---Thailand has made impressive achievements in health in recent decades. The country, once characterized by poor health indicators and a very weak health infrastructure, especially at the local level, had achieved universal health coverage (UHC) by 2002. Over the years health service utilization increased, financial risk protection mechanisms improved and greater equity in health outcomes was attained.
How did these changes come about?
---Several factors have contributed to Thailand’s improved health outcomes in recent decades. Among them are overall economic growth and improved literacy. The launching of the Expanded Programme on Immunization in 1977, prompted by low immunization coverage and the lack of an effective primary health-care (PHC) system, is another.
Most importantly, a functioning PHC system was developed at the district level to achieve equitable access to health services by all.
Simultaneously, financial risk protection mechanisms were improved to keep people from experiencing financial hardship and prevent households from becoming impoverished on account of the use of health services.
Two synergistic policies designed to improve access to health services were at the heart of efforts to develop the Thai health system: one was to increase the availability of functional services and the second was to reduce financial barriers to health service access. In this paper we examine the key actions undertaken in these areas and the main lessons learnt from the Thai experience. We review Thailand’s socioeconomic development and its health achievements and progress in health service coverage, with a focus on how the health system and the health workforce were developed and how both have contributed to a functioning PHC system – a critical element in attaining UHC and equitable access to health services.