Identifying challenges and barriers in the delivery of primary healthcare at the district level: a study in one Thai province.
In 2001, the universal health coverage policy was adopted by Thailand with primary healthcare (PHC) as the major focus of the policy. In order to understand the structural and institutional factors affecting the implementation of PHC in rural Thailand, a qualitative study, utilising individual interviews with national and provincial policy decision makers, community health directors, heads of hospital primary care units, chiefs of district health offices, heads of health centres and community representatives, from one rural province was undertaken. Findings showed that the sustainability of PHC service provision under the administration of community hospitals is problematic as barriers exist at the policy and operational levels and access to PHC for all citizens may not be achieved until these barriers are addressed. Furthermore, although PHC needs to be acknowledged and implemented by all stakeholders within the health industry and government, the roles and responsibilities of the stakeholders in health services management at the district level need to be clarified.
Faculty of Public Health, Naresuan University, Thailand.
Phudit
P
Tejativaddhana
David
D
Briggs
John
J
Fraser
Victor
V
Minichiello
Mary
M
Cruickshank
D000328:Adult; D003151:Community Health Centers / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006740:Hospital Administrators; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D012041:Regional Medical Programs / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration; D013785:Thailand; D019472:Universal Health Insurance / Q000458:organization & administration