Policy Evaluation of the “Thais Free from Non-Communicable Diseases(NCDs)” Initiative : A Case Study in Chonburi Province, 2025

Abstract

Non-communicable diseases (NCDs) remain a major public health challenge, particularly in the Eastern Economic Corridor (EEC) of Thailand, where rapid industrialization, high labor mobility, and lifestyle constraints limit effective health management. Despite the continuous implementation of the “Thais Free from NCDs” policy, there remains a lack of empirical evidence at the local level regarding the gap between service coverage and health outcomes. This study aimed to evaluate the implementation of this policy in Chonburi Province. A Mixed-Research method was employed under a health policy evaluation framework, integrating formative and summative evaluations to examine both implementation processes and outcomes. The study covered 33 subdistricts across 11 districts. Participants included 44 stakeholders and 148 patients. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through thematic analysis. The findings revealed that the policy was effectively implemented at the local level, with a shift from hierarchical governance to network-based collaboration, where social capital played a key role in facilitating coordination. However, a critical systemic paradox was identified: despite achieving high service coverage and meeting key performance indicators (100%), population health outcomes did not significantly improve. This reflects a gap between knowledge, attitudes, and health behaviors, alongside limitations in fragmented data systems and service models that do not align with the working lifestyles in industrial areas. These findings suggest that policy success cannot rely solely on increasing service coverage but depends on the system’s capacity to integrate service delivery, population behavior, and health information into meaningful health outcomes. Therefore, proactive and flexible service models-such as after-hours services, workplace-based interventions, and digital health monitoring-should be developed, alongside integrated data systems, to enhance policy effectiveness in the EEC context.