สำนักงานหลักประกันสุขภาพแห่งชาติ (สปสช.)
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News And Events

Combat NCDs with resilient healthcare

Bangkok 29 January 2019—When Sakaoduen Numseangkul became a doctor at Khonburi Hospital in 1994, non-communication diseases (NCDs) was already presented in the local population.

 

Based in Nakhon Ratchasima Province, she was in charge of the hospital’s diabetes unit, with little success in reducing prevalence of the disease.

“I watched many patients suffered. But it was also the suffering for doctors and health staff who couldn’t improve the conditions of patients,” she recalled.

The factors behind chronic illnesses were ranged from the overcrowded ward that discouraged patients from visiting the hospital to social and economic circumstances that affected unhealthy behaviors of patients.

Without getting support from the central government, Sakaoduen and her colleague set their own mission to combat the NDCs.

In 2005, three years after the launch of Universal Healthcare Coverage (UHC) in Thailand, her team began studying the NCDs reduction programs of other hospitals. They joined the training, conducted gap analysis with local communities and improved their disease prevention and screening.

They trained communicational skills to hospital staff, who then pursued patients to quit unhealthy behaviors and have continual treatment. Patient groups were set up, with local community members who could watch over the health conditions of each other.

Spoke at a Tuesday (29 Jan 2019) panel ‘Resilient Health System and NCDs: A case of Thailand’ at the sideline of Prince Mahidol Award Conference 2019, Sakaoduen said her team’s endeavor yielded reduction of NCDs prevalence in local communities eventually.

This achievement was raised as an example of a successful resilient health system---which health staff can respond to local health problems without depending on the mercy of the central government.

“Resiliency is a foundation of sustainability in the health system,” said Dr Rajata Rajatanavin, a former Public Health Minister. “It’s [the practices] to cope with internal and external challenges and allow health system to be recovered.”

Though the UHC was initiated in Thailand since 2002, he said, Thai health system is facing several challenges in recent years including instable politics, an economic downturn, and aging society.

Premature death due to NCDs is another major challenge. According to Public Health Ministry’s data, NCDs killed 320,000 people annually. It’s the leading cause of death in Thailand, accounting 75% of all deaths.

Somsak Chunharas, President of the National Health Foundation, said that health staff was one of the major actors who could cultivate a resilient health system. In the Thai context, he has seen some good characteristics in the health system that build up resiliency.

For example, there are some certain values such as favoring for the public mind that keeps health staff developing their system for the benefits of patients. Some health staff has good leadership. Some hospital operators create enliven environment that encourages empowerment of health staff. They can obtain autonomy at a certain level, which allows them to break through financial constraint. They also maintain the long-term process of capacity building.

“If you can identify what works for resilient healthcare, you can build up resiliency in a long run. It will not only make the UHC successful. It can also cope with new challenges," said Dr Somsak.

…………………29 January 2019