Location Thailand ASEAN

Flag

Coat of Arms

Government Monarchy under the constitution (1). , and. Democracy with a parliament (2).

King His Majesty King Bhumibol Adulyadej the Great Pr York microscopy.

Chancellor Yingluck Shinawatra.

King

Country Background of Thailand

6/07/12 2

Thailand profile- Southeast Asia

Region- GDP per capita USD 4,608- Population of 64 million- Population growth rate 0.5%- Infant mortality rate: 11.8/1,000 live birth- Life expectancy

-Male 69.6-Female 76.9

A Journey towards Health Systems Reform in Thailand

PHC/HFA (1980)Quality of Life Concept based on Basic Minimum Needs (2007)

National Health Act

(2001) Thai Health Promotion Foundation Act - Sin Tax

(2002) National Health Security Act

(1997)Economic crisis and political reform with People Constitution

(1990) Economic led Growth Policy causes social inequity, Deteriorated natural resources

(2000) Health System Reform Office

(2007)Constitutionreplacing an interimconstitution by an army-led coup

(1992) Health System Research Institute Act

(2001) IHPP under MOU of MoPH & HSRI

(2010)National Refrom Committee

• Propose health policies and strategies

Network of members and communities

• Management of the Health Promotion Fund

• Management of the NationalHealth Security Fund

• Health related operation

Local Administrative Organizations

• National HealthStatute

Other Networks

• Creationof knowledge

สช. ปรบัปรุง พ.ย.

50

• Health Assembly

Parliament

CabinetNESAC NESDB

HSRI

Ministry of Public Health and other

ministries relevant to health

THF

NHSO

อปท.Regional Agencies

NHC/NHCO

Web of the Health Systems Mechanism

Professionaland AcademicNetwork

Press and medianetworks

HA

National Health Commission Office

Mr. Techid ChawbangpomExpert of social networking

National Health Commission, Thailand

Essence of the National Health Act

• New Definition of Health Health is Well-Being

• New Governance Body beyond Public Health Ministry: National Health Commission

• New Tools for Policy Process: Health Statute, Health Assembly, HIA,

National Health Commission

NHC

NHCO

EB

• Chair : PM• Vice : MoPH

Minister

MoPH

Cabinet

MoPHMoPHOtherMinistry

NESDB Etc

Tools• Health Statute (HS)• Health Impact Assessment (HIA)• Health Assembly (HA)• Health Station, TV and Radio on line

Wellbeing

Healthy Public Policy

National Health Commission (NHC)

People participation at all levels

10 Dissemination of health information 3 Health security and protection

7 Promotion of Local health wisdom

5 Prevention and control of health threatening factors

8 Consumer protection

11 Formation and development of health personnel

1 Philosophy and basic concepts of health system

Statute on National Health System

2 Desirable health system and its and goal

4 Health promotion

6 Public health services and quality control

9 Generation and dissemination of health knowledge

12 Health financing

5

Health Impact Assessment (HIA)

• Maximize positive impacts and minimize negative impacts on people health

• Support the decision making at policies, programs or projects• Learning process of the society as a whole

“a process in which the relevant public and State agencies exchange their knowledge and cordially learn from each other through a participatory and systematically organized forum, leading to recommendations on Healthy Public Policies or Public Healthiness.”

Definition of Health Assembly

“The Triangle that Moves the Mountain” Strategy

Knowledge (K)

Social (S)

Political Involvement (P)

NHA

4

Three Health Assembly Models under the Same Principles

Models1. National Health Assembly (NHA)2. Area-based Health Assembly

(AHA)3. Issue –based Health Assembly

(IHA)

NHA

IHAAHAPrinciples1. Involvement of Stakeholders2. Systematic Management3. Learning and sharing

System and Mechanism of Health Assembly

National Health

Commission(NHC)

National Health Assembly’s Organizing Committee( NHAOC )

NHCO

National Health

Assembly

Principles and Procedures of Organizing NHA

Linked

Mechanism for technical

Support

Area based Health

Assembly

Issue based Health

Assembly

Private/Civil society Political

/Gov.

Academic/Professional

Multi Sectoral

Mechanism

Principles and Procedures of Organizing Area based HA and Issued based HA

Put proposal to practice

• Cabinet

• Parliament /Political sector

• State agencies

• Local administrative organization

• Local communities

• Academic profession organization

• Private /Business / or other orgs.

Put proposal to practice

National Health Assembly is a year-long process

Call for agenda

Agenda

selection Drafting

technical and

resolution

Stakeholder

constituency

consultationRevise

document

Circulate for

constituency

consultation National

Health Assembly

Submit to

Cabinet Implementation

6/07/12 Thai Health Systems and National Health Assembly

14

2 dimensions, 4 values, 5 strategies

6/07/12 Thai Health Systems and National Health Assembly

15

Participatory healthy public policy

Social empowerment

Participatory Democracy

Interactive Learning

through action

Participatory healthy

public policy

process

Social Movement

5 StrategiesIncrease participation from all 3 sectors and build

ownershipDevelop the Assembly System that are systematic

with clear pattern but with flexibilityUse inclusive approach to involve all stakeholdersSupport downstream process to bring policy to

implementationLink National Health Assembly to Thailand Reform

Assembly and Assembly at International level

6/07/12 Thai Health Systems and National Health Assembly

16

26

Needs of People

Government Sector State Policy

Civil SocietySector

Conceptual Idea of Health Assembly on the Development of Healthy Public Policy

Participatory Policy Formulating

Knowledge Sector

Politic/Government Sector

Civil Social Sector

Health Assembly

ExampleCase learning

to public development in Thailand

The Enhancement of Local Disaster Management

to Public Policy Development in Thailand

Scopes of Presentation• Disaster situation and the 2011

flood situation in Thailand • Roles of civil society organizations

and local communities in disaster management

• Movement of participatory public policy development

• Contents of Thai NHA Resolution on disaster management with local communities as the focal point

Disaster Situations in Thailand (year 1989-2010)

Disasters Numbers(times)

PeopleInjured

Peoplekilled

Cost(million US)

Flood 213 7,896 2,938 3,735.1Landslide 9 > 500 541 66. 2Storm 36,024 1,367 842 163.0Fire 46,986 3,775 1,639 916.7Tsunami 1 11,775 5,401 225.8

83,233 > 25,313

11,361 5,040.8

Department of the Disaster Prevention and Mitigation, Ministry of Interior

Flood Situation in Thailand, 2011• July 2011- January 2012 • Covered 65 provinces, 684

districts, with 4,086,138 households and 13,595, 192 people affected.

• Houses : whole houses 2,329; partially damaged 96, 833

• Damaged agricultural areas 11.20 million Rais; 13,961 roads; 777 drainage ditches; 724 bridges/bridge-necks; 231,919 fish/shrimp/clam farms.

• 813people were killed and 3 were lost.

• The World Bank approximated damage cost at 45,000 million baht.

Importance Causes• Communities’ lack of disaster

planning• Lack of effective warning

system and lack of accessible communication system

• People’s lack of knowledge about disaster prevention.

Songkla Partner Against Disasters

• Damage (2010) : 16 districts, 12 municipalities, 119 sub-districts, 1,049 villages/communities, 269,233 households, 802,247 people

• Activities: Providing horizontal warning system – focus

on networking Setting up database in both risk and safe

areas Encouraging communities to be alerted and

self-dependent during disasters

Examples of community roles:

Nakhon Sawan Community Network• Damage : 4 sub-districts, 59

communities, 18, 464 households, 72, 331people

• Activities: – Setting up 11 relief shelters– Sacrificing some houses to safe

the communities – Setting up Disaster Fund

Examples of community roles:

Nakornpathom People Network

• Damage : 7 districts, 102 sub-districts, 905 villages, 85,381 households, 230,165 people

• Activities:Setting up relief shelters in temples,

schools and government offices Setting up the shared kitchen Recovering the indigenous orange,

Nakornchaisri, orchards

Examples of community roles:

National Health Assemblyin National Health Act, 2007

a process in which the relevant public and State agencies exchange their knowledge and cordially learn from each other through a participatory and systematically organized forum, leading to recommendations on Healthy Public Policies or Public Healthiness.

Timeline- Development of public policies on community-

centered disaster management

The 14-province Southern Health Assembly Network in

proposed to enclose the issue in the agenda of The 4th NHA

(May 2011)Songkla Partner

Against Disasters

The agenda was announced in The 4th NHA &

academic team working on development of policy recommendation was set

up

Forum on Lessons learned

from flood management(Jan 2012)

The 4th National Health Assembly (NHA) (2-4 Feb

2012)

The Cabinet approved on NHA’s Resolution

and assigned departments to act on accordingly (May

2012)

Flood Oct-Dec

2011

Resolutions• Revise the Disaster Prevention

and Mitigation Plans• Provide local community

network’s preparation planning• Set up national fund• set up fund and collaborative

mechanism in local level• Support knowledge management

Resolutions• Provide frequency bands for TV,

radio broadcast • Encourage development of diverse

volunteer networks• Set up area based health assembly

to address disasters in the areas. • Prepare learning curriculums in

every class level

Lessons Learn• The power of local communities and civil

society networks is crucial in dealing with disasters in Thailand in 2011

• Working experiences of local communities and civil society networks are important sources for development of the policy recommendation

• the Thai NHA, founded in accordance with the national Health Act, is a tool used for participatory development of healthy public policies, which is recognized by all sectors including the government