title: Analysis of health promotion and prevention financing mechanisms in Thailand.
abstract: In the transition to the post-2015 agenda, many countries are striving towards universal health coverage (UHC). Achieving this, governments need to shift from curative care to promotion and prevention services. This research analyses Thailand's financing system for health promotion and prevention, and assesses policy options for health financing reforms. The study employed a mixed-methods approach and integrates multiple sources of evidence, including scientific and grey literature, expenditure data, and semi-structured interviews with key stakeholders in Thailand. The analysis was underpinned by the use of a well-known health financing framework. In Thailand, three agencies plus local governments share major funding roles for health promotion and prevention services: the Ministry of Public Health (MOPH), the National Health Security Office, the Thai Health Promotion Foundation and Tambon Health Insurance Funds. The total expenditure on prevention and public health in 2010 was 10.8% of the total health expenditure, greater than many middle-income countries that average 7.0-9.2%. MOPH was the largest contributor at 32.9%, the Universal Coverage scheme was the second at 23.1%, followed by the local governments and ThaiHealth at 22.8 and 7.3%, respectively. Thailand's health financing system for promotion and prevention is strategic and innovative due to the three complementary mechanisms in operation. There are several methodological limitations to determine the adequate level of spending. The health financing reforms in Thailand could usefully inform policymakers on ways to increase spending on promotion and prevention. Further comparative policy research is needed to generate evidence to support efforts towards UHC.
authors.affiliation: Department of Public Health, Graduate School of Medicine, Juntendo University, Japan.|Department of Health System Governance and Financing, World Health Organization, Geneva, Switzerland.
authors.forename: Akihito
authors.initials: A
authors.lastname: Watabe
authors.affiliation: International Health Policy Program, Nonthaburi, Thailand.
authors.forename: Weranuch
authors.initials: W
authors.lastname: Wongwatanakul
authors.affiliation: Department of Non-Communicable Diseases and Environmental Health, South East Asia Regional Office, World Health Organization, New Delhi, India.
authors.forename: Thaksaphon
authors.initials: T
authors.lastname: Thamarangsi
authors.affiliation: International Health Policy Program, Nonthaburi, Thailand.
authors.forename: Phusit
authors.initials: P
authors.lastname: Prakongsai
authors.affiliation: Department of Public Health, Graduate School of Medicine, Juntendo University, Japan.
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Yuasa
mesh_terms: D005380:Financing, Government / Q000706:statistics & numerical data; D006291:Health Policy; D006293:Health Promotion / Q000191:economics*; D061889:Healthcare Financing; D006801:Humans; D011634:Public Health / Q000191:economics*; D013785:Thailand; D019472:Universal Health Insurance / Q000191:economics
keywords: economic analysis; evaluating health promotion; health policy analysis; population health; sustainable development