Assessment of health services under the universal coverage scheme for rural people in Thailand | |
| Author | Boontawee Teamvan |
| Call Number | AIT Thesis no.RD-07-18 |
| Subject(s) | Public health--Thailand Rural health services--Thailand |
| Note | A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Regional and Rural Development Planning |
| Publisher | Asian Institute of Technology |
| Abstract | The research assessed health services under the universal coverage scheme (UCS) for rural people in Northeastern Thailand. The main objectives of the study were: to describe the structure, components and function of the UCS; to study health service utilization of rural people on under the UCS; to obtain feedback of the rural people on health service quality and benefit gained under the UCS; to identify problems encountered and needs as regards the UCS; and to provide recommendations to make the UCS more beneficial for the rural people. The structure, components and function of the scheme encompassed policy, resources and organization. Policy covered its objectives, entitled beneficiaries, registration system and benefit packages. Resources incorporated existing health infrastructure, health personnel, medical supplies and equipment, and per capita budget allocation. Organization dealt with responsibilities of PCUs and contracted units, along with coverage of population under the UCS. Health service utilization captured frequency and reasons for using out-patient care, and disease prevention and health promotion provided under the scheme. The research was conducted in Lamduan district, Surin province, in Northeastern Thailand using a survey with a total of 271 respondents as a prime method for data collection. Also, eight beneficiaries were gathered for a focus group. Moreover, five health personnel were interviewed as key info1mants. The research primarily focused on quantitative analysis but qualitative analysis was also applied. Main findings of this research showed that mistargeting of the UCS beneficiaries brought about benefit leakage; fee at the PCU level was flexible; and health personnel had usually violated villagers' right to choose their registered PCU and CUP. Medical supplies and equipment accessible at a PCU were modem enough to provide primary care however their shortage and contamination were problems. Its PP budget was misused for other purposes. As for organization, there was close collaboration between all PCUs and the CUP within the studied primary care network. Preference for one's own registered healthcare provider indicated the person's acceptance of the UCS. All respondents had access to PP services through home visits and/or village meetings. Generally, the villagers were satisfied with the UCS benefit packages and the services by their PCU. The UCS was perceived to help the underprivileged rather than to improve standard of healthcare quality. Major problems regarding the UCS implementation in the study area were: inclusion error, restriction on registration, benefit packages as being inconsiderate to beneficiaries, lack of knowledge about the scheme, poor management of medical tools and equipment, misuse of PP budget, overworked health personnel, inadequate monitoring and evaluation at the provincial level, ineffective information system, and low incentives for the personnel. Certain recommendations were given in this research to strengthen the implementation of the UCS. They were free services for all beneficiaries, expansion of coverage for all PCUs and for all services, increase in number of health staff at the PCU level, and improvement on information dissemination of the scheme. |
| Year | 2007 |
| Type | Thesis |
| School | School of Environment, Resources, and Development (SERD) |
| Department | Department of Development and Sustainability (DDS) |
| Academic Program/FoS | Rural Development, Gender and Resources (RD) |
| Chairperson(s) | Soparth Pongquan; |
| Examination Committee(s) | Routray, Jayant Kumar;Ahmad, Mokbul Morshed; |
| Scholarship Donor(s) | RTG Fellowship |
| Degree | Thesis (M.Sc.) - Asian Institute of Technology, 2007 |