a public health problem among pre-school rural children in Southern Thailand. No need to set hookworm prevention program to prevent IDA in this young group because it is rare. There is 46.4% of non IDA anemia which should further study before setting policy formulation of anemia among this population group in Southern Thailand.


location: , 'Thailand year: 2023 source: HSRI

title: Seroprevalence of Hepatitis A, B, C, Measles, Mumps, Rubella, Varicella, Diphtheria, Tetanus and Pertussis (IgG Antibodies) in Chonburi Province

abstract: Objective: To assess the immunity status against vaccine-preventable diseases in the Expanded Program on Immunization (EPI) program, including hepatitis B, measles, mumps, rubella, diphtheria, tetanus and pertussis, along with other important diseases or vaccine-preventable diseases in the EPI pipeline (hepatitis A, hepatitis C and varicella) in Thai individuals residing in Chonburi Province, Thailand. Methods: A cross-sectional descriptive study was conducted in Chonburi Province between October 2022 and February 2023. The subjects in this study consisted of the population living in Chonburi province from birth to 80 years of age. Participants were grouped into age categories based on ten-year intervals. The level of immunity against hepatitis A, B, C, measles, rubella, mumps, varicella, diphtheria, tetanus, and pertussis. Results: A total of 1,459 subjects met the selection criteria and were enrolled. Seroprevalence rate against hepatitis A (anti-HAV IgG) were low in individuals below 40 years of age. The overall trend showed an increase in seroprevalence with age. For immunity against hepatitis B, children and young adults who were born after implementation of infant universal Hep B vaccination in Chonburi Province in 1988 had seroprevalence of HBsAg less than 1%, anti-HBc less than 3%. The anti-HBs levels were highest in children under 5 years of age. These findings are consistent with the integration of Hep B vaccination into the EPI. For anti-HCV, seroprevalence rate was 1%, with the majority of seropositive individuals being adults and elderly. Seroprevalence against measles, mumps and rubella in 657 individuals across all age groups showed that individuals between 11-20 years old possessed the lowest immunity. Older adults and elderly possessed high levels of immunity against measles and mumps, whereas children under 5 years of age and the elderly possessed high levels of immunity against rubella. Results of anti-diphtheria toxoid IgG (anti-DT IgG) in 657 individuals across all age groups showed that 65.4% of individuals were seroprotective as defined by anti-DT IgG ≥0.1 IU/mL. The lowest seroprotection rate for anti-DT IgG was found in 31–40-year-old age group (48.9%), followed by 51-60-year-old age group (50.5%) and 41-50-year-old age group (56.9%). Regarding the anti-tetanus toxoid IgG (anti-TT IgG), 95.1% of individuals were seroprotective with the lowest seroprotection rate found in 60-70-year-old and ≥ 70 year-old age groups. In contrast, the geometric mean titers against pertussis toxin were highest in children under 5 years due to recent vaccination. The results of anti-varicella IgG shows that the seroprevalence increases with age, starting at 20 years old. Conclusion: The immunity status against hepatitis A, B, C, measles, rubella, mumps, chickenpox virus, diphtheria, tetanus and pertussis showed that the seroprotection rates are under achieved in the following diseases: diphtheria, pertussis, measles, mumps, rubella, in different age groups as described. After the COVID-19 pandemic has subsided, revisions of the vaccine policy should be performed in order to prevent the outbreak of vaccine-preventable and other relevant diseases. The study's findings are preliminary for one province, but they provide valuable data on the immunity status against vaccine-preventable diseases. This will help guide the vaccine policy development for Thailand in the future.


location: , 'Thailand year: 2013 source: HSRI

title: Functioning data based on the International Classification of Functioning, Disability and Health (ICF) classification system: implications for multidisciplinary rehabilitation plans for persons with disabilities

abstract: Approximately 1.3 million people have been registered as persons with disabilities (PWDs) according
to the Persons with Disabilities’ Quality of Life Promotion Act (2007) of Thailand. There have been a
number of regulations across multiple governmental organizations launched as following actions recommended
by the United Nation Convention on Rights of Persons with Disabilities. There were, however,
quite a few rehabilitation projects implemented by local level policies. One possible reason could be the
lack of comprehensive database which can be shared among different organizations providing rehabilitation
services for people in need. The International Classification of Functioning, Disability and Health
(ICF) was introduced by the World Health Organization to be used to record functions and levels of disabilities
in a person. The author applied a questionnaire based on the concept and ICF classification system
in face-to-face interviews with 328 PWDs in the Mahasarakham Municipality. Database comprised of
types of impairment, ability to perform activities of daily living, needs for education, vocation, social
participation and benefits entitled. The database can be used to develop individual multidisciplinary
rehabilitation plans which could be regularly monitored and evaluated whether rehabilitation goals are
achieved. The database should be user-friendly, easily accessible and timely updated. Another factor that
should be created is an organization perform as a coordinator across multiple organization to emphasize
the success of the improvement of PWDs’ quality of life.


location: , 'Thailand year: 2003 source: HSRI

title: Development of juvenile delinquents care system in the observation and protection center of Ubonrachathanee : action and evaluation

abstract: The evaluation on development of a care system for children and juveniles in a child and juvenile observation and protection center was the final stage of this action research.  It aimed to evaluate the development of child and juvenile care system and to assess the changes of the children and juveniles’ behaviors, families, and personnel being in charge of the care, including, learning about development and working process.  It was a long-term study cooperated with cross-sectional study of both qualitative and quantitative research methodologies.	The project evaluation was carried out by Auto-Evaluation technique.  And the holistic assessment on development of child and juvenile care system was accomplished by qualitative and quantitative analysis.  In the assessment, the system theory had been followed as a concept paradigm.  The inputs were organization structure, policy and budget, care personnel, children and juveniles, and environment conditions.  All of these had been being processed participatorily in the development of the child and juvenile care system.  It was fruitedly on effectiveness of the child and juvenile care process.  They were appropriately well cared.  Also, there were some changes of children and juveniles’ behaviors.  They had self-reliance, pride, and self-worthiness.  As a result, they were well accepted by their families and communities.	A conclusion of the research was as follow:	1.  There were a lot of better changes in the organization structure.  For instances, there were: well-defined policy for jobs, better motivation on running work to meet the objectives, good interrelationships, better attitudes towards children and juveniles, clean, well-ordered and good scenery of environments.	2.  The participation in thinking and operation geared to successful development.  By the way this resulted from the realization and confronting bravado of the executives, cooperation between the executives and personnel of the organization, tightly relationships of the organizational personnel, and steadily hold to the ultimate goal and the objectives of the development.	3.  The development from “grass roots” to “policy” was resulted from government official reform.  It made the organization having more clear administration system.  There was a cooperative network for development between the Mental Health Department and the Department of Child and Juvenile Observation and Protection.	The outstanding aspects of this research were presented in the department and ministry level.  As a result, it fostered an opportunity for better development.  It could be also motivated the ones who had steadily willingness and active inspiration for development.	Important factors helping development of children and juveniles in the Observation and protection Center were:Cooperative participation between the researchers and Organizational stakeholders.To achieve problem solving, operation must follow the plan.Operation evaluation and improvement of the plan.Operation conclusion.Interchanging of learning.


location: , 'Thailand year: 1999 source: HSRI

title: Resource allocation for improving quality of life of the aged: a proposed guideline

abstract: Resource allocation for improving  quality of life of the aged: a proposed guidelineThe findings from the study  showed  that  in the year 1997 all kinds of government pensions and gratuities  totalled 24.7 billion bahts  while the medical expenses for the retired government officials added up to around 1.9 billion baths. Both items amounted to 3 percent of total governmental budget  or around 3.2 percent of governmental revenue from taxation. The study also forecasts the serie of these expenditures  until  the year 2011,  which is the last year of the Working-Plan for Welfare and Public Assistance Program to the Aged (1999-2011).  It was estimated that in the year 2011,   total expenditures for the retired public servants will amount to 2.24 , 10.85  , 11.97  , and 13.59 percents of the gross domestic products,  the total governmental budget, the total governmental revenues, and the revenue from taxation respectively.As to the amount of public welfare spent for the aging-poors  on housing and the service-centres, a much larger proportion  of the budget  go to the administrative cost. For the monthly living allowances, less than 50 percent of total needy-aging persons have accessed to it. Similarly, less than 50 percent of total budget for medical aid to the poors have been allocated to the needy aging persons who hold old-aged medical cards.  The study forecasts that welfare expenses that spend through the Ministry of Labor and Social Welfare and the Ministry of Public Health for the aging-poors  in the year 2011 will amount to 0.15  , 0.75 , 0.83 , and 0.94 percents of the gross domestic products, the total governmental budget, the total governmental revenues, and the revenue from taxation respectively.In addition, the study has analyzed factors determining the out-of-pocket expenses for  medical cares of the aging persons using  the 1994 national survey of the National Statistical Office.  The result was used for estimating the average medical expenditures of  the lowest income group in order to find out the public cost of medical assistance to the aging-poors.  If the government were to grant monthly living allowances of 300 bahts per person together with free medical assistance to all the needy-aged persons, it was calculated that the total cost will add up to 7.1 billion bahts in  the year 2011 which will amount to 0.1, 0.5, 0.56, and 0.63 percents of the gross domestic products,  the total governmental budget,  the total governmental revenue and the total revenue from taxation respectively.


location: , 'Thailand year: 2001 source: HSRI

title: Operating costs of health centers in Samut Sakhon, fiscal year 1999

abstract: Samut Sakhon, a small province in Central region has three districts, Muang, Banphaeo and
Krathumbaen. Banphaeo hospital, the first autonomous hospital in Thailand through Public
Organization Act, 2542 BE. will be financed through capitation according to population size in the
district. This will have significant changes to financing mechanism at provincial health office and
health centers in the district. The objective this study is to assess unit cost (covers labor and material
costs, excludes capital depreciation costs) of services provided by health centers in order that
Banphaeo hospital could fairly purchase care from health centers. We assess operating cost in fiscal year 2542 BE., among all health centers in the province. Staff time allocation survey was done to
allocate labor cost to various key activities of health center, material cost was directly collected for
each activities. Cost from general administration and reporting function were allocated to service
activities using simple allocation method.
Results: operating expenditure per capita population at health center was 120 Baht per year, (110
Baht from health centre and 10 Baht from District Health Office). Annual operating expenditure was
834,136 Baht per health centre, of which 56% was labor and 44% material cost. Each health center
was staffed by 4.16 health workers. Time allocation reported 22% contributed to curative services,
27% to administrative function, 18% on health promotion activities and 30% community based
services. Curative services consumed 40% of total operating expenditure, most were drugs and
supplies. Unit operating cost for curative service at health center was 59 Baht per visit (range 53 to
65), health promotion and mother child health services was 100 Baht per visit (range 88 to 120). If
cost from District Health Office was included, unit cost would increase by 9%. Unit cost was
influenced by staffing intensity, magnitude of labor cost and productivity. Unit cost is one of several
tools for proper resource allocation.
This study provides evidence on how hospital could purchase services from health center that reflects
operating cost. Several options are capitation base on population size, total cost inclusive for each
group of activities, or unit cost per service rendered. It depends on how to stimulate proper service
behavior by health center. However, current funding available at health center from central
government and local administration should be taking into account to purchase services from health
centers.


location: , 'Thailand year: 2022 source: HSRI

title: Analysis of the effect of COVID-related policies and other information on public behavior for healthcare prevention using mask-wearing data obtained from CCTV and artificial intelligence image analysis

abstract: Background: The COVID-19 pandemic has caused immense health and financial loss globally. Prior to mass vaccination, the only way to limit its spread was with standard health precautions, including mask-wearing, hand washing and social distancing. Compliance with these measures vary between countries, depending on the culture, the public awareness and the policies enacted by the government. A higher rate of mask-wearing is thought to be more effective in limiting the spread of the disease and methods of monitoring mask-wearing would be useful for campaigns to increase mask-wearing. Although the mask-wearing rate has been estimated with questionnaires and episodic counting studies, there are very few reports visually documenting the rate of mask wearing sequentially over time. In this study we developed an artificial intelligence (AI) system to analyze images from public CCTV’s to document the rate of mask wearing in Bangkok, Thailand, and correlate the rate with public health policies and COVID-19 events. Methodology: Public CCTV cameras in the Bangkok Metropolitan Area (BMA) were selected in view of their location and camera viewpoints. Every week, 9 hours of video clips from each of these cameras were downloaded and sent for analysis by an AI that had been trained to detect mask-wearing using pictures with and without masks from public databases. Images were divided for analysis into 2 parts, one part containing the mobile population and the other the non-mobile/vendor population. A number of the images was also visually checked for accuracy. The rate of mask-wearing was analyzed and correlated to public health measures and COVID-19 infections. The images of faces without masks were reviewed to understand factors related to not wearing masks. An in-person questionnaire was also performed on pedestrians in Bangkok to ascertain the factors for mask-wearing, or not, and to try to ascertain the attitudes, understanding and behavior of the general population in Bangkok. The mask-wearing rate seen on CCTV was compared with the mask-wearing rate obtained by a governmental online questionnaire.


location: , 'Thailand year: 2007 source: HSRI

title: The Principle of a “Sufficient Economy” in a District Hospital : The Experience of Rongkwang Hospital

abstract: The purpose of this study was to consider the result of the management of
Rongkwang Hospital in “sufficient economy.” The authors planned continuous management
and changed the way of creating suitable benefits for consumers, care-givers and
the hospital. This retrospective study compared financial liquidity, the quality of healthcare
services, the contentment of officers with the “sufficient economy” theory both premanagement
and post-management. Result of the study indicated that the average in-crease in financial liquidity was 80.82 percnt, which in pre-value and post-value measure
were 0.99 and 1.80, respectively. The decreased expenses included the public utility’s
value at 7.64, investigated material’s value at 0.08, and supportive medicine’s value at
28.63. The value of other materials was 10.42 when the quality service of health care in
the remedication rate for seven days decreased from 2 to 0.01 percent, the readmission
rate decreased in 28 days from 3.16 to 3.05 percent, the OPD consumer contentment rate
increased from 84.62 to 95.49 percent, the IPD consumer contentment rate increased
from 87.61 to 100 percent and the officer contentment rate increased from 74.75 to 75.31
percent. In conclusion, the result shows that management, in utilizing the principle of a
“sufficient economy” in Rongkwang Hospital, increased its financial liquidity without
any adverse effect on the quality of health-care services and the satisfaction of the officers
concerned.


location: , 'Thailand year: 2011 source: HSRI

title: Education and Lifelong Learning of Thai Senior Citizens

abstract: The research study on “Education and Lifelong Learning of Thai Senior Citizens” is a mixed-method research. The study aims to: 1) study the overview of lifelong education management for senior citizens that includes objectives of lifelong education management, characteristics of targeted senior citizens, curriculums and content, education facilitators and instructors, education management methods, education media and learning resources, assessment methods, management and the results of education management; 2) explore demand for lifelong learning among the senior citizens also in terms of objectives of lifelong education management, characteristics of targeted senior citizens, curriculums and content, education facilitators and instructors, education management methods, education media and learning resources, assessment methods, management and the results of education management; and 3) study a scenario of education and lifelong learning management for Thai senior citizens. Finally, two different research instruments were questionnaires and group discussions.
The research findings can be summarized below:
1. Overview of lifelong education management for Thai senior citizens: The lifelong education management for senior citizens was designed mainly to maintain healthful conditions for the senior citizens aged between 60 and 64 years old. The education facilitators and instructors include local public health officers who conduct short-term training sessions where personnel media acts as the main education media as well as learning sources. The results of this education management can be assessed by means of observation. In 2010, various organizations organized a maximum of one to three projects aimed at educating the senior citizens.
	2. Demand for lifelong learning among Thai senior citizens: Similar to the aforementioned issue, the lifelong learning activities for senior citizens are also aimed at taking care of the senior citizens aged between 60-64 years old. The education facilitators or instructors are wisdom teachers or knowledgeable individuals in the communities. The leaning is also seen in a form of shot-term training sessions. The most popular education media and learning resource is personnel media.  Meanwhile, the results are assessed by the observation of the actual progress. Finally, various geriatric clubs expect to form partnership and collaboration in managing lifelong education.
	3. A scenario of education and lifelong learning management for Thai senior citizens: The major objective of the education and lifelong learning management for Thai senior citizens is to help senior citizens stay so healthy that they enjoy solid relationship with their families and are able to happily adapt themselves to the communities and society. With their healthful conditions, they are also able to participate in all activities available in the society. The education and lifelong learning is managed for Thai senior citizens in a form of the edutainment, in which the learning at the formal education system, non-formal education system and the information education system is very well integrated. Groups of senior citizen leaders are formed up and act as leaders encouraging the other fellows to participate in the learning activities which are designed mainly for two major target groups, namely a self-reliant group and a non self-reliant group. The content for the learning should suit the demand of the senior citizens as well as their abilities to learning.  Further, the content should be applied to their daily lives. Generally, the content of knowledge is divided into five aspects- sanitary, adaption to society and metal states, economy and saving, learning and the legal rights of senior citizens. There are many ways to manage the education and lifelong learning for senior citizens.  The education managers or facilitators should motivate the senior citizens to learn. In so doing, they may promote the learning activities as well as convincing senior citizens of the benefits they will gain from the learning activities. The education facilitators and instructors should ideally be those who work on geriatric development in the localities. The learning activities should vary and are organized for multi-age learners. The activities should allow learners to discuss and exchange knowledge in casual ways. Education media as well as learning resources should pay a key role in the management of education and lifelong learning for individual senior citizens. The results of the learning can be assessed by observation of the real progress of the learners. Finally, in managing education and lifelong learning for senior citizens, involved parties should also apply a partnership approach where all parties join hand to manage the learning, offer some financial aids as well as managing all resources available in the communities.


location: , 'Thailand year: 2022 source: HSRI

title: Health Adjusted Life Expectancy Region 3, 2022

abstract: The purposes of this were to study the health adjusted life expectancy (HALE) of people in health region 3, 2022, and prioritize diseases and health hazards that are important problems in health region 3. The cross-sectional study design was used. A sample of 1,230 Thai people aged 10 and over in the responsible area of health region 3, were randomly selected using a multistage sampling technique. The EQ-5D-5L Thai Version is composed of Mobility Self-care Usual activities Pain/discomfort, and Anxiety/drepression. The Sullivan method was used to analyze the data. For priority diseases and health hazards problems in health region 3, data was collected by the priority setting methods were seven components of the World Health Organization. From the committee of the health region 3. The results revealed that the HALE of people in health region 3, 2022 was 65.16 years. Lower than the Thailand target set by at least 68 years. The self-care dimension had the greatest effect on utility scores. Health status at best scores 48.94% and lowest score 0.08%. The priority diseases and health hazards that are important problems in health region 3, showed that the top three were stroke, ischemic heart disease, and road traffic injuries. Further research should be recommended to determine the model or approach to increasing HALE. as well as developing policies and measures to solve disease and health hazards and allocating sufficient resources to lead to more effective and efficient implementation.


location: , 'Thailand year: 2015 source: HSRI

title: Projection of Pharmacist Workforce in Thailand

abstract: This review aimed to describe the methods that have been used for workforce projections and to
explore the relevant literatures of pharmacist workforce in Thailand and other countries. Determining a
workforce is an important part of workforce projections. Several methods were used for workforce projection
which included: population ratio method, health need method, health demands method, service targets
method, adjusted service target-based method, budget driven mechanisms, workload measurement
method, work point evaluation method, and needs assessment models. The selection of methods used
depends on the availability/accessibility of data and the proposed application. Forecasting the future is a
difficult task and related situations are always dynamic. Therefore, a continuity of workforce projection
studies is essential to ensure the data accuracy in both micro and macro perspectives in order to illustrate
the problem at national and local levels.


location: , 'Thailand year: 2019 source: HSRI

title: Economic evaluation of HIV Pre-Exposure Prophylaxis

abstract: Pre-Exposure Prophylaxis (PrEP) is one of the preventive measures for HIV infection in population with substantial risk such as Men who have Sex with Men (MSM), transgender women, people who inject drugs (PWID) and heterosexual HIV-1 sero-discordant couples. In Thailand, PrEP service has been supported by governmental bodies and private sectors, from both national and international levels. This service is run as a pilot programme and is available only in certain areas. It is also not included in any health coverage schemes. For more effective prevention against HIV as well as for keeping AIDs problems under control by 2030, the Department of Disease Control, Ministry of Public Health, had proposed an inclusion of such service into the Universal Health Coverage Benefit Package (UCBP). The service was selected for evaluation with health technology assessment, in which economic evaluation and budget impact analysis were conducted. Health Intervention Technology Assessment Programme (HITAP) was assigned from the subcommittee of Health Benefit Package, National Health Security Office, to conduct an economic evaluation of the PrEP service, which covers both Tenofovir Disoproxil Fumarate (TDF) and Emtricitabine (FTC), as well as related laboratory tests. The evaluation was performed in order to aid the decision making process of whether to include the aforementioned service into the UCBP.


location: , 'Thailand year: 2004 source: HSRI

title: Community participation for health promotion 0-12 year old in Namka village, Payakaew sub district, Chiangkhang district, Nan

abstract: The project   “researching community in development health of 0 – 12 years old children” of Namka village, Moo 1, Payakaew sub-district, Chiangklang district, Nan, has  4 objectives; namely:To solve the problem of lack nourishing food in 0 – 5 years children of Namka village, not over 5 percentage of one level, none in two levels within A.D. 2003.To solve the problem of dental health in 0 – 12  years children of Namka  that has not over 30 percentages within A.D. 2003.To get the form of 0 – 12 years children  health promoting that is suitable for Namka Community.To learn community’s participation process in problem solving of community.Procedure Chiangklang Health Team that consists of doctors, nurses, public health  academic, pharmacist and  dental officers had researched “community in development health of 0 – 12  years children” of Namka community. The community analyzed the problems of 0 – 12 years children in community, found the ways to solving, solved the problems and evaluated by itself. The Chiangklang Health Team gave the supporting about the knowledge and helping in this progress. It’s the good collaboration of community, school, kindergarten and hospital.Community’s participation activity make the community realize the problems, cause of problems and the ways to solve the problems of lack nourishing food, dental health problems and other social problems of 0 – 12 years children, namely;Setting up the environment in the community including school, kindergarten, community stores, must  not have food stall that demolish children health.There is a good culture in anniversary birthday celebration of children. There is no party but it replaces merit making in the temple, and giving a little money as gift.There is teaching in the brushing teeth like brother teaches sister, and parents are care about children’s dental health.There are not candies, coffee and health demolished beverage in funeral.The community has its rule, and punishes the people who break the rule as to fine.Result	After the community do this process, there is health effect, namely;Before this project (June, 2002) in the lacking nourishing food, we found that 7 children have lack nourishing food ( 15.22 percentages), and nobody  has lack nourishing food after 6 months. We follow this project one years later, we found that there is not lack nourishing food of children in Namka community.From June 2002 – December 2003, there is changing in dental health as followingPre-primary	:  	A. level (dental health is good)  from 34.78 percentages a			72.73 percentages.E. level ( dental health must be cured suddenly) from 43.48 percentages as 22.73 percentages.Baby teeth decayed from 82.61 percentage as 72.73 percentages.Primary	:	A. level from 44.59 percentages as 64.94 percentagesE. level from 40.54 percentages as 26.78 percentagesPermanent teeth decay from 29.73 percentages as 15.58 percentages.The result of dental health in kindergarten :No teeth decay from 20.83 percentages as 53.70 bad brushing teeth from 16.60 percentages (June 2001) as 0 percentage (June 2002 – Nowadays)3.	Participated process of Namka community that effects children’s health development as specific, can measure the effect of nutrition health and dental health. That process has success because of good participation, such as, analyzing problems, finding causes, finding the way to solve, including  care the rule that set up by community. The success factor is similar to “Ottawa Charter”, for example, construct public policy, construct an environment that is useful for health promoting, construct the power of community firming,  improving personal skill (especially of community leader and parents) and changing the role of public health officers).4	The important factor of success is the good environment that useful for health development. Moreover , the location of community is fine. Because the Namka community is not too big. It separates from other community that surrounding  with rice farms, so the community can take care each other.Suggestion for improvingHealth construct in organizations should bring “Ottawa Charter” to apply in progress.There should have community in the vicinity of Namka. Its leader has strong power, and the community is ready, realize children health problems. That community can participate with Namka to exchange the idea, knowledge and spread the united front  to take care the children health. If we have a big group, we can have community network for care children health that can make unanimity in our country.For Namka community, there should have enlarging health development in other age level by participation  process such as, drinking problem, smoking problems, etc. Local government organization and municipality  should participate in this process or promote health such as, to except taxes of the stores that participate in this project or give fund to that store or shop. Health promoting is a mission that the community must do, if the community makes this process by itself, the district should support the fund.


location: , 'Thailand year: 2000 source: HSRI

title: A review of the management strategies for alcohol-ralated disorders

abstract: A review of the management strategies of alcohol-related disordersHeavy drinking and alcohol dependence are major public health and social problems in Thailand and worldwide. The alcohol-related problems may arise as a result of a single bout of drinking, alcohol abuse and dependence and may affect not only the drinker but also the drinker’s family, friends and associates as well as others with whom the drinker comes into contact. The enormous social, medical and economic costs of alcohol use and its related disorders have urged a lot of efforts to improve prevention and treatment techniques for alcohol-related disorders worldwide. Both alcohol consumption and alcohol dependence exists within continua, i.e.; consumption and problems range from abstainer without any problem to heavy drinker and alcohol dependent with substantial or serious problems. Likewise, there is a continuum of response to alcohol-related problems, ranging from primary prevention, secondary prevention to specialized treatment. The public health paradigm of prevention should concern the interacting elements of agent (alcohol), host (the drinker) and environment. Therefore, the prevention strategies should include measures taken to modify the environment and to change individual behaviours. The overall management components are consisted of prevention activities directed at drinkers in general, problem drinkers and those at risk for developing alcohol abuse and dependence, early identification and intervention of nondependent drinkers and treatment approaches for those with alcohol dependence problem.The purpose of this review was to analyse international scientific papers on existing prevention and treatment programs for persons at risk for developing alcohol-related problems and persons who already have had such problems. It aimed to provide an overview of the current state of the research on the effective intervention and management measures of alcohol-related disorders for general practitioners and other health professionals, for researchers, for non-health professionals and those responsible for making policy decisions on health care expenditure. The review was divided into five chapters: 1) Definitions and terminology of alcohol-related disorders and impact of the problems, 2) Primary prevention strategies, 3) Prevention strategies for alcohol-related traffic injuries, 4) Secondary prevention strategies, and 5) Tertiary prevention strategies.Primary prevention focuses on general population including non-drinkers, hazardous and harmful drinkers and alcohol dependent individuals. The comprehensive prevention policy of alcohol problems has three principal components; control, education and the provision of alternatives. Control measures comprise legislation and laws on the alcohol advertising and media portrayals of alcohol, alcohol beverage container warning labels, alcohol sales and price of alcoholic beverages and the minimum drinking age. Education measures include school and community-based programs and mass media campaigns aimed at changing individual behaviours.Prevention for alcohol-related traffic injuries is composed of four strategies; general deterrence, specific deterrence, community-based prevention programs and mass media campaign. General deterrence is based primarily on enforcement and publicizing of laws concerning driving under the influence of alcohol such as legal blood alcohol limits for drivers, zero tolerance law, random screening of drivers and administrative per se laws. Specific deterrence is based on changing the behaviours of those drivers who have been identified as driving under the influence of alcohol. The drivers’ behaviours are controlled to a certain degree by the imposition of a penalty like fine, loss of license, mandatory jail or remedial treatment. Examples of specific deterrence are mandatory jail, certified driver intervention program and alcohol ignition interlock. Other strategies used in the prevention of drunk driving are alcohol server training program to promote responsible beverage service, mass communication campaigns to increase the general public awareness of the risk of drunk driving accidents and change individual behaviours, designated driver and community action programs.Secondary prevention emphasizes early identification of those at risk for alcohol-related disorders and problems and providing appropriate intervention before they become dependent on alcohol which treatment yields unfavorable outcome. Early intervention is a proactive measure, composed of early detection of the problems by means of screening instruments such as questionnaires or laboratory methods and brief intervention for those detected as hazardous or harmful drinkers. The commonly used screening questionnaires for alcohol dependence and hazardous or harmful use are Michigan Alcoholism Screening Test, CAGE and AUDIT. Laboratory methods can be used to identify markers for recent alcohol intake (blood alcohol concentration), heavy or hazardous drinking (gamma glutamyl tranferase and other liver function tests), alcohol-related liver diseases and susceptibility to alcohol dependence (mitochondrial ALDH genotype). Brief intervention is a clinically based, cost effective, time efficient intervention designed to counsel nondependent problem drinkers about strategies to reduce their alcohol consumption. The ultimate goal of brief intervention is to prevent future alcohol-related health problems and injury. The principal components of brief intervention include 1) Feedback, 2) Responsibility, 3) Advice to change, 4) Menu of strategies, 5) Empathy, 6) Self-efficacy.Tertiary prevention includes treatment of the alcohol dependent individuals and a long-term management program to prevent their relapse to drinking.  Treatment process can be divided into four phases; 1) preparation phase including history taking, physical and mental examination and laboratory tests, 2) detoxification phase as an out- or inpatient case, 3) rehabilitation phase and 4) post-rehabilitation phase when patients return to their families and society. Pharmacological treatment of alcohol dependence has five main objectives, i.e. reducing alcohol withdrawal symptoms, reducing alcohol intoxication symptoms, reducing alcohol consumption and preventing relapse, preventing alcohol craving, and treating co-morbid psychiatric illness. There are several methods used for psychosocial intervention of alcohol use disorders, including 1) cognitive behavioral therapy, 2) supportive psychotheray, 3) behaviour therapy, 4) community reinforcement approach, 5) psychodynamic/interpersonal therapies 6) brief intervention, 7) marital and family therapy, 8) interactional group therapy, 9) family psycho education and family therapy, 10) aftercare service, 11) Self-help group (Alcoholic Anonymous and Alanon).


location: , 'Thailand year: 2010 source: HSRI

title: A Case Study of Pathways leading to “Yaba” (Amphetamine) use by Drug Users and Drug Dealers, as Female Clients of the Wing 23 Drug Rehabilitation Centre, Udon Thani  Province, Thailand

abstract: The aims of this case study, conducted at the Wing 23 Drug Rehabilitation Centre, Udon Thani Province, Thailand, were to ascertain, by means of qualitative research, the pathway(s) leading to “Yaba” (Amphetamine) use by drug users and dealers and determine the factors influencing those behaviours. The participating cases (n=70) were female clients at this institution. Structured questionnaires were used for data collection, using an open-ended in-depth interview format with guidelines to ensure content validity. The use of triangulation methodology ensured enhanced validity and reliability, while content (thematic) analysis was used for overall data analysis. The results were as follows:
With respect to the pathway(s) leading to habitual drug use, the study results indicate that the use of Yaba began in participants’ youth, after being introduced to it by friends or boy friends who suggested that they try the drug, thus forming an incipient behavioural pattern of regular use. The influencing factors found to predispose toward such use included a positive attitude deriving from a perception of Yaba’s benefits as a helpful means of acquiring friends and reducing suffering. An important enabling factor was cost, as drug users who have more money can acquire more Yaba and can therefore use it more frequently. Reinforcing factors included the need for acceptance and the influence of significant persons such as friends, boyfriends and family members.
In considering the likely pathway(s) leading to involvement in drug dealing, the study results indicate that such cases had a history of drug-taking, and the increasing need for money to support their habit motivated them to eventually become drug dealers. The results therefore suggest that lack of money was an important contributory factor impelling them towards drug dealing. An influential predisposing factor was a positive attitude engendered by the realization that they could work and earn money by their own efforts, leading to improvement in their economic status, with a concomitant feeling of pride in their ability to do so. The fact that Yaba could be obtained more easily, and that they could sell the drug for 2-4 times more than the original cost, were important enabling factors. A significant reinforcing factor facilitating their decision to become drug dealers was the realization that increased income would lead to greater

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levels of convenience in their life. Family members were also implicated as persons influencing their decision to become drug dealers.
With respect to approaches to solving the narcotic problem, the study indicates that most participants supported maintaining significant interaction between all relevant parties, advocating vigilance with respect to drug-related behaviours. Community members should also participate by providing important information to investigators.  However, some participants suggested that the narcotic problem could not be solved easily because of its large scale and the fact that it was related to personal attitudes, beliefs, behaviours and needs.  Both family and environmental factors within the community were implicated as contributors to the problem. The consensus opinion was that, as an effective approach toward a solution, narcotics production should cease altogether.


location: , 'Thailand year: 2010 source: HSRI

title: ผลการศึกษาการประเมินการบริหารจัดการการคลังเครือข่ายบริการปฐมภูมิ (CUP) และการพัฒนาระบบข้อมูลเพื่อการบริหารจัดการการคลังสถานพยาบาลปฐมภูมิ

abstract: The objectives of this study are as followed; 1) to assess financial situation of
primary care in terms of; income, expenditure, productivity, costs and production
efficiency 2) to assess management style of CUP 3) to develop information system for
management and monitoring of the development of primary care system.The study employed both quantitative and qualitative approaches. A self-administrative
questionnaire survey on financial status and supports of each CUP and its’ network was
done. In-depth interviews were conducted with the Chief Medical Officers, hospital
directors, and District health officers; in addition, focus group discussions were
conducted separately with representatives from the hospital and health center. Twelve
provinces locating in 12 NHSO regions were purposively selected according to wellestablishment
of health information system. These included Chiang Rai, Phitsanulok,
Uthai Thani, Nakhon Nayok, Samut Songkhram, Samut Prakan, Kalasin, Nong Bua Lam
Phu, Surin, Si Sa ket, Surat Thani, and Songkhla. Al least three CUP were purposively
selected; one provincial hospital CUP, one big district hospital CUP, and one small district
hospital CUP; moreover, additional private hospital or other public hospital CUP was also
included if health centers were included as their network. There were totally 44 CUPs in
the study including 270 health centers under provincial hospital CUPs, 396 health centers
under district hospital CUPs, and 5 health centers under a private hospital CUP.
Results of study show that the financial status of all hospitals and its’ networks
had been improved during 2006 – 2008, net savings of all categories of hospitals and
health centers had been increasing. This indicates that over budgets were sufficient for
the system, but allocation of budget was probably problematic. Financial management
system as a CUP impose the hospital and its’ network, health centers, have to work
closely in terms of supports, communication, and referring. However, how well they
worked together depends on vision and attitude of the hospital director and local
contexts. The itemized payments made by NHSO was criticized as it will deteriorate the
integration and holistic concept of primary care; moreover, it lets health workers putting
emphasis on these activities and entering data in order to get more budgets and may
neglect in providing other services. Average annual total costs of health centers or
primary care units (PCU) in 2008 were 2,571,535.86 Baht for those having doctor,
1,837,809.64 Baht for those having registered nurse, and 1,190,663.21 Baht for those
providing services by health workers. Average annual numbers of productivity were
17,032.24, 10,927.80, and 7,432.85, visit/unit/year for different type of PCU respectively.
The efficiency score calculated by DEA of PCU or health centers was relatively low,
0.538 – 0.593, and there were room for improvement. The result was against with the
complaints of health workers that they had high burdens of work and reports. This was
probably due to burden from reporting was not accounted as productivity of primarycare unit. Moreover, the current available data include only quantity of services
provided, not including quality dimension or non-services activities. Results from the
study illustrates that current available data within the CUP and province was able to use
for management and monitoring of the development of primary care; however, it needs
more efforts in managing the data and require training of staffs.
Policy recommendations are as follows: 1) the provincial health office is crucial
actor in the development of primary care and should not be ignore or bypass; 2) the
payment models for primary care should be designed with caution ensuring that they
will not deteriorate the concept of a holistic and integration of primary care; 3) a good
governance of CUP board should be strengthen and separation of budget for primary
care from secondary care is needed; 4) a national mechanism to monitor efficiency of
budget spending should be established in addition to incentive measures and
mechanisms to improve the efficiency of health service production; 5) strengthening
management information system for planning, monitoring, and development of primary
care.


location: , 'Thailand year: 2004 source: HSRI

title: People involvement and participation mechanism and health system reform process in the north of Thailand

abstract: This research aimed to comprehend the concepts, practices and judgment on mechanisms of health system reform movement and impacts of the past and present health system reform mechanisms by studying perception and expectation of people concerning the reform process, the outcomes, participation and role of people.  The study also intended to determine the development trend and formation of various groups and agencies involving in health system reform process.  The qualitative research method was employed.  Study population included people attending health assembly forums and people who lived in Phayao, Nan and Chiang Mai provinces in the North of Thailand during October 2003 – March 2004.	The main findings of this study are as follows:	1. Most people still held on the biomedical model of health that emphasized on physical health mainly illnesses and diseases.  Few people gave other health concepts that linked to other dimensions such as occupation and socio-economic aspects.  Even among health personnel, they seemed to have no clear concepts and judgment on health in the new paradigm of “holistic health”.  The so-called holistic health was just a discourse commonly used among people without obvious explanation.	2. People’s concepts and judgment of health still affixed to physical and mental health and absence of disease.  This reflected the practices on health promotion and medical care that also concerned mainly physical health.  People continued to perceive that health promotion was an approach to prevent themselves from getting diseases and was responsible solely by doctor or health personnel.  It was evident that health care and health promotion activities depended on activities of health personnel.	3. The symbol of health was still the “hospital or doctor”.  Health care was a matter of explanation in relation to the conventional structure of health service system such as hospitals and health centers.  People or even health personnel still could not elucidate how school, temple or other organizations in a community could help build the health and how people can promote their health.	4. There was a disparity of perception among samples with different education levels.  Most of subjects who took part in health assembly forums could explain the reform process better than other groups.  Subjects who did not directly participate in the forum mostly did not know or were not aware of the reform process.  Although some subjects mentioned that they had heard about the process, but they could not describe its definition or meaning.  Most people noticed the ongoing changes through the development of health care facilities in the community in forms of building extension, sophisticated equipment, and presence of specialized doctors.	5. Activities and formation of groups, besides actions taken by health personnel, for example, livelihood, income and well-beings, were perceived as matters not related to health.  Health personnel mostly initiated health campaigns during health system reform movement.  These included groups or clubs connected to health centers like an exercise group, an herb group, and an elderly group whom people could not interpret as health or holistic health issues and as results of health system reform.	6. Health system reform process or movement in community level did not sufficiently stress on learning process.  Exercise groups, which were set up almost everywhere, were promoted as activities without the promotion of learning process.  This did not stimulate people to modify their thoughts on health care satisfactorily.  The promotion of various job clusters was not linked to learning process in health as well.	7. People partially involved in health system process particularly in cooperation, policy acknowledgement and implementation.  The involvements in lesser extent were participation in thinking, initiating, and making decision by people themselves.  Concepts and beliefs of most people still stuck to conventional thoughts that those who were skillful of health care were exclusively health personnel whom people placed their trust on and ready to follow suit.  It was perceived that the major role of health movement propulsion belonged to health personnel and health volunteers.  Community leaders or tambon administration organization committees also regarded health as a separated issue from other modes of development.	In performing the health system reform policy implementation, the learning process must be integrated to the developmental activities.  The lessons learned will thus be the analytic thinking exercise.  Health promotion needs the new paradigm of health that connects all dimensions of health particularly the spiritual aspect.  Shifting of health paradigm among health personnel is needed in the development of understanding in health system reform process among villagers, groups, local agencies including health personnel itself.  The research should also focus on the learning process of civic sector.


location: , 'Thailand year: 2023 source: HSRI

title: The Quality of Life and Clinical Outcomes of Children with End Stage Kidney Disease Undergoing Automated Compared with Continuous Ambulatory Peritoneal Dialysis Under the National Health Security System Coverage

abstract: Introduction: Peritoneal dialysis (PD) is a common renal replacement therapy for most children with end stage kidney disease (ESKD). Automated peritoneal dialysis (APD) is a method of PD using a cycler machine, suitable for overnight use during sleep, allowing minimal disruption to the daily activities of both children and caregivers. This is in contrast to continuous ambulatory peritoneal dialysis (CAPD), which necessitates daytime self-administration and can impact the quality of life for children receiving renal replacement therapy. Objectives: To investigate and compare the quality of life among pediatric ESKD patients undergoing APD and CAPD. Additionally, to explore and compare the incidence of infection-related complications associated with peritoneal dialysis, alterations in blood pressure, sleep problems, and changes in electrolyte balance within the body during APD and CAPD. Methods: This is an open-label randomized controlled trial conducted across 11 institutions. Volunteers include ESKD pediatric patients aged 1 to 18 years who are eligible for treatment under the national health security system. Patients undergoing long-term peritoneal dialysis were selected. Specifically, participants needed to reside in locations with electricity access and have proficiency in the Thai language. A total of 40 volunteers were required for each group. The study involved a 48-week follow-up of participants in both the APD and CAPD groups. Clinical data were collected. Quality of life was assessed using the PedQL, and health utilities were evaluated with the EQ-5D. Results: The study involved 30 volunteers in each of the APD and CAPD groups, with average ages of 10.5 (SD, 4.3) and 12.3 (SD, 3.1) years, respectively. Participants had been on peritoneal dialysis for an average of 14.9 and 15 months in the APD and CAPD groups, and gender distribution was similar in both groups. The most common cause of ESKD was renal hypoplasia (18.3%), followed by reflux nephropathy (15%). Of the participants who completed the study, 12 withdrew. Using the PedsQL, assessed by parents, there were no significant differences in the quality of life between the two groups in all aspects. However, self-reported assessments found that the social dimension scores were significantly higher in the APD group than the CAPD group at week 16, with statistical significance. Both groups exhibited a notable improvement in social, emotional, and overall scores at the end of the study but no significant differences were nevertheless found in other aspects of quality of life. The EQ-5D, assessed by both parents and patients themselves, did not reveal any significant differences between the two patient groups. The mixed-model repeated measure analysis did not find statistically significant differences in changes in both quality of life and benefits between the two groups. The study found a peritonitis rate of 0.34 cases per year, and there were no significant differences between the APD and CAPD groups. Blood chemistry changes and blood pressure changes over 48 weeks showed no differences between the two groups. Notably, the CAPD group had more hospitalizations for hypertensive urgency and/or emergency (12 cases) compared to the APD group (3 cases) (p < 0.01). In week 16, patients aged 6-12 years in the CAPD group had a significantly higher rate of excessive sleepiness (40.7%) compared to the APD group (16.7%) (p < 0.04). By week 48, patients aged 13-18 years in the APD group had longer daily sleep duration on both weekdays (10 hours) and weekends (10 hours) compared to the CAPD group (8.5 hours and 8 hours on weekdays and weekends, respectively) (p < 0.03). Discussion and conclusion: Quality of life score changes showed no statistically significant differences between the APD and CAPD groups. However, clinically significant improvements in quality of life scores were observed in the social, school, and overall dimensions for the APD group, as assessed by parents and self-assessment. These improvements exceeded the minimal clinically important difference for both PedsQL and EQ-5D in dialysis patients. In contrast, the CAPD group showed some improvement in scores but not to a statistically significant degree. The lack of significant differences in quality of life changes may be due to the limited sample size. It's worth noting that EQ-5D was not designed to evaluate children's quality of life and did not encompass school and social dimensions. Treatment with APD and CAPD did not differ significantly in the incidence of peritonitis due to infection. Changes in kidney function, blood chemistry levels, and blood pressure complications showed no significant differences between the two treatment methods. Nevertheless, hospitalization incidents for severe high blood pressure were significantly more common in the CAPD group than the APD group. Most patients experienced sleep problems, with significantly higher rates of excessive sleepiness in the CAPD group compared to the APD group, at 2.4 times higher. Also, the APD group had longer daily sleep hours on both regular and weekend days in patients aged 13-18 years compared to the CAPD group, which may be attributed to clinical significance.


location: , 'Thailand year: 2021 source: HSRI

title: Promoting Walking and Cycling in Daily Life: A Case Study of four Communities in Thailand

abstract: Walking and cycling are common physical activities that can be performed regularly in daily life which provide health, environmental and economic benefits. This study aimed to 1) assess community-level walking and cycling promotion strategies or activities by stakeholders in selected communities, 2) investigate implementation gaps and 3) provide recommendations on walking and cycling promotion in community. Qualitative method was employed. A total 28 key informants in 4 communities of 4 regions were recruited: 1) King Taksin community in Bangkhla district, Chachoengsao province, 2) Suksabaijai community in Mueang Kalasin district, Kalasin province, 3) Ban Khaoniwet municipality school community in Mueang Ranong district, Ranong province, and 4) Ban Thatsobvan community in Chiang Kham district, Phayao province. Content analysis was used. The results showed that three main actors to promote walking and cycling in community were local government, civil society, and academia. These actors had different roles but worked collaboratively to achieve common goals. The implementation gaps were the negative attitude as well as improper and unsafe built environments towards walking and cycling. Recommendations for further program implementation include communication campaign to promote positive attitude and social awareness on the value of walking and cycling, improvements on built environments especially a speed reduction intervention in community, and leadership and supportive policy towards walking and cycling in daily life.


location: , 'Thailand year: 2017 source: HSRI

title: How Much of Energy Expenditure from Physical Activity and Sedentary Behavior of Thai Adults: The 2015 National Health and Welfare Survey

abstract: This study aimed to determine the amount of energy expenditure from moderate to vigorous intensity physical activity in 3 domains (occupation, transportation, and recreation), and sedentary behavior of Thai adults disaggregated by subgroups of participants. The data of 113,882 Thai adults aged 15 and above from the 2015 National Health and Welfare Survey conducted by National Statistical Office were analyzed using descriptive statistics and two-part model. The results showed that the average energy expenditure from moderate to vigorous intensity physical activity by 3 domains was 1,728 metabolic equivalent of task-minute/week. The energyexpenditure from work domain was the highest (1,113 MET-minute/week), followed by transportation (286 MET-minute/week), and recreation (230 MET-minute/week), much lower than the results from other international studies. The energy expenditure in sedentary activities was also high at 774 MET-minute/week. The energy expenditure from 3 physical activity domains was higher in males and adults (aged 30-44) living in rural areas including farmers and laborers, and those who had lowest education and income levels, without underlying diseases, and self-reported with lower health problem status. These subgroups with higher energy expenditure from physical activity also reported lower energy spent sedentary. Our findings will benefit to the national policy development on physical activity by transforming energy expenditure in sedentary activities to other physical activity domains. For example, office-based employee spent low energy expenditure from work domain should be encouraged to the standing break or walking every hour of sitting, using stairs instead of elevator, or using public transport, walking or biking to workplace. In addition, we urge for the improvement of national physical activity to be more accurate and conducted continuously.


location: , 'Thailand year: 1995 source: HSRI

title: The Social and Health Problems of Construction Workers in Bangkok

abstract: The social and health problems of construction workers in BangkokThe objective of the study was to acquire social and health-related information of workers in Bangkok construction areas.  The cross-sectional descriptive research was carried out, and the construction areas used in the study were divided into internal and external areas of Bangkok.  A simple random sampling was used to identify the sampling frame, the representative of the internal and external areas, which Klongtoey and Ladkrabang districts were chosen respectively.  The same technique was then used to randomize 10 each of large and small construction sites.  A systematic random sampling was used for the selection of the workers of each site.The study showed that 67% of workers in Bangkok were in working age.  The ratio of male to female workers was 1.4:1.  The study also found that 88% of them were from the northeastern and northern region, that 84% were married, and that 87% completed primary level of education.  Additionally, 64% were daily employee with no definite contract.  On average the workers had 2 children.  Of which, 4% aged under one year, 27% aged between 1 to 5 years, 16% aged between 6 to 8 years, and 33% aged between 9 to 15 years.  Only 13% of the children aged 6 – 15 years lived with their parents.  There were no differences on basic information of the population between those working in Klongtoey District and Ladkrabang District.  Nor were those working in a large construction area and a small construction area.  However, for other aspects, such as environment, safety, wages, and other benefits, those working in a large construction area tended to be in better condition than those in a small area.  So did the Klongtoey workers as compared to Ladkrabang workers.  Serious morbidity rate due to accident while working was 58.7/1,000 workers.  For the past 12 months, injury while working was 208/1,000 workers in Klongtoey and 180/1,000 workers in Ladkrabang.  This was probably due to the fact that the employer did not adequately provide equipment for personal protection, and the workers themselves did not pay attention to the use of such equipment as their own protection either.Working environment and residential area, including sanitation, were not in a good condition.  Most of the workers (53%), especially male, had personal risk behavior, such as drinking, smoking, using drugs and narcotics, and having stress problem.  Periodontal disease and dental caries were major problem in dental public health.  Moreover, the study showed that most of the workers lack knowledge of labor law, workers’ right and benefits.


location: , 'Thailand year: 2022 source: HSRI

title: Tuberculosis in schoolchildren

abstract: Background: Thailand is among the 30 countries with high tuberculosis (TB) prevalence. Cases of TB in Secondary schools have been reported and aggregated adolescents in school are at risk of TB transmission. Children with latent TB may develop TB diseases later on. Nevertheless, studies of TB diseases and latent TB prevalence in schoolchildren in Thailand are scarce. Method: We did an observational cross-sectional study in Secondary school children grade 7-12 in a school in Bangkok and a school in another province of Thailand. We used the Symptoms scoring questionnaire developed by the Bureau of Tuberculosis and Chest radiography to screen for pulmonary TB to identify the TB prevalence. And we used tuberculin skin test (TST) at a 10 mm. cut-off to identify latent TB infection in grade 7 students. Also, 80 students were undergone QuantiFERON® TB Gold (QFT) blood test together with TST. Furthermore, we did a survey on knowledge, attitude, and practice (KAP) of TB in school among personnel of the 2 schools using a structured questionnaire. Results: A total of 1,005 from 5,113 students from 2 schools were enrolled, 496 from Nawaminthrachinuthit Bodindecha School in Bangkok and 509 from Chonburi Sukkhabot School in Chonburi province. Three hundred and fifty-four, 176, 154, 176, 141, and 153 students were from Grade 1, 2, 3, 4, 5, and 6 respectively. The mean age was 14.6±1.8 years. Forty-six and 21.8 percent had the household incomes of 20,000-40,000 and less than 20,000 Thai Baht per month. Twelve percent had the history of TB exposure in the past. The screening with Symptoms scoring questionnaire and chest radiography revealed no TB disease in this survey. Meanwhile, 270 first grade students were screened for latent TB and 13 were positive, resulted in latent TB prevalence of 4.8% (95% Confidence Interval (CI), 2.3-7.4%) Of them, none developed TB disease during the 1-year follow-up. The TST at 10 mm. cut-off had the sensitivity 50% (95% CI 6.8-98.2) and specificity 98.7 (95% CI, 92.9-100%) compared to QFT. Furthermore, the results of KAP survey among the school personnel showed lower percentage (11-39%) of correct answers to knowledge of TB symptoms in children, transmission, and prevention of TB in community. Most personnel had positive attitude to learn about TB and help students to receive treatment (78-99%). However, 55% tended to separate students with TB from others even the students already receiving treatment and 29% would not be a personal tutor for students with TB after the treatment. Conclusion: The prevalence of TB disease and latent TB in Thai school children is not high. The routine TB screening in Thailand may target other population groups with higher TB rate. However, the protocol for reporting and investigation should be put forward for schoolchildren who develop TB diseases along with school personnel education on TB transmission and prevention.


location: , 'Thailand year: 2021 source: HSRI

title: Operational system for excellence in medical bioinformatics for lower southern Thailand in health region 12

abstract: Operational system for excellence in medical bioinformatics for lower southern Thailand in health region 12 is a fundamental implementation of genomic medicine in South of Thailand co-operated by the Faculty of Medicine, Prince of Songkhla University and Health Systems Research Institute, Ministry of Public Health. To integrate genomic medicine into the healthcare system in the Heath Region 12, infrastructures including clinical data management, biological sample processing and storage and certified molecular laboratory were considered to be organized in Translational Medicine Research Center (TMRC), Songklanagarind Hospital. Not only infrastructure standardization, but the project has also consent volunteers for clinical data and biological sample retrieval under the approval of the Human Ethical Committee, Faculty of Medicine, Prince of Songkla University. To achieve goal of the study, we included 175 participants covering 3 major genetic associated diseases (hereditary cancer, rare diseases and infectious diseases). Moreover, clinical data and specimens were collected under standard operation procedure of Genomic Thailand Consortium and consecutively shipped to Department of Medical Science, Ministry of Public Health. For the leftover specimens, whole exome sequencing was performed to intensively discover pathogenic variants related to respective participants and their families. Ultimately, annotated exome sequences were comprehensively integrated to establish aggregated exome database which provides useful clinical implication of each variant and regional specific minor allele frequency as a public database. In conclusion, our project has laid infrastructures for genomic medicine and linked them to the clinical environment in the South of Thailand.


location: , 'Thailand year: 2022 source: HSRI

title: Willingness to Accept and Willingness to Pay on a COVID-19 Vaccine Booster Shot in Thailand

abstract: The study of willingness to accept and pay for a COVID-19 vaccine in Thailand aims to 1) explore the prevalence of accepting the COVID-19 vaccine and vaccine booster shots 2) factors associated with accepting the COVID-19 vaccine and vaccine booster shots 3) reasons and willingness to pay for the COVID-19 vaccine and vaccine booster shots and 4) the policy recommendation for the COVID-19 vaccine and vaccine booster shots. This study conducts 3 phases. Phase 1 is to study the prevalence and factors of accepting the COVID-19 vaccine and vaccine booster shots by cross-sectional research of having vaccinated COVID-19 group and having not been vaccinated COVID-19 group, covered four regions in Thailand, by an online survey questionnaire. The total sample is 1,740 used multiple stratified sampling techniques. Data analysis were by a descriptive statistic and multiple logistic regression. Phase 2 is associated with exploring the reasons and willingness to pay for the COVID-19 vaccine and vaccine booster shots. The developed questionnaire is from an online survey. Data analysis is a descriptive statistic. The results from phase 2 are defined policy recommendations. Phase 3 is an expert and stakeholder meeting to propose and discuss policy recommendations. The result showed 86.38% of respondents reported the COVID-19 vaccine acceptance. Respondents had no vaccination accounting for 9.16%, 10.76%, and 53.19% for the first, second, and third doses, respectively. 66.72% of the respondents accepted to have the next dose of the COVID-19 vaccine. Only 8.22% of the respondents refused the COVID-19 vaccine. One-third of the respondents received their desired COVID-19 vaccine. Factors related to the willingness to accept the COVID-19 vaccine and vaccine booster shots were an intention to take the vaccine, vaccine efficacy, attitude towards the COVID-19 vaccine, some doses of the COVID-19 vaccine, age, living area, having Influenza vaccination history, medical personnel, and income. Reasons and willingness to pay for the COVID-19 vaccine and vaccine booster shots were self-efficacy, safety, and proof by WHO. The main reason for refusing the COVID-19 vaccine was negative news on vaccines. Whereas the main reasons for the COVID-19 vaccine acceptance were protecting themselves, the safety of their families, social responsibility, herd immunity, and safety of their co-workers. One-fifth of respondents reported the willingness to pay for a booster shots vaccine between 1-5,000 Thai baht. News objectivity, in a particular vaccine against the severity of illness more than prevention, increased confidence towards the vaccine to higher-educated and higher-income groups, promoted a campaign for a single status group, priority groups for vaccination, combating fake news, and developed efficacy of the COVID-19 vaccine created in Thailand were the policy recommendations for the COVID-19 vaccine and vaccine booster shots in Thailand.


location: , 'Thailand year: 2015 source: HSRI

title: Development of Electromyography Needle Electrodes for Spasticity Treatment

abstract: With a promising import-substituting alternative of electromyography (EMG) needle electrodes used in spasticity treatment, this research aimed to investigate polymer types and polymer coating technologies that were suitable for coating on the needle shaft of the common hypodermic needles. Previous study of the EMG needle electrodes with accessible data of related coating products and Thailand’s commercially available raw materials data revealed a potential technique of implementing the dip-spinning process of aqueous fluoropolymer dispersion coating onto the surface of 316 stainless steel needle shaft. As a result of the former research on topic “a study of polymer coating on needle for medical application” financially supported by National Research Council of Thailand, the newly designed dip-spin coating equipment was used to coat FEP and PTFE on the needle shafts of the common hypodermic needles. Various characterizations and testing of the polymer-coated surfaces were conducted. Depended on predetermined coating parameters, thicknesses of FEP and PTFE could be coated on the needle shafts in the range of 5-10 μm. Both FEP- and PTFE- coated needles showed good adhesion with no polymer film detachment after insertion the needles into a piece of pork shoulder. In addition, the results of penetrating the FEP- and PTFE- coated needles to the injection vial stoppers showed low friction forces and good adhesion. Film adhesion qualities were in agreement with measuring adhesion by using tape test on the FEP- and PTFE- coated flat surfaces of 316 stainless steel plates that showed no detachment. As results of penetrating the FEP- and PTFE- coated needles to the injection vial stoppers, their drag forces were compared with the commercially available EMG needles. Drag forces of the FEP- and PTFE- coated needles were, respectively, 1880-1900 mN and 2650-3000 mN while the commercially available EMG needles from companies A and B were, respectively, 1450-1520 mN and 1400-1900 mN. However, the coats from company A were detached from the needle shafts during penetrating the injection vial stoppers with possible cause of poor adhesion of the coat on the needle shaft. Biological evaluation testing was complied with Thailand’s TIS-1398 sterile hypodermic needles for single use and TIS-2395 Biological evaluation of medical devices. Seven sets of the biological evaluation testing included cytotoxicity testing, irritation testing, sensitization testing, pyrogen testing, haemocompatiblity testing, systematic toxicity testing, and intracutaneous testing.


location: , 'Thailand year: 2017 source: HSRI

title: Cost-utility of arthroscopic knee surgery for anterior cruciate ligament with or without meniscus injury in an M1 general hospital in the 7th Health Region

abstract: Health Region 7th has developed strategies to build up and enhance capacity for medical services in orthopedic at the M1 level hospital. This study was aimed to assess cost utility of arthroscopic knee surgery in patients who had anterior cruciate ligament injury with or without meniscus injury at M1 hospital level as compared to the operation performed at only the provincial hospital level. The present study was based on decision tree analysis with the time horizon of 1 year using a societal perspective. The primary data collection was performed to obtain the following key variables: waiting time, complication rate, return to sport outcome (up to 1 year), direct medical cost, direct nonmedical cost, indirect cost, and utility (EuroQoL-EQ-5D-5L). The study sites included Sirindhorn Hospital (M1 level) and Khon Kaen Hospital (provincial hospital). The training cost and cost of instruments were 99,328 Baht. At Sirindhorn and Khon kaen hospitals, proportions of patients undergone surgery within 2 months were 93% and 25%, and the averages of waiting time were 1.03 ± 0.67 and 4.3 ± 3.0 months, respectively. The complication rates were similar of 7%. All patients with or without complications could return to sport within 1 year. Utilities at baseline, after surgery, 3, 6, 12 months thereafter were 0.66±0.15, 0.77±0.22, 0.92±0.07, 0.93±0.06 respectively. Under the timeframe of 1 year, direct medical cost, direct non-medical cost, and indirect cost for one case were 19,215, 7,488, and 1,479 Baht at Sirindhorn Hospital and 19,413, 7,888, and 1,538 Baht at Khon Kaen Hospital. For one case, total costs were 31,493 and 28,839 Baht, and quality-adjusted life years were 0.91 and 0.85, respectively. An incremental cost effectiveness ratio was 41,058 Baht/Quality adjusted life year. In conclusion, arthroscopic knee surgery for anterior cruciate ligament injury at M1 hospital level could reduce waiting time and was cost effective as compared to the operation performed at the provincial hospital level. The complication rates were similar and relatively low. All patients with and without complications in both hospitals could return to sport within 1 year. The policy recommendation proposes that provision of orthopedic services at the M1 hospital level should be promoted for the procedures that complication rates were similar and relatively low in both levels, complications do not lead to the final clinical outcomes, post-treatment utility outcome would increase by 0.24 (EQ5D 5L), and waiting time should not be greater than 2 months. The procedure as such would be cost-effectiveness if the initial program cost is about 662 Baht per one case.


location: , 'Thailand year: 2011 source: HSRI

title: Performance of Health Care for Elderly and impact on Public Health Care Financing during 2011-2022

abstract: Analysis of administrative data between 2008-2010 from the Comptroller’s General
Department, National Health Security Office, Social Security Office and Ministry of Public Health
found that accessibility to health care of Thai Elderly people in 2010 was better than previous
fiscal years. However, coverage of prevention services still low in the elder group. Compare to
other age groups, elderly people had higher utilization rate of annual physical checkup, outpatient
visits (6.3 visit per person per year) and in-patient-visits (0.23 visit per person per year).
There were inequity on access to health care among different age-cohort, geographical regions
and different social health protection schemes. Elderly people had higher utilization rate until
the age around 75 years old. Then their access to health care gradually declined. Analysis for
Preventable Admission of the year 2010 is lower than previous fiscal years. This indicator
showed that performance of primary care was better than previous years. Regarding statistic of
admission for length of stay at least 2 months, nearly 40 percent of this admission type was
occupied by elderly patients. Elder beneficiaries of the Civil Servant Medical Benefit Scheme
(CSMBS) shared 72 percent of all CSMBS’s patients who stayed in hospitals at least 2 months.
This is an indirect evident for need of system of intermediate care and long term care, which do
not exist in current Thai health care system. Total expenditure of social health protection
schemes in 2010 was 0.64 percent of GDP.
Forecast of health care expenditure of social health protection schemes during 2011-
2022 was performed using actuarial model, which include assumption of demographic and
macroeconomic development during that period. Changing of demographic structure from
elderly society plays minor role on the future health care expenditure. Technology change and
inflation are key cost drivers. Health care expenditure of the social health protection schemes at
the year 2022 in status quo will be 1.1 percent of GDP. Sensitivity analysis for expansion of
utilization and unit cost of services showed that total expenditure will increase to 1.4 percent of
GDP. Aggresive cost containment measures may decrease heath care expenditure to 0.8
percent of GDP. Better health status also reduces health care expenditure to 1.0 percent of
GDP. Health care performance indicators for elderly people have been developed using
systematic review, gray literature review and result from administrative data analysis. Three
dimensions of indicators are identified, health care production process, health care function and
burden of diseases. Many indicators were dropped due to lack of accurate or reliable data.
Finally, 9 indicators were identified for the first version. More indicators will be included into the
next version if data is available.
In conclusion, Trend of health care performance for elderly care is better compare to
previous year. However, fragmented and incomplete data is a main problem of this study.
Interpretation of the detail result of the study has to be careful. This study also showed
possibility to establish Information of health care performance at Country level, which needs
systematic and official arrangement with continuous effort to guarantee the comprehensive and
accurate data


location: , 'Thailand year: 2011 source: HSRI

title: Drug using among diabetic patients with chronic renal failure during the month of Ramadan : Case study of Nongjik Hospital, Pattani Province

abstract: The objective of the study was to determine the effect of a health education program on drug use
during the month of Ramadan among diabetic patients with chronic renal failure who attended the diabetic
clinic in Nongjik Hospital, Pattani Province, during 1 October 2009 - 31 December 2010. Of the 56
patients, 28 had the Ramadan education program and home visit (study group) and 28 had usual health
care services (control group). Data from hospital records and the drug use follow-up form during Ramadan
of both groups were reviewed. Both groups had comparable characteristics including sex, age, co-morbidity, serum creatinine, estimated
glomerular filtration rate, microalbuminuria, cardiovascular risk score, number of drugs currently
used, fasting blood sugar, and systolic blood pressure. During Ramadan, good drug practice was significantly
higher in the study group (89.3 %) than the control group (14.3 %). Patients in the study group had
significantly lower fasting blood sugar, and systolic blood pressure than the other group. Factors correlating
with good drug practice were principal antidiabetic drugs and modification of drug use during
Ramadan.
It is essential to prepare drug use among Muslim diabetic patients before Ramadan. Good drug
practice during Ramadan will provide effective treatment results in these patients.


location: , 'Thailand year: 2020 source: HSRI

title: The Study of Clinical Outcome, Quality of Life and Cost-Effectiveness in Glaucoma Patients   Receiving Trabeculectomy Versus Medications

abstract: Objective: To study intraocular pressure (IOP) reduction after trabeculectomy compared with antiglaucoma medications in open angle glaucoma, including complications and evaluate the effect on quality of life and cost-effectiveness between two arms. Methods: This is a randomized controlled trial study that divided patients into 2 groups to receive trabeculectomy or antiglaucoma medications and analyze the clinical outcomes, quality of life and cost-effectiveness at 4 and 12 months. Results: There were 38 enrollment subjects, 18 eyes in trabeculectomy (Trab) group and 20 eyes in medication (Med) group. At baseline, mean (SD) IOP in Trab and Med groups were 25.86 (8.80) mmHg and 27.48 (9.85) mmHg, respectively. At 4 months, there were 17 and 18 eyes remained in Trab and Med groups. Mean IOP reduction (SD) were 19.29 (7.48) mmHg (38.67%) and 10.91 (5.51) mmHg (22.50%) in Trab and Med groups, respectively. The quality of life was assessed using visual function questionnaire-28 and found that Med group had better quality of life than Trab group at 1 year (p = 0.002). However, the results were different since baseline. The total cost was not different between 2 groups at 4 months and 1 year (p = 0.08 and 0.09). Conclusion: Trabeculectomy is more powerful than medications in IOP reduction with acceptable complications at 4 months and 1 year. The cost in Trab group was higher with similar quality of life. However, the sample size in this study is not enough, even after the recruitment strategy was modified. And therefore, may affect the final result. Further study: Evaluation of the outcomes between trabeculectomy and medications is still needed to be addressed. Gathering information about cost from hospital database in combination with an estimation of other expenses may be helpful.


location: , 'Thailand year: 2022 source: HSRI

title: Knowledge and Awareness of Antibiotic Use and Antimicrobial Resistance: A Survey in Fisheries Officers of Thailand

abstract: Aquaculture plays an important role in global food supply and in national economic development in low and
middle income countries. However, during the process of aquaculture production, farmer may inappropriately use
antibiotics to prevent and to treat infections. This may lead to antimicrobial resistance in humans and environment.
This study aimed to assess fisheries officers’ knowledge and awareness of antibiotic use, antimicrobial resistance, and
knowledge on regulations related to antibiotic use in aquaculture sector. A self-administered questionnaire survey was
conducted in 92 fisheries officers whose work was related to aquatic animal health and aquaculture management from
61 provinces in February 2019. The questionnaire comprised four parts: 1) knowledge about the Thailand’s National
Strategic Plan on Antimicrobial Resistance 2017-2021 (NSP-AMR); 2) knowledge on antibiotics; 3) awareness of antimicrobial
resistance; and 4) regulations on chemicals and antibiotic use in aquatic animals. Over half of the respondents
(57.6%) had heard about the NSP-AMR, but most of them (62.3%) did not know the content. The level of knowledge
of antimicrobial was measured using six true/false statements. Results showed that level of knowledge on AMR and
antibiotic use was high, as 73.9% of respondents gave correct answers to more than 3 out of 6. The majority of respondents
(more than 80.0%) correctly recognized the importance of antibiotic use and AMR problems, and all of the
respondents agreed that AMR was an important problem that needed policy attention. More than half of respondents
gave correct answers in all statements regarding the antimicrobial use regulations in aquaculture sector. This study was
the first study which assessed knowledge on antibiotic use and antimicrobial resistance among fisheries officers in
Thailand. We applied the questionnaire from the National Health and Welfare Survey 2019 and the results showed
that respondents had a high level of knowledge about antibiotic use and antimicrobial resistance. But, gaps remain in
the dissemination of antibiotic-related policies. Training should be provided to improve knowledge and awareness on
AMR and to support fisheries officers in regulating and ensuring rational use of antibiotics in the aquaculture.


location: , 'Thailand year: 2012 source: HSRI

title: Drug price control: Lessons from the past, present findings and recommendations for the future

abstract: Drug price control is one of the measures to contain health care costs. This paper briefly reviewed
the price control methods that have been commonly employed in developed countries. Experience in controlling drug prices by government agencies in Thailand was analyzed and recent findings from the
Research Projects on Drug Prices (B.E. 2553-2555) that have been supported by the Health Systems Research
Institute were summarized. Policy recommendations for the control of both purchased and reimbursed
prices were additionally proposed. The National Lists of Essential Medicines should be strategically
mobilized as an indirect measure of price control. To control the purchased prices of new drugs,
innovative strategies of pool purchasing and price negotiation should be implemented under collaboration
with health insurance funds. Routine monitoring of the hospital-purchased prices should be supported
so as to obtain the regular and update information on drug pricing. The reimbursed price of a
generic drug that is covered by the National Lists of Essential Medicines should be set at an adequately
high rate that can incentivize the use. An agency for the development and maintenance of standardized
drug databases should be established. The long-run development should include the price monitoring
infrastructure in every step, from essential drug selection, drug purchasing, utilization and reimbursement.


location: , 'Thailand year: 0 source: HSRI

title: Cost of Health Care Services for Treating Patient with Common Illness at Drugstore Compared to Outpatient Treatment at Hospital

abstract: Common illness is the most symptoms sickness in people. Since they are less severe and less complicated, people could do initial selfcare to recover from these symptoms. Receiving services at drug stores is therefore an option for people. This is the first study to estimate the cost savings of common illnesses that cover 16 symptoms as announced by the National Health Security Office (NHSO) in conjunction with the Pharmacy Council in the new Common Illness pharmacy project at drug stores to cost of Thailand's health system. This study gathered retrospective secondary data from several studies those reported the number of visits for treatment 16 symptoms common illnesses, direct medical costs direct nonmedical costs, and indirect costs. The cost of illness of treatment for 16 symptoms common illnesses at a pharmacy compared with outpatient treatment at a hospital from 3 perspectives: government perspective, patient perspective and social perspective were estimated. This study assumed that patient is responsible for cost of drug and health care services. The average number of hospital visits of treatment for 16 symptoms common illnesses was 2,356 visits per month. The first most 3 symptom groups that patients received services were sore throat, fever, and abdominal pain. The average number of hospital visits were 529, 442 and 394 visits. The estimation of the cost savings of treatment for 16 symptoms common illnesses at drug stores to cost of Thailand's health system from 3 perspectives including government, patient, and societal at tertiary care hospital were 446 – 683, 665 – 901, and 742 – 927 Baht per visit, respectively. When calculating from the amount of service received in a year, it was found that the average cost saving per year were 16.49 – 25.23, 24.56 – 33.30, and 27.39 – 34.26 million Baht, respectively. At secondary care hospital, cost saving per visit were 212 – 448, 430 - 667, and 507 - 692 Baht, respectively. Cost saving per year were 7.81 – 16.56, 15.88 – 24.63, and 18.72 – 25.58 million Baht, respectively. In conclusion, every 1 Baht reimbursed for treatment 16 symptoms common illnesses at drug stores will save additional costs in Thailand's health system if people choose to receive treatment services for 16 symptoms common illnesses at drug stores instead of receiving outpatient services from tertiary care hospitals saving ranged from 1.41 – 8.58 Baht and secondary hospitals savings ranged from 0.67-5.63 Baht. This savings comes from the fact that people do not have to take time off work to wait for receiving health care services at the hospital. It can be concluded that the treatment for 16 symptoms common illnesses at drug stores can clearly save costs.


location: , 'Thailand year: 2020 source: HSRI

title: Citizen Participation in Governing Thailand’s Universal Health Coverage Scheme

abstract: Citizen participation in policy decision making process is a key component of good governance. The
National Health Security Act (NHSA) 2002 deliberately provides legal space for civic participation in governing
the Universal Coverage Scheme (UCS). Articles 13(4) and 48(8) mandate the representation of
civil society organizations (CSO) as members in the National Health Security Board and the Quality and
Standard Board. This paper aimed to analyze the processes and outcomes of citizen indirect participation
in Thai UC Scheme through CSO representation in UCS governance. Qualitative research method was
employed. Literature review and in-depth interviews with 10 informants were conducted.
The study found that CSO representatives actively participated through three functions of the UCS
governance: 1) participating in decision making and governance through representation as committee
members, 2) supporting the decision making process through representation as sub-committee members
appointed by the two committees, and 3) interlinking between CSO representatives in the two committees
and various sub-committees and the broad-based CSO networks at grass root level, for which
problems and concerns are seamlessly transmitted from local to policy decisions (at UCS governance)
which ensure effectiveness of the UCS. The outcomes of CSO contributions included successful expansion
of services in the benefits package and building public ownership of the UCS through surveillance, protect,
promote and support the implementation of the UCS for the benefit of people. Citizen participation,
which has advanced beyond legislative provision, was the result of policy space that allowed citizens to
indirectly engage (through CSO representative) in the governing body and the active citizenship has
maximized the use of policy space provided by the Law.