Key messages
• Thailand has outperformed many other countries in improving health
outcomes at relatively low per capita health spending. Interventions essential
to child survival and maternal health, notably free antenatal care, skilled
birth attendance, family planning, and immunization, reached universal
coverage by the 1990s, and all health Millennium Development Goals
(MDGs) were achieved by the early 2000s.
• These services are provided mainly by the public sector – in primary health
care centres and district hospitals geographically accessible to the rural poor.
Longstanding policies of government bonding and rural deployment of all
graduates of the health-related professions have been critical to the successful
expansion of district health systems.
• Financial risk protection, introduced initially to protect the poor and
vulnerable, was subsequently extended to achieve universal coverage of the
entire population by 2002.
• Nine successive five-year national health plans ensured continuity over four
decades of health system development. Generations of charismatic leaders
and highly influential technocrats and medical leaders inside and outside of
the Ministry of Public Health (MOPH), sharing a common vision of
improving the health of the poorest, ensured that pro-poor, pro-rural health
policies remained the priority of health system development.
• Royal Health projects, promoted by the Royal Family, contributed to
comprehensive rural development, not only improving health but also
empowering rural communities.
• Other contributing factors to Thailand’s good health outcomes have been
economic growth and poverty reduction, a high level of female literacy and
a fall in the gender literacy gap.
• Thailand has developed the institutional capacity to generate evidence to
inform policy, which puts it in a good position to deal with current and
future health challenges.