Financing Health Promotion: A Case Study on Thailand

Abstract

Objectives: To review the burden of diseases resulted from chronic non-communicable diseases and its trend between 1999 and 2004, financing health care and financing health promotion and disease prevention, with the experiences of innovative financing health promotion and policy makers views on innovative financing health promotion. Methods: The study applied several methodological approaches including literature reviews, interviews of key informants, and primary survey through self administered mail questionnaire to key stakeholders in and outside the Ministry of Public Health. Results: In view of consistent increasing trend of burden of diseases resulted from chronic NCD, the economic and health impact of NCD is far-reaching. The resources available for health promotion is far too low compared to curative services, most of this funding went to personal clinical preventive and health promotion services and little for public interventions. The resources mobilized by the Thai Health Promotion Foundation through 2% levy on tobacco and alcohol consumption, is far too small, though plays a significant catalytic role in mobilizing public awareness toward major killers such as tobacco, alcohol and road traffic injuries, to serve as a strong leverage to halt and reverse the trend of chronic NCD. Two major stakeholders, Ministry of Finance responsible for Civil Servant Medical Benefit Scheme (CSMBS) and the Social Security Office responsible for Social Health Insurance have a tunnel view, and yet to be convinced to invest more in health promotion for their beneficiaries. Recommendations: Three policy messages were proposed, (1) Increase level of financing health promotion and primary, secondary prevention of disease through significant Increase in MOPH annual budget on health promotion and amendment of CSMBS regulation and Social Security Act to incorporate health promotion and disease prevention as their mandates; (2) Increase value for money of conventional clinical prevention and health promotion services through the application of a recent publication on Disease Control Priority for Developing Countries by Jamaison et al (2006), and improve program effectiveness based on evidence; (3) Sustain and accelerate the work of Thai Health Promotion Foundation (THPF) through increase levies from 2% to 5% of tobacco and alcohol consumption and diversify THPF portfolio to cover cost effective interventions. Portfolio and social mobilization by THPF has to be guided by sound evidence.