๑๕ มี.ค. ๒๕๕๙ - ตามที่สำนักงานปลัดกระทรวงสาธารณสุขได้แต่งตั้งคณะทำงานสนับสนุนข้อมูลในประเด็นผลกระทบของความตกลงหุ้นส่วนเศรษฐกิจภาคพื้นแปซิฟิค (Trans-Pacific Partnership: TPP) เพื่อทบทวนข้อมูลวิชาการและงานวิจัยที่เกี่ยวข้องนั้น สำนักการสาธารณสุขระหว่างประเทศ ร่วมกับ ITH ได้จัดการประชุมคณะทำงานสนับสนุนครั้งที่ ๑/๒๕๕๙ ขึ้น เมื่อวันที่ ๑๔ มีนาคม ๒๕๕๙ ณ สำนักงานพัฒนานโยบายสุขภาพระหว่างประเทศ โดยที่ประชุมได้รับทราบถึงความเป็นมา การดำเนินงานของกระทรวงสาธารณสุข และผลการวิเคราะห์ประเด็นผลกระทบด้านสาธารณสุข อีกทั้งยังร่วมพิจารณากรอบและแนวทางการทำงาน รวมไปถึงหารือเรื่องงานวิจัยต่าง ๆ ที่เกี่ยวข้องอีกด้วย
นพ.ทักษพล ธรรมรังสี ผู้อำนวยการสำนักงานพัฒนานโยบายสุขภาพระหว่างประเทศ (IHPP) และจิตอาสา IHPP ร่วมทำกิจกรรมผลิตเก้าอี้เปเปอร์มาเช่เพื่อมอบให้น้องผู้พิการทางสมอง ที่ขาดทุนทรัพย์ โดยได้เชิญคุณอุบลรัตน์ ชุนเจริญ อดีตนักเวชนิทัศน์ สถาบันราชานุกูล กรมสุขภาพจิตเป็นผู้ให้ความรู้ในการผลิตเก้าอี้ เมื่อวันที่ 16 พฤษภาคม 2558 ที่ผ่านมา และจะนำส่งมอบให้แก่พ่อแม่ผู้ปกครองของน้องผู้พิการทางสมองที่ขาดทุนทรัพย์ ในโอกาสต่อไป
ดร. ภูษิต ประคองสาย อภิปราย "การประเมินความเป็นธรรมทางสุขภาพ (health equity analysis)"
การดำเนินงานตามมาตรการและผลลัพธ์ที่เกิดขึ้นตามแนวนโยบายบูรณาการยุทธศาสตร์สุขภาพ ๑๕ ด้าน เป้าหมายและตัวชี้วัด ปี ๒๕๕๘ กระทรวงสาธารณสุข
ณ โรงแรมริชมอนด์ นนทบุรี
วันที่ ๒๕ กันยายน ๒๕๕๗ เวลา ๐๘..๓๐ - ๑๒.๐๐ น.
ดร. ภูษิต ประคองสาย บรรยาย "ASEAN Post-๒๐๑๕ Health Development Agenda"
การดำเนินงานตามมาตรการและผลลัพธ์ที่เกิดขึ้นตามแนวนโยบายบูรณาการยุทธศาสตร์สุขภาพ ๑๕ ด้าน
เป้าหมายและตัวชี้วัด ปี ๒๕๕๘ กระทรวงสาธารณสุข
ณ โรงแรมริชมอนด์ นนทบุรี
Venue: MFA, Bangkok
Date and time: Friday 15 August 2014, 12.00-14.00
On Friday, 15 August 2014 at the Ministry of Foreign Affairs (MoFA), Bangkok, Thailand, MoFA convened a lunch talk, an interactive forum, between Ministry of Public Health (MoPH) and MoFA on global health issues. This Lunch Talk aimed to provide the latest issues of global health and health diplomacy among executives and officers of MoFA, serving to provide not only knowledge on global health, but also to strengthen a closer collaboration between foreign policy by MoFA and global health by MoPH. In addition, this Lunch Talk was arranged as a preparation for a workshop between MoFA and MoPH for drafting National Global Health Strategy that will be held on 23-24 August 2014 at Sampran Riverside Resort.
The Lunch Talk was a lively discussion by three panelists from MoPH and moderated by the Deputy Director General of International Organization Department, MoFA. There were around 80 attendees present at the talk, about 50 MoFA staff and 20 MoPH staff, including Candyce Silva, Sarocha Rachawong, Yaowalak Wanwong and Angkana Sommanustweechai from CapUHC.
Dr. Suwit Wibulpolprasert, Vice President of International Health Policy Foundation, MoPH, pointed out the important linkage between MoFA and MoPH. Health related issues can have extensive impacts to cross-country relationships. According to Post 2015 development agenda, Universal Health Coverage (UHC) is one of the items under the foreign policy global health framework. UHC is a strong influential tool leading to social and economic development. UHC contributes to poverty reduction by preventing financial catastrophe and impoverishment of households from paying medical bills. UHC aims to ensure equitable access of quality health services for all; therefore a strong effective health system is a pre-requisite for UHC achievement.
Dr. Apichai Mongkol, Director General of Department of Health Science, MoPH, elaborated that Global Health Security Agenda was led by the US government. It mainly focused on implementation of International Health Regulation (IHR) and practicing diseases outbreak control. There are three components: prevention, detection and response. All three are relevant to health care provision development in Thailand. Currently, Thailand plays a significant role as the leading country of Antimicrobial Drug Resistance and infectious disease laboratory network in the Southeast Asia Region
Dr. Supamit Chunsuttiwat, Senior Expert in Preventive Medicine of Department of Disease
Control, MoPH, shared information on the current most urgent disease in the world, Ebola, a viral zoonotic disease, which was first discovered in Africa in 1976. It’s transmitted from human to human by direct contact with blood, saliva, and other bodily fluids of an infected person. Symptoms of Ebola disease include high fever, weakness, vomit, diarrhea and raised rash (similar to hemorrhagic fever). Ebola’s fatality rate can fluctuate between 20-90%, and this outbreak’s rate is considered high at approximately 50%, although sanitation, hygiene and health care provision have recently been improving. The World Health Organization has declared the outbreak a Public Health Emergency of International Concern (PHEIC). That designation could trigger an immediate “internationally coordinated response” to contain and control the outbreak, as well as request all countries activate their emergency pandemic preparedness plans. In Thailand, following WHO recommendations, there have been three surveillance measures at 3 focused areas including immigration checkpoints, hospitals and communities.
Participants followed the panel remarks with an active discussion. The issue of linkage between disease transmissions across countries, as “Disease without border” was raised. The health measures for border citizens are considered a very important in the future because health crises are no longer considered to be individual, but humanitarian problems. Another interestingand challenging issue is increasing the collaboration among neighboring countries and ASEAN, in particular AEC, ASEAN Economic Community, in 2015.
Participants left the talk with a better understanding of UHC, it’s importance for developing foreign policy toward global health framework, and how it is linked to global security, economics and social cooperation, which is a fundamental to the Ministry of Foreign Affairs.
On Saturday 9th August 2014 at TK Palace hotel, Bangkok, Thailand, the “we love Universal Coverage Scheme” group hosted the seminar on “Security and Sustainability of Universal Health Coverage Scheme: the Equitable Health Care Financing for Thai”. This event served as a platform for economists, health financing specialists, and civil society members to share their view on Thailand’s Universal Coverage Scheme (UCS).
Dr. Ammar Siamwalla, Distinguished Scholar of the Thailand Development Research Institute (TDRI), pointed out that at the time of establishment, the UCS was believed to be only benefit for the poor and use a large portion of the national budget, when in fact the Thai health expenditure consumed just four percent of the Gross Domestic Product (GDP). He added that providing health services must be the Government’s commitment by supplying an adequate health budget. For the past couple years, however, the UCS budget has been halted and has not advanced along with inflation or increased health professionals’ salary. Dr.Ammar recommended the Government reduce the budget for ineffective, high cost projects and shift those fund to proven effective activities. He stated, “UCS is the most cost-effective health insurance system.”
Dr.Viroj Tangcharoensathien, Secretary General of IHPP Foundation, cited that Thai UCS is well accepted by international development agencies, namely the United Nations, the World Bank, and the World Health Organization. Over the past thirteen years UCS has contributed to better health for Thais, but key challenges for UCS remain including: annual budget allocation that is dependent on political decisions, the health transition from infectious to non-communicable diseases (NCDs), the demographic transition to an ageing society, and providing health protection to non-Thai citizens. Dr.Viroj suggested maintaining the strengths of UCS, e.g., the benefits package, purchasing mechanism and budget source, while increasing fiscal space through tax reform, both for general purposes and specifically for health, and focusing on primary and secondary prevention for NCDs. New sources of tax should be introduced when political windows of opportunity open such as Tobin tax, or the financial transaction in stock exchange market, as well as land and inheritance taxes; all which have high a potential to boost government revenue and spending on health.
Dr.Winai Sawasdivorn, Secretary General of the National Health Security Office (NHSO), presented the advantage of the UCS purchasing mechanism, capitation, and global budget in order to increase purchasing power and cost control. NHSO has set up its audit unit, and developed different means for public hearingaiming to improve quality of service.
Mr.Jon Ungpakorn, member of quality and standard control of health service by civil society committee, indicated that access to equitable health services is a human right that UCS can provide. He expressed his concern that some, particularly the private sector, use common misconceptions of UCS, such as a large budget and poor quality of health services, to discredit the UCS reputation.
On the whole, participants agreed that the UCS is essential for health financial risk protection and the source of UCS budget should be tax based. A health service costing study for all levels of health service providers should be urgently conducted to reflex the unit cost of health services in order to allocate a sufficient health budget.
The voice of civil society on financing of UCS was echoed by the media. Click here to read more from Manager Online.
On Wednesday, August 13th 2014, CapUHC representatives, Dr. Angkana Sommanustaweechai, Mrs. Candyce Silva and Ms. Sarocha Rachawong, attended the WHO-SEARO field visit to the Thai Health Promotion foundation, or ThaiHealth, with visiting participants from Bangladesh, Bhutan, the Maldives, Nepal, and Myanmar. The ThaiHealth team presented their experiences establishing a health promotion program in Thailand and gave demonstrations of the interactive, health promotion related exhibits available at their campus in Sathorn. CapUHC helped to facilitate the group session and distributed CapUHC brochures and promotional materials to the participants and partners who were eager to learn more about universal health coverage in Thailand(photos below).
Introduction to ThaiHealth
The Health Promotion Foundation Act of 2001 introduced a 2% surcharge tax on tobacco products to be paid directly to the newly created Thai Health Promotion Foundation. Independent of the excise tax, the tobacco surcharge is paid by cash or check daily, brings in $150 million USD every year, and represents just 1% of the total government health expenditure. One, year, and ten year plans for 14 key health issues drive program design and activities.
After a brief introduction to ThaiHealth and a healthy lunch, the 22 participants were divided into three small groups and shown to three rally bases where they learned about various health promotion programs at ThaiHealth. The exhibitions and presentations focused on 1) Tobacco, Alcohol and Road Safety, 2) Physical Activity and Healthy Eating, and 3) Healthy Workplace and Community. Presenters shared a short presentation on their work and activities, distributed educational materials, and led participants in short demonstrations. At the alcohol awareness station, for example, participants attempted to toss a ball into a target a short distance away while wearing impairment goggles that gives the realistic feeling of being intoxicated. Participants were led in a short stretching and exercise demonstration at the physical activity station, using a resistance band tool that is inexpensive and easy to carry. Inside the healthy community exhibit, the ThaiHealth staff escorted the participants through miniature neighborhood simulations that depicted ways the community can be healthy through awareness, physical activity, and healthy eating.
Dr. Supreda Adulyanon, ThaiHealth Deputy Chief Executive Officer, began the day’s final session by presenting ThaiHealth’s financial mechanisms to participants, highlighting that the dedicated tax allowed ThaiHealth to rollover funds from previous years and to use the money according to carefully crafted program plans. Dr. Supreda summarized ThaiHealth’s governance: two boards, an executive board with the prime minister serving as chairperson, and an evaluation board whose senators report back to the executive board govern ThaiHealth’s budget.
Dr. Piroj Saonuam, Director of Monitor and Evaluation Unit, stated that as an independent state agency, a quality monitoring and evaluation system is necessary for the organization. Each year, ThaiHealth spends significant funds to promote more than 1,000 projects through multi-sector partners. The M&E system is divided into two levels: 1) the project or program Level to detect and assure that all funding sufficient for the project’s outcomes, 2) organization level in which the Evaluation Board has the authority to review relevant documents, and produce an annual report to submit to the cabinet.
There are also challenges for ThaiHealth in the future, which will intensively focus on a result-based monitoring and evaluation system. A strong evaluation, high-performance capacity building, innovative and strategic thinking, including transparent and effective processes, will play important roles for ThaiHealth in the next decade.
Dr. Pairoj Saonuam, Director Monitor and evaluation Unit of ThaiHealth, highlighted the concept of the Social Return on Investment (SROI) that assesses the outcomes of implementation by comparing outcomes and inputs, and activities and outputs in monetary units. The three categories of impact considered include economic, environmental and people value. Currently, the ThaiHealth has seven studies of SROI, i.e., road traffic accidents, tobacco control, physical activities, food consumption project, consumer protection, children youth and family health and health of the elderly. Road traffic accident prevention ranked first in social return on investment among the seven categories, at 130.21 per 1 baht. It should also be noted that since ThaiHealth’s inception in 2002, the smoking rate in Thailand has steadily declined.
To find out more about health promotion in Thailand, and ThaiHealth’s programs and activities, visit: http://www.thaihealth.or.th/.