Universal Health Coverage in Thailand: Achievement and Experiences Learned

Doshmangir L^1,2 (MSc, PhD), Rashidian A^3,4 (MD, PhD), Bazyar M³* (MSc, PhD Condidate)

¹ Department of Health Services Management, Iranian Center of Exellence in Health Management,

Tabriz University of Medical Sciences, Tabriz, Iran

² Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

³ Department of Health Management and Economics, Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

⁴ Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran

Original Article

Received: 27 Apr 2015, Accepted: 25 Jul 2015

Abstract

Introduction: Universal health coverage (UHC) means all people can use preventive, curative, rehabilitative and palliative health services whenever they need them, without exposing to financial hardship. Achieving the UHC is an aspiration for many countries. Thailand is an examplar of such a successful country in achieving the UHC. The aim of this study was to investigate the process of achieving the UHC in Thailand and the experiences learned from this national movement.

Methods: We used the health policy triangle framework (Walt & Gilson model) to analyze the UHC in Thailand. Documents, including official published and unpublished reports, journal articles, PowerPoint slides, and news were selected from related websites including the World Bank and WHO. Additional data were gathered from key health policymakers involved in the UHC in Thailand via email. Data from related discussions were included as well.

Results: The UHC implementation resulted in equity and financial protection in Thailand. The UHC resulted in more accessibility to essential health services, equity in health service utilization, and less impoverishment due to the use of health services. The convergence of three facilitators caused achievement of the UHC in Thailand including political commitment, civil society mobilization and technical knowledge. 

Conclusion: Thailand's political commitment to the full implementation of the UHC and financial feasibility made the UHC achievable. Using closed-end payment methods -aiming for total health care expenditures constraint-, economic growth, and focusing on primary care were among other reasons which helped Thailand to achive the UHC. Lessons learned from Thailand's UHC should be used in low- and middle-income countries.

Key words: universal health coverage, policy analysis, Thailand

Please cite this article as follows:

Doshmangir L, Rashidian A, Bazyar M. Universal Health Coverage in Thailand: Achievement and Experiences Learned. Hakim Health Sys Res 2015; 18(3): 217- 232.