Thailand Health System in Transition Review (HiT). Second edition

Overview

This is the second edition of Thailand’s health system review (HiT), updating the old one that was published in 2015. Since then the country has witnessed limited health sector reforms. Noteworthy developments include the devolution of subdistrict health centres from the MoPH to locally elected governments at the provincial level. The impact of this ongoing transition, launched in 2022, awaits further evidence of its positive or negative effects on population access to services. Other incremental reforms include the NHSO’s expansion of the benefit package, guided by evidence of cost–effectiveness, long-term budget sustainability, and health system capacity.

The COVID-19 pandemic, prompted substantial resource consumption, notably through domestic loans, especially during the peak of the Delta strain in the third quarter of 2021. Innovative adaptations, though not major health reforms, emerged to alleviate overcrowding in hospital-based outpatient services. Telemedicine, teleconsultation, and medication dispatch via post were among the strategies employed

Prevalence of NCDs remains a significant challenge, with NCDs contributing to a majority of deaths and DALYs. The country faces specific challenges in road injuries, stroke, and ischaemic heart disease compared to nations with a similar sociodemographic index. Addressing the commercial determinants of NCDs, such as tobacco and alcohol, requires robust implementation of WHO-recommended interventions, necessitating collaboration between government entities, including the MoPH and the Excise Department.

Additionally, challenges persist in promoting exclusive breastfeeding, tackling childhood malnutrition, and ensuring optimal early childhood development. Exclusive breastfeeding rates in Thailand fluctuated from 12.3% (2012) to 23.1% (2015) but fell to 14% in 2019. Thailand’s 2019 Multi-Indicator Cluster Survey revealed disparities in child nutrition: 13% stunting, 8% wasting, and 8% overweight, with regional variations and maternal education.

Finally, the threat of antimicrobial resistance, the need for rehabilitation care for the ageing population, and the evolving landscape of chronic health conditions pose ongoing challenges that demand focused research and policy attention.

How to Cite this publication

Tangcharoensathien V . editor. Thailand health system review. Manila: World Health Organization, Regional Office for the Western Pacific; 2024.