systems supported the effective delivery of these interventions. The fourth
section examines how and why over time the health system’s development and
other wider policy interventions were possible. Finally, the contributions of
other sectors and the sociopolitical and cultural factors influencing health gains
are assessed.
■ Better health?
Between 1975 and 2005, life expectancy in Thailand increased markedly, with
female life expectancy outpacing male (Figure 7.3) due to the impact of AIDS
in the 1990s. The 1999 and 2004 studies on the burden of disease showed that
HIV is the leading cause of disability-adjusted life years (DALYs) lost for both
men and women14.
Infant mortality has fallen sharply in Thailand, from a rate of 68.0 per 1000 live
births in 1970, to below 20 in 1991, reaching under 10 in 2006 (Figure 7.4). The
urban–rural gap has decreased, although rural infant mortality was still 20%
higher than urban infant mortality in the early 2000s. Likewise, a consistent
reduction in under-5 mortality was observed, although it slowed in the mid-
systems supported the effective delivery of these interventions. The fourthsection examines how and why over time the health system’s development andother wider policy interventions were possible. Finally, the contributions ofother sectors and the sociopolitical and cultural factors influencing health gainsare assessed.■ Better health?Between 1975 and 2005, life expectancy in Thailand increased markedly, withfemale life expectancy outpacing male (Figure 7.3) due to the impact of AIDSin the 1990s. The 1999 and 2004 studies on the burden of disease showed thatHIV is the leading cause of disability-adjusted life years (DALYs) lost for bothmen and women14.Infant mortality has fallen sharply in Thailand, from a rate of 68.0 per 1000 livebirths in 1970, to below 20 in 1991, reaching under 10 in 2006 (Figure 7.4). Theurban–rural gap has decreased, although rural infant mortality was still 20%higher than urban infant mortality in the early 2000s. Likewise, a consistentreduction in under-5 mortality was observed, although it slowed in the mid-
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