using innovation in tobacco - prakit vathesatogkit
Existing approach New approach Preventive & Activator for Promotive care change; : services - Lifestyle - Environment Mainly within MOH Out side MOHInvolve MOH and those Involve the whole of thewho are sick & family government and society 2
• HP as the Preventive & Promotive Care Provision focus on services to individuals, groups or communities. are mostly vertical activities / within health service sectors. (Health education, vaccine etc.)• HP as the Activator - focus on Population/Societal base. - create and coordinate HP activities of related sectors. - activate mostly through policy advocacy and social mobilization. 3
Targeting different groups of population Health Healthy Promotion Having (ThaiHealth) Risk behavior Diseases but not seeking care Conventional Sick and Health seek Care system 4 care (MOH)
– establishing Thai Health Promotion Fund under an autonomous state agency,– requiring 2% of alcohol and tobacco surcharged levy to this fund. 5
61. Health promotion needs regular and sustainable budget.2. Because health promotion concentrate on software rather than hardware, existing funding agencies do not understand process-based funding priorities.3. A dedicated/specific source of funding provide a predictable, more stable amount of budget.4. Less susceptible to diversion of funding for other purposes.
Critical proposal/Politically acceptable source of budget- The fund to come from tobacco and alcohol importer/producer to pay an additional 2% of excise tax (whenever they pay for the excise tax).- Key word: Government does not have to pay : The polluter pay 7
Parliamentarian :- How to oversight the fund?- How to prevent corruption / abuse / misuse?- How to measure the effectiveness?
Provisions of Thailand Health Promotion Fund Act 20011. Objective/Mission of the fund2. Sources of funding3. Structure and functions of governing board4. Organization of health promotion office5. Evaluation auditing monitoring processes6. Reporting to cabinet / parliament
Performance Evaluation1. Board of evaluation (propose by MOF, appointed by the cabinet).2. Internal auditing committee.3. Subject to auditing by General Accounting Office.
Thailand Health Promotion Foundation’s Regulation1. Criteria of funding2. Funding for program/ project only3. Program/project review selection/approval processes4. Fund administration/ monitoring /auditing system Make all processes transparent
ThaiHealth Budget as % of total health (million USD) 2006 2007 2008Total Gov.Health Budget 6,365 7,421 8,780Thai Health 74 74 94 = 1.16% 0.99% 1.07% 17
Population Groups Classify According to Health Status Health Promotion Healthy (1 % of health budget) Having Risk behavior Diseases but not seeking care Conventional Sick and seek care Health Care system(99 % 18 of health budget)
Ministry of Public Health and ThaiHealth Budget 2002 - 2007Unit:Baht Million (MoPH) Unit:Baht Million140,000 10,000 9,000120,000 8,000 MoPH Avg Growth 13%100,000 7,000 6,000 80,000 5,000 60,000 4,000 40,000 ThaiHealth : 1-2 % of MoPH 3,000 2,000 20,000 1,000 - - 2002 2003 2004 2005 2006 2007 Source: Thai Health Profile 2005 – 2007 and ThaiHealth Annual Reports