Health Inequity Reduction in Thailand: On the Way Toward Healthy Public Policy
•Download as PPTX, PDF•
1 like•188 views
By Cholnapa Aukul, SIRNet Manager Presentation on Saturday, July 19, 2014: 8:30 AM-10:20 AM, "Collaborative Governance for Health Equity and Healthy Public Policies" Room: F206, RC15 Sociology of Health, by the 18th ISA World Congress of Sociology in Yokohama, Japan.
Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (15)
Similar to Health Inequity Reduction in Thailand: On the Way Toward Healthy Public Policy
Similar to Health Inequity Reduction in Thailand: On the Way Toward Healthy Public Policy (20)
Recently uploaded
Recently uploaded (20)
Health Inequity Reduction in Thailand: On the Way Toward Healthy Public Policy
- 1. Health Inequity Reduction in Thailand On the Way Toward Healthy Public Policy Cholnapa ANUKUL Social Inequity Reduction Network (SIRNet), Thailand 274 Collaborative Governance for Health Equity and Healthy Public Policies Saturday, July 19, 2014: 8:30 AM-10:20 AM Room: F206 RC15 Sociology of Health
- 2. Outline Background Health & Health Equity Situation in Thailand SIRNet: integrated intersectoral action Objectives Methods Findings Conclusion
- 3. Country Background Total population (2012) 66,785,000 Gross national income per capita (PPP international $, 2012) 9,280 Life expectancy at birth m/f (years, 2012) 71/79 Probability of dying under five (per 1 000 live births, 2012) 13 Probability of dying between 15 and 60 years m/f (per 1 000 population, 2012) 182/90 Total expenditure on health per capita (Intl $, 2012) 386 Total expenditure on health as % of GDP (2012) 3.9 Latest data available from the Global Health Observatory 0.6% Unemployment rate 16% Percentage of women in Thai Parliament 3.4% Inflation rate 4Million households affected by drought per year 55Average age of rice farmer
- 5. Social Determinants of Health Inequities A Conceptual Framework for Action on the Social Determinants of Health, World Health Organization, 2010 Governance Macroeconomic Policies Labor market structure Social Policies Labor, Housing, Land Cultural & Societal Values Socioeconomic & Polictical Context Socioeconomic position IMPACT on equity in health and well-being STRUCTURAL DETERMINANTS Differential social, economic and health Consequences Differences in Exposure Differences in Vulnerability Health System INTERMEDIARY DETERMINANTS Public Policies Health, Education Social Protection Social Class Gender Ethnicity (Racism) Education Occupation Income
- 6. National Health Commission Office (NHCO) Social Research Institute, Chula University International Health Policy Program (IHPP) Health System Research Institute (HSRI) Thai Health Promotion Foundation Social Inequity Reduction Network
- 7. Policy Mobilization Researches Core Team & Steering Committee Social Awareness Working Model: Integration
- 9. Public Policy Process Agenda Proposal Agenda Selection Conceptual Framework Evide nces Social Workers Conceptual Framework Draft Resolution Agenda Circulation among constituencies National Health Assembly 2000 members from 182 constituencies, experts, int’l representatives, interested persons and observers
- 10. Mechanism • Various kind of Working Groups (young researchers, youth facilitators, ngos) Knowledge • Theories: health equity, SDH and social justice in Thai context • 4 health thematic reports (gender equality, reproduction health, informal labor) • 16 social research reports and 3 social inequity situation review reports • Various policy recommendations Policies • Participatory Occupational Health Policy in Nation Level Social Awareness • Health Equity & Social Justice Agenda Setting • 2 Health & Social Equity Annual Reports 3 Years - Collaborative Results
- 11. Objectives Achievement Leverage Need Better Intersectoral Collaboration Working Model
- 12. Methodologies Observations and Lesson Learned Interviews Thirapandhu’s 3 levels of Integrations Basics: philosophy, value, meaning Process: working process, structure Output: output, outcome, impact CSDH’s 5 level of participation Information, consultation, engagement, co-ordination, empowerment Longwe’s 5 levels of empowerment Social welfare, equality of access, problem awareness, participatory policy mobilization in all levels, power control
- 13. Findings: Collectiveness Community of commitment of interdisciplinary researchers Consensus strategy for social health equity Equity lens: monitoring of public policies Fair equality of opportunity The greatest benefit to the least-advantaged members of society Well-being of marginalized population groups complete social health equity Equity policy always includes the least-advantaged members of society
- 14. Findings: Integration Gaps Knowledge and Action Burawoy’s 4 types of knowledge: theory, critics, policy, communication Participatory action researches without health and equity lens Thematic reports without participation process Conceptual framework and Strategy based on action researches results Research linkage: health and social science researchers Different views of evidence-based research Need of health status database / health inequity monitoring indicators Professional practices: academics, social workers and policy makers Dialogues and Actions Inter-organizational Collaboration: Skills and project works integration
- 15. Findings: Empowerment Needs Dialogues in all levels Academics, social workers, communities, networks, organizational leaders, society Healthy public policy process Leverage of participatory action researches to public policy process Leadership skills Collective and transformative Leadership
- 16. Conclusion Challenges Strengthening collective resources Closing the gaps Supply the needs New collaborative working models Advanced integration level More participation
- 17. •Propose health policies and strategies Network of members and communities •Management of the Health Promotion Fund •Management of the National Health Security Fund • Health related operation Local Administrative Organizations • National Health Statute Other Networks •Creation of knowledge สช. ปรับปรุง พ.ย. 50 • Health Assembly Parliament CabinetNESAC NESDB HSRI Ministry of Public Health and other ministries relevant to health THF NHSO อปท.Regional Agencies NHC/NHCO Web of the National Health System Mechanism Professional and Academic Network Press and media networks HA
Editor's Notes
- Good morning, Ladies and Gentleman. It’s my pleasure to attend the 18th ISA World Congress of Sociology in Yokohama. I would like to share my experience as the main co-ordinator of the Social Inequity Reduction Network (SIRNet) on “Health Inequity Reduction in Thailand: On the way toward healthy public policy” Recently, health inequity initiatives introduced by the World Health Organization emphasizes actions on social determinants of health with collaboration across research disciplinary and organizational boundaries in relatively innovative approach. The recent tackle of health inequity initiatives in Thailand, SIRNet – Social Inequity Reduction Network, illustrates a good instance of this kind of effort. This paper describes the development of the three years collaborative projects among five organizations in Thailand and its attempt to address social determinants of health and formulate a set of effective policy recommendations based on real-world problems in Thai context.
- Before jumping to what have happened in Thailand, I would like to start with the background of this work, with the overview of health and health equity situation in Thailand. This will give you an understanding of a health landscape of Thailand and a background of how we can apply an integrated and intersectoral action to health. Later on I will use SIRNet which was established in as an example and pilot model of inter-organization collaboration for mobilization of healthy public policies. Last but not least, in this kind of conference, sharing a best practice alone is worthless. Challenges we have faced is worth sharing and combating together.
- This Report shows that Thailand has met several MDGs targets, i.e. poverty and hunger, universal primary education, gender equality, fight against HIV/AIDS, access to clean drinking water and sanitation, improving the lives of people in slums, and global partnership. More strenuous effort is needed to achieve sustainable development and to address the country’s ambitious MDG+ targets on child mortality and maternal health in remote areas, all of which requires relentless engagement from all parties.
- Recently, health inequity initiatives introduced by the World Health Organization emphasizes actions on social determinants of health with collaboration across research disciplinary and organizational boundaries in relatively innovative approach. The recent tackle of health inequity initiatives in Thailand, SIRNet – Social Inequity Reduction Network, illustrates a good instance of this kind of effort. This paper describes the development of the three years collaborative projects among five organizations in Thailand and its attempt to address social determinants of health and formulate a set of effective policy recommendations based on real-world problems in Thai context.
- The study examines working models across academic and organizational boundaries focused on researches linkage, professional practices, communities and networks actions, leadership skills and healthy public policy process.
- The study examines working models across academic and organizational boundaries focused on researches linkage, professional practices, communities and networks actions, leadership skills and healthy public policy process.
- Many people claim that research hardly respond the need of the society. The process of NHA shows that the research have to go in parallel with the public interest and sometime do educate the public. Agenda proposed are screened out with 4 criteria; no public interest, not severe impact enough, not important enough and unlikely to drive it into policy. From 52 to 8 agenda items. Each agenda has to develop a background paper and draft resolution. Researchers or academic people will come to help this step. When we have the first draft of background paper and draft resolutions, they are disseminated to our networks for comments twice before bringing them to discuss at the NHA. Last year there are many resolutions that have strong research support such as asbestos. The research reveals that asbestos causes Thailand consume asbestos the 2nd largest consumption and people consume average as 3 kilograms/person/year. Currently Thailand has no specific law to control the use of asbestos. The general chemical substance law is applied to all types of chemical substances. Therefore, workers in the construction, insulation and brake lining industry still face significant asbestos exposure on the job. The employers are not concerned the occupational safety and health of the workers, in spite of its hazard which causes the lung cancer, pleura cancer, peritoneal cancer and pleura thickening. The evidence shows construction sites and factories has no regulation to prohibit smoking and drinking water at the workplace with full of asbestos dust, or no appropriate uniform and qualified respiratory protection equipment provided
- While a wide-ranging of information collected and knowledge emerged from broad action researches, the academic community states the tendency to the arguments of theories of justice and the consensus of strategy. Therefore, although the strong conceptual framework of social health equity for Thai society is established, the community based policy recommendation is rarely analyzed and formulated by researchers. Although the collaborative programs are initiated among the organizational leaders, the implementation process includes only few people into the working group. Hence, the change seems to be presented in individual and network level, but not in the organizational level. We need effective models of collaboration to bridge various gaps between researchers, social workers and policy makers.
- So, in Thailand we don’t have only the Ministry of Public Health in charge of everything on health. We do have many organizations and networks at a national and local level work hand in hand with the Ministry. Besides, the health organizations also work closely with NESDB or the National Economic and Social Development Board.