Thailand’s Challenges of Achieving Health Equity in the Era of Non-Communicable Disease

Authors

  • Kathleen Potempa RN, PhD, University of Michigan, School of Nursing, Ann Arbor, MI, USA.
  • Benjaporn Rajataramya RN, PhD, Praboromarajchanok Institute for Health Workforce Development Nonthaburi, Thailand.
  • Naruemol Singha-Dong RN, PhD, Suranaree University of Technology Institute of Nursing Nakhon Ratchasima, Thailand.
  • Philip Furspan PhD, University of Michigan, School of Nursing, Ann Arbor, MI, USA.
  • Erin Kahle PhD, MPH, University of Michigan School of Nursing and Center for Sexuality and Health Disparities, Ann Arbor, MI, USA.
  • Rob Stephenson PhD, MSc, University of Michigan School of Nursing and Center for Sexuality and Health Disparities, Ann Arbor, MI, USA.

Keywords:

Aging, Global health, Health policy, non-communicable disease, Thailand

Abstract

Thailand is an exemplar of the challenges faced in addressing the increasing dual demands of aging populations and increasing incidence of non-communicable disease (NCDs). By understanding the dilemmas and solutions posed by Thailand, we propose a framework of key factors to be addressed in order to accelerate capacity in addressing the NCDs challenges in aging populations. Methods proposed by world health organizations to improve population health could impact NCDs if Quality Adjusted Life Years (QALYs) are increased as well as life expectancy through these measures. Four recommendations for achieving these objectives are discussed: expand investments in health care infrastructure for NCDs prevention and early detection; expand public health policies to full population health goals; expand to universal coverage for health care access; engage multi-sectoral constituencies in policy and strategic implementation programs for health. With the emergence of an aging population and the inevitable rise in NCDs, the Thai government is engaging each element of our recommendations and grappling with the policy trade-offs in the context of broader economic and other strategic goals. The experience of Thailand in achieving its goal of population health is a case study of focus, perseverance, and consistent policy strategies.

References

World Health Organization [Internet]. Global Health and Aging (NIH publication no. 11-7737). World Health Organization: Geneva. 2011 [cited 2021 Sep 28]; Available from: https://www.who.int/ageing/publications/global_health.pdf

The World Bank [Internet]. Thailand economic monitor : aging society and economy - June 2016 (English). Washington, DC;2016 [cited 2021 Sep 18]; Available from: http://documents. worldbank.org/curated/en/830261469638312246/Thailand-economic-monitor-aging-society-and-economy-June-2016

World Health Organization [Internet]. Global status report on noncommunicable diseases 2014: World Health Organization;2014 [cited 2021 Sep 28]; Available from: https://apps. who.int/iris/handle/10665/148114

Kaufman ND, Chasombat S, Tanomsingh S, Rajataramya B, Potempa K. Public health in Thailand: emerging focus on non-communicable diseases. Int J Health Plann M. 2011;26(3):e197-212. doi.org/10.1002/hpm.1078

Siraprapasiri T, Ongwangdee S, Benjarattanaporn P, Peerapatanapokin W, Sharma M. The impact of Thailand’s public health response to the HIV epidemic 1984-2015: understanding the ingredients of success. J Virus Erad. 2016;2(Suppl 4):7-14. doi.org/10.1016/S2055-6640(20)31093-1.

Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. Lancet. 2018;391(10126):1205-23. doi.org/10.1016/S0140-736(18)30198-3.

Pagaiya N, Noree T. Thailand’s health workforce: a review of challenges and experiences. 2009 [cited 2021 Sep 26];Available from: http://documents1.worldbank.org/curated/en/453661468171879780/pdf/546330WP0THLHe10Box349423B01PUBLIC1.pdf

Lumbiganon P, Chuenkongkaew W, Putthasri W. editors. Education reform of health professionals for the 21st century: a situation analysis in Thailand. Nonthaburi: Health Professional Education Foundation; 2016. Available from:http://www.healthprofessionals21thailand.org/wp-content/uploads/2016/11/Situation-analysis-in-Thailand_final.pdf

Wiwanitkit V. Mandatory rural service for health care workers in Thailand. Rural and Remote Health. 2011;11:1583. doi.org/10.22605/RRH1583.

Buse K, Hawkes S. Health in the sustainable development goals: ready for a paradigm shift? Globalization Health. 2015;11(1):1-8. doi.org/10.1186/s12992-015-0098-8.

United Nations [Internet]. Thailand - Addressing ongoing and emerging challenges for meeting the Millennium Development Goals in 2015 and for sustaining development gains in the future. United Nations; 2014 [cited 2021 Sep 25]; Available from: https://www.un.org/en/ecosoc/newfunct/pdf14/thailand_nr.pdf

Saengpassa C. Healthy legacy of the caring King. The Nation-Thailand. 2016, Available from: https://www. nationthailand.com/in-focus/30298914

United Nations Population Fund [Internet]. Impact of demographic change in Thailand: United Nations Population Fund Country Office in Thailand; 2011 [cited 2021 Sep 27]; Available from: https://thailand.unfpa.org/sites/default/files/pub-pdf/Impact-Full-Report-a-Eng.pdf

The World Bank [Internet]. Population ages 65 and above (% of total population) - Thailand, 2019 [cited 2021 Sep 27]; Available from: https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS?locations=TH

World Health Organization [Internet]. Joint mission of the United Nations Interagency Task Force on the prevention and control of noncommunicable diseases: Thailand, 28-30 August 2018. 2018 [cited 2021 Sep 27]; Available from: https://apps.who.int/iris/handle/10665/275090

Sumriddetchkajorn K, Shimazaki K, Ono T, Kusaba T, Sato K, Kobayashi N. Universal health coverage and primary care, Thailand. B World Health Organ. 2019;97(6):415-22.

World Bank [Internet]. World Development Report 1993: ‘Investing in Health.’ New York: Oxford University Press, 1993 [cited 2021 Sep 27]; Available from: https://openknowledge.worldbank.org/handle/10986/5976

Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et al. Global health 2035: a world converging within a generation. Lancet. 2013;382(9908):1898-955.

Roser M, Ritchie H. Burden of Disease 2016. Published online at OurWorldInData.org, [cited 2021 Sep 24];Retrieved from: https://ourworldindata.org/burden-ofdisease’

Cowling K, Magraw D. Addressing NCDs: Protecting health from trade and investment law: comment on “Addressing NCDs: Challenges From Industry market Promotion and Interferences.” Int J Health Policy Manag. 2019;8(8):508-10. doi: 10.15171/ijhpm.2019.41.

Delobelle P. Big tobacco, alcohol, and food and NCDs in LMICs: an inconvenient truth and call to action comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences.” Int J Health Policy Manag. 2019;8(12):727-31. doi: 10.15171/ijhpm. 2019.74.

Rose G. Sick individuals and sick populations. Int J Epidemiol. 2001;30(3):427-32. doi.org/10.1093/ije/30.3.427.

Kickbusch I, Allen L, Franz C. The commercial determinants of health. Lancet Glob Health. 2016;4(12):e895-6. doi.org/10.1016/S2214-109X(16)30217-0.

Supawongse C, Buasai S, Thanapathara J, WHO [Internet]. The evolution of the tobacco consumption control in Thailand / by Choochai Supangwongse, Supakorn Buasai; Jitsiri Thanapathara. Nonthaburi, Thailand : Dept. of Health. Available from: https://apps.who.int/iris/handle/10665/42410

World Health Organization [Internet]. WHO country cooperation strategy, Thailand: 2017–2021. 2017 [cited 2021 Sep 28]; Available from: https://apps.who.int/iris/handle/10665/255510

World Health Organization [Internet]. Global strategy to reduce the harmful use of alcohol: World Health Organization; 2010 [cited 2021 Aug 27]; Available from: https://www.who.int/substance_abuse/msbalcstragegy.pdf

World Health Organization [Internet]. Global strategy to accelerate tobacco control: advancing sustainable development through the implementation of the WHO FCTC 2019-2025. World Health Organization; 2019 [cited 2021 Jul 21]; Available from: https://www.who.

int/fctc/implementation/global-strategy-to-acceleratetobacco-control/en/

World Health Organization [Internet]. Health promotion and disease prevention through population-based interventions, including action to address social determinants and health inequity. 2018 [cited 2021 Sep 7]; Available from:http://www.emro.who.int/about-who/public-healthfunctions/health-promotion-disease-prevention.html

Adulyanon S. Funding health promotion and disease prevention programmes: an innovative financing experience from Thailand. WHO-SEAJPH. 2012;1(2):201. Available from: https://apps.who.int/iris/handle/10665/329828

Nonkhuntod R, Yu S. Lessons from Thailand: universal healthcare achievements and challenges. Int J Soc Econ. 2018;45(2):387-401. doi.org/10.1108/IJSE-03-2017-0107.

Mukem S, Sriplung H, McNeil E, Tangcharoensathien V. Breast cancer screening among women in Thailand:analyses of population-based household surveys. J Med Assoc Thai. 2014;97(11):1106-18.

World Health Organization [Internet]. Hypertension care in Thailand: best practices and challenges, 2019. 2019 [cited 2021 Sep 1]; Available from: https://apps.who.int/iris/handle/10665/330488

World Health Organization [Internet]. The Kingdom of Thailand health system review. Manila: WHO Regional Office for the Western Pacific; 2015 [cited 2021 Sep 2];Available from: https://apps.who.int/iris/bitstream/handle/10665/208216/9789290617136_eng.pdf sequence=1&isAllowed=y

In Wikipedia [Internet]. Education in Thailand (January 20,2021), [cited 2021 Sep 27]; Available from: https://en.wikipedia.org/w/index.php?title=List_of_countries_by_life_expectancy&oldid=981893303

Erickson J, Milstein B, Schafer L, Pritchard KE, Levitz C, Miller C, et al. Progress along the pathway for transforming regional health: a pulse check on multi-sector partnerships. 2017 [cited 2021 Sep 26]; Available from: https://www.rethinkhealth.org/wp-content/uploads/2017/03/

-Pulse-Check-Narrative-Final.pdf

World Health Organization [Internet]. Rio political declaration on social determinants of health. Geneva; 2011 [cited 2021 May 27]; Available from: http://www.who.int/sdhconference/declaration/en/

Office of the National Economic Social Development Board [Internet]. The twelfth national economic and social development plan (2017‐2021). 2017 [cited 2021 Sep 3]; Available from: https://www.nesdc.go.th/ewt_dl_link.php?nid=9640#:~:text=Foreword-,The%20Twelfth%

National%20Economic%20and%20Social%20Development%20Plan%20(2017%2D2021,Thailand%20itself%20was%20undergoing%20reforms

Thailand National Strategy Committee [Internet]. NATIONAL STRATEGY 2018 – 2037. 2017 [cited 2021 Aug 27]; Available from: http://nscr.nesdb.go.th/wp-content/uploads/2019/10/National-Strategy-Eng-Final-25-OCT-2019.pdf

Thailand’s Voluntary National Review on the Implementation of the 2030 Agenda for Sustainable Development. 2017 [cited 2021 Jul 27]; Available from: https://sustainable development.un.org/content/documents/16147 Thailand.pdf

The World Bank [Internet]. The World Bank in Thailand. 2020 [cited 2021 Sep 17]; Available from: https://www.worldbank.org/en/country/thailand/overview#1

Witthayapipopsakul W, Cetthakrikul N, Suphanchaimat R,Noree T, Sawaengdee K. Equity of health workforce distribution in Thailand: an implication of concentration index. Risk Manag Healthc Policy. 2019;12:13-22. doi:10.2147/RMHP.S181174.

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Published

2022-03-05

How to Cite

1.
Potempa K, Rajataramya B, Singha-Dong N, Furspan P, Kahle E, Stephenson R. Thailand’s Challenges of Achieving Health Equity in the Era of Non-Communicable Disease. PRIJNR [Internet]. 2022 Mar. 5 [cited 2024 Dec. 19];26(2):187-9. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/256503