Articles The study of the impacts of external factors on the future dental health service system in district level.

Abstract

This study aimed at studying how the changes of external factors influence the future dental health service system. These factors were : the economic crisis situations, public reforms and public personnel-freezing policies, and decentralization. The study was carried out by reviewing the relevant documents, and interviewing the high level administrators and senior technical officials of ministry of public health and the external senior experts.

The study revealed that the economic recession during 1997-1999 had led to the decrease of the annual public health budgets in these consecutive years, resulting to a reduction of dental units supply for district level. According to the public reforms, there would be a transfer of public health mission to the local authorities. With the need of more flexible and efficient management of the future limited resources, the public health facilities might be needed to be the autonomous hospitals. And due to the personnel-freezing policies of the government, the public health facilities might have to recruit the desired personnel as employees paid from the hospital revenue. Concerning the decentralization practice, only few local authorities were providing public health services to the population. From the document reviews, many local authorities at Tambon levels were not ready to do so. But those which could do were providing a few and limited public health services, mostly related to sanitation, environmental health and primary health care activities.

The study concluded and recommended that: (1) the health care system in the future has to be focused on the efficient management of resources and more ownership of local community, (2) the transformation of public hospitals under the central government to be those under the local authorities or the autonomous hospitals really needs to be well prepared in terms of human resources for health development according to the suitable health care model for local authorities to serve the population, and (3) besides those who are permanent officials, some health personnel will be employed temporarily by the public hospitals or local authorities by using their own budgets.