Thailand
Although the HRH policy and governance milestones of 1990–2009 were clearly influential in Thailand's success, critical decisions were also made in the 1970s. Such decisions continue to exert an influence 40 years later.46,47 Policies on the provision and financing of health services are pro-poor.48 Primary health care at the district level was made possible through a comprehensive health workforce policy developed in 1995 that centred on retention and professional satisfaction to encourage rural deployment,49 as well as through policy revisions introduced in 1997 and 2005. Several policies adopted from 1994 to 2009, emphasizing continuous reflection and improvement, have aimed to improve quality: development and strengthening of professional councils, regulation over curriculum standards and quality of training institutes, worker licensing and re-licensing. The establishment of the Healthcare Accreditation Institute in 2009 has consolidated these quality efforts. Post-service training in advanced practice for nursing cadres, such as nurse practitioners, intensive care unit nurses and anaesthesiology nurses, plays a significant task shifting role. Policy has centred on strengthening local and district health systems as a strategy to translate policy into practice and improve equity.
The attention to equity is particularly important. Although in 1991–2009 the overall increase in nurses (210%) and physicians (186%) outstripped population growth (13%), the accessibility dimension improved even more. For example, the ratio of nurses to people increased from 1:7.2 to 1:3.4 in 1991–2009. Regional variations in workforce deployment between the least affluent north-eastern region and affluent areas such as Bangkok have also been substantially reduced.
ThailandAlthough the HRH policy and governance milestones of 1990–2009 were clearly influential in Thailand's success, critical decisions were also made in the 1970s. Such decisions continue to exert an influence 40 years later.46,47 Policies on the provision and financing of health services are pro-poor.48 Primary health care at the district level was made possible through a comprehensive health workforce policy developed in 1995 that centred on retention and professional satisfaction to encourage rural deployment,49 as well as through policy revisions introduced in 1997 and 2005. Several policies adopted from 1994 to 2009, emphasizing continuous reflection and improvement, have aimed to improve quality: development and strengthening of professional councils, regulation over curriculum standards and quality of training institutes, worker licensing and re-licensing. The establishment of the Healthcare Accreditation Institute in 2009 has consolidated these quality efforts. Post-service training in advanced practice for nursing cadres, such as nurse practitioners, intensive care unit nurses and anaesthesiology nurses, plays a significant task shifting role. Policy has centred on strengthening local and district health systems as a strategy to translate policy into practice and improve equity.ความสนใจในหุ้นมีความสำคัญอย่างยิ่ง แม้ว่าในปี 1991-2009 เพิ่มโดยรวมพยาบาล (210%) และแพทย์ (186%) outstripped อัตราการเติบโต (13%), มิติถึงดีขึ้นยิ่งขึ้น ตัวอย่าง อัตราส่วนของพยาบาลคนเพิ่มขึ้นจาก 1:7.2 1:3.4 ในปี 1991-2009 ภูมิภาคการเปลี่ยนแปลงในการใช้งานแรงงานระหว่างภาคตะวันออกเฉียงเหนือแต่ละอย่างและแต่ละพื้นที่เช่นกรุงเทพฯ มียังลดลงมาก
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