การมีส่วนร่วมของประชาชนในการอภิบาลระบบหลักประกันสุขภาพแห่งชาติ

Kamonwan Kiewnin; Somtanuek Chotchoungchatchai; Kanang Kantamaturapoj; Aniqa Islam Marshall; Walaiporn Patcharanarumol; Viroj Tangcharoensathien

Authors

Kamonwan Kiewnin International Health Policy Program, Ministry of Public Health, Thailand
Somtanuek Chotchoungchatchai International Health Policy Program, Ministry of Public Health, Thailand
Kanang Kantamaturapoj Faculty of Social Sciences and Humanities, Mahidol University, Thailand
Aniqa Islam Marshall International Health Policy Program, Ministry of Public Health, Thailand
Walaiporn Patcharanarumol International Health Policy Program, Ministry of Public Health, Thailand
Viroj Tangcharoensathien International Health Policy Program, Ministry of Public Health, Thailand

Keywords:

citizen participation, governance, Thailand, Universal Coverage Scheme

Abstract

Citizen participation in policy decision making process is a key component of good governance. The National Health Security Act (NHSA) 2002 deliberately provides legal space for civic participation in governing the Universal Coverage Scheme (UCS). Articles 13(4) and 48(8) mandate the representation of civil society organizations (CSO) as members in the National Health Security Board and the Quality and Standard Board. This paper aimed to analyze the processes and outcomes of citizen indirect participation in Thai UC Scheme through CSO representation in UCS governance. Qualitative research method was employed. Literature review and in-depth interviews with 10 informants were conducted.

The study found that CSO representatives actively participated through three functions of the UCS governance: 1) participating in decision making and governance through representation as committee members, 2) supporting the decision making process through representation as sub-committee members appointed by the two committees, and 3) interlinking between CSO representatives in the two committees and various sub-committees and the broad-based CSO networks at grass root level, for which problems and concerns are seamlessly transmitted from local to policy decisions (at UCS governance) which ensure effectiveness of the UCS. The outcomes of CSO contributions included successful expansion of services in the benefits package and building public ownership of the UCS through surveillance, protect, promote and support the implementation of the UCS for the benefit of people. Citizen participation, which has advanced beyond legislative provision, was the result of policy space that allowed citizens to indirectly engage (through CSO representative) in the governing body and the active citizenship has maximized the use of policy space provided by the Law.

References

Primary Health Care Division, Department of Health Service Support. The evolution of primary health care in Thailand (1978–2010). Nonthaburi: Veterans Organization Printing Office; 2014. (in Thai)

McCawley P. Governance in Indonesia: some comments. Tokyo: Asian Development Bank Institute, Discussion Paper No. 38. 2005.

Limsawart W. National Health system governance of Thailand after promulgation of the National Health Act B.E. 2550: framework, development and proposal for improvement. Journal of Health Systems Research 2009;3(3):419-33. (in Thai)

Storeng KT, Puyvallee´ AB. Civil society participation in global public private partnerships for health. Health Policy and Planning 2018;33(2018):928–36.

Chompunth C. Good governance and public participation in decision-making process of development project. Journal of Environmental Management 2013;9(1):85-106. (in Thai)

World Bank. Worldwide governance indicators [internet]. Washington, DC: World Bank; 2019 [cited 2019 Dec 6]. Available from: http://info.worldbank.org/govern.ance/wgi/.

Kantamaturapoj K, Kulthanmanusorn A, Witthayapipopsakul W, Viriyathorn S, Patcharanarumol W, Kanchanachitra C, et al. Legislating for public accountability in universal health coverage, Thailand. Bull World Health Organ 2020;98(2):117-25.

National Health Security Office. People’s Participation of the universal coverage scheme (UCS) in Thailand. 2019.

National Health Security Act, B.E. 2545 [internet]. Bangkok: Government of Thailand; 2002. [cited 2019 Oct 5]. Available from: http://web.krisdika.go.th/data/law/law2/%CB29/%CB29-20-2545-a0001.pdf. (in Thai)

International Association for Public Participation. Spectrum of public participation [Internet]. 2018 [cited 2019 Dec 6]. Available from: https://cdn.ymaws.com/www.iap2.org/resource/resmgr/pillars/Spectrum_8.5x11_Print.pdf.

Sribuaiam K, Vorathepputipon T, Sukreeyabongse P, Sirorot P, Burikul T, Jarusombat S. et al. Guidelines for enhancing participatory democracy under the Constitution of the Kingdom of Thailand 1997: problems, obstacles and solutions. Bangkok: Thummada Press; 2002. (in Thai)

National Health Security Office. Announcement of the National Health Security Office: Registered private organizations for exercising the right to select representatives for committee members under the National Health Security Act (Mar 16, 2007). (in Thai)

The Secretariat of the Cabinet. Extension of renal replacement therapy (RRT) for end-stage renal disease in the universal health coverage scheme [internet]. 2007 [cited 2019 Nov 3]. Available from: https://cabinet.soc.go.th/soc/Program2-3.jsp?top_serl=214283&key_word=%E4%B5&owner_dep=&meet_date_dd=30&meet_date_mm=10&meet_date_yyyy=&doc_id1=&doc_id2=&meet_date_dd2=&meet_date_mm2=&meet_date_yyyy2=. (in Thai)

Act Amending the Criminal Procedure Code (NO. 11), B.E. 2535 [internet]. Bangkok: Government of Thailand 1992 [cited 2019 Oct 10]. Available from: https://www.krisdika.go.th/librarian/get?sysid=305514&ext=pdf. (in Thai)

The minutes of the National Health Security Committee Meeting 2/2015 2015 February 9 at 13.30-16.30, venue: Dr.Sanguan Nittaya Ramphong meeting room, National Health Security Office. (in Thai)

The minutes of the National Health Security Committee Meeting No. 2/2012 2012 January 24 at 14.00–16.30, venue: Dr. Sanguan Nittaya Ramphong meeting room, National Health Security Office. (in Thai)

National Health Security Office. Order of the National Health Security Committee No. 4/2019: Appointment of Sub-committee members under the National Health Security Committee, (May 16, 2019). (in Thai)

The minutes of the National Health Security Committee Meeting 3/2015, 2015 March 2 at 13.30-16.30, venue: Dr.Sanguan Nittaya Ramphong meeting room, National Health Security Office. (in Thai)

Announcement of the Quality and Standard Control Board: Rules procedures and conditions for selection and appointment of Subcommittee for the Quality and Standard Control Board in sub region 2019, (Oct, 10 2019,). (in Thai)

The Quality and Standard Control Board. National Health Security Office. The performance summary of the Quality and Standard Control Board, the 1st term (2003-2007), the 2nd term (2007-2011). (in Thai)

Sirisinsuk Y. A study on access to health promotion services of members in three main schemes under the health promotion benefits of Universal Coverage Scheme. Final report. Bangkok: Indyconsumer; 2017. (in Thai)

Sadan, E. Empowerment and community planning: theory and practice of people-focused social solutions. Tel Aviv: Hakibbutz Hameuchad Publishers; 1997.

Enjolras B, Steen-Johnsen KJCS, the Third Sector, Governance SE, Democracy. Democratic governance and citizenship. In: Laville J-L, Young DR, Eynaud P, editors. Civil society, the Third Sector and social enterprise: governance and democracy. New York: Routeledge; 2015. p. 191-204.

World Health Organization. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva: WHO Document Production Service; 2017.