An Evaluation of Management System of the National Health Examination Survey in Thailand

Abstract

In Thailand, a series of National Health Examination Surveys (NHES) have been conducted every five years since 1991. The NHES employed two approaches for data collection including basic physical measurements and structured interviews. The NHES exclusively provided objective information on health status and health risks of the population which cannot be obtained from other sources. Consequently, this information has been used for development of health promotion and disease prevention policies as well as for monitoring health indicators and policies. Throughout 25 years of the NHES, no systemat­ic evaluation of the survey’s management has been conducted. The present study evaluated the NHES management system in four areas covering the role of agencies responsible for conducting the NHES; resources used for conducting the NHES; database management and the utilization of the NHES data; and ethical issues related to access to the NHES database with the aim to provide policy recommenda­tions for future developments. The present study collected data through document reviews from Sep­tember 2016 to January 2019 and in-depth interviews with 26 people including personnel in funding agencies, survey managers, researchers who were part of survey networks and potential data users from December 2016 to April 2017. The scope of literature review and questions for in-depth interview includ­ed the NHES I-V.

The present study found that NHES I-V involved many agencies in different capacities such as re­sponsible agencies for conducting and managing the survey, funding agencies, and steering committees. There were frequent changes of agencies responsible for conducting NHES reflecting the lack of long-term policies regarding the implementation of NHES. Every NHES reported budget constraints, yet there re­mained neither budget allocation from the government in the long run nor long-term funding agencies. Hence, the agencies implementing NHES had to propose budget request for each survey. These limitations inhibited long-term capacity building on survey practitioners and institutionalization. Furthermore, policies and guidelines for the utilization of NHES data and other information were vague. Although there was a guideline drafted in the IV NHES, the guideline has not been put into practice making it difficult for re­searchers outside the NHES networks in getting access to NHES database and specimens, hence NHES data have been under-used. On the other hand, some health issues investigated by the NHES might be duplicated with those of other health surveys conducted by the National Statistical Office or other higher education institutes granted by the same funding agencies as the NHES. Therefore, it is highly suggested that relevant authorities should consider the integration of health surveys at the country level in all aspects.