Ministry of Public Health &

Ministry of Social Development and Human Security

The 8th ASEAN & Japan High Level Officials Meeting on Caring SocietiesTokyo, Japan 30 August-2 September 2010

Dr. Supakit Sirilak MD., MPHM., Board of Preventive Medicine

Director of Bureau of Policy and Strategy, MoPH

Challenge:

The Promotion of assimilation of children with disabilities issues into all plans at local, and national level for inclusive society

Action:

-Seminars/training forums and for enhancing understanding and awareness of officials in social welfares, medical services, and laws and regulation for children with disabilities

Challenges:

Comprehensive knowledge management guidelines for children with disabilities

Action:-Joint cooperation or sharing information between MSDHS and MOPH, to

develop knowledge management guidelines indicating welfare and rehabilitation services for children with disabilities

Follow up of 7th High Level Officials Meetingin our country

Follow up of the 7th High Level Officials Meeting Visitation by Japanese delegation

Date: 26 February 2010

Delegation Led by Dr.Daisuke Tanaka, Deputy Director of Office of International Cooperation, Min. of Health, Labour and Welfare

Institutions visited

Home for Intellectual-Disabled Babies (Baan Fueng-Fa)

The Community Rehabilitation Center in Nonthaburi Province

Sirindhorn Center of the MOPH

Regional Activities Introduced initiatives at SOMSWD meeting between 12-13 January

2010 in Singapore

To promote GO-NGO cooperation on PWDs in ASEAN through

Capacity building of PWDs and disable people’s organizations (DPOs)

Public awareness on disability issues

Mainstreaming disability perspectives in ASEAN social policies including ASEAN-Roadmap on MDGs

Network building among DPOs in ASEAN

Establishment of ASEAN Disability Forum, poverty reduction of PWDs in ASEAN

Proposed to convene the People-Oriented Forum to develop a concrete action plan on PWDs for 2010-2012 and prepare for ASEAN Decade of PWDs

Develop an ASEAN+3 Network for Empowerment of PWDs

to strengthen ASEAN’s mechanism of PWDs

To support the ASEAN Decade of PWDs

To promote barrier-free societies

The SOMSWD meeting supported the initiatives on PWDs as they are in line with the ASCC Blueprint’s strategic objectives.

The meeting requested Thailand to develop a programmatic project proposal for consideration of SOMSWD.

Thailand will take lead in a development of programme on PWDs under the new strategic framework for 2011-2015.

Regional Activities

Current situation

General Information Data year

1.GNI per capita (PPP US $) 8100 2010

2.Poverty rate 8.12 2009

3.Adult literacy rate

male 96 2009

female 90.6 2009

4. Urban population(%) 36.1 2009

5.Budget for social welfare as % of total

national budget 0.53 2009

6. Budget for health as % of total national

budget 9.5 2009

Government Budget Allocation

*Security

22.6

16.1

13.8

15.2

24.7

*Debt serv.

8.2

5.0 5.3

9.1

12.6

17.9

*Education

16.9

25.8

21.7

22.1

*Health

4.4

7.6

10.2

8.8

0

5

10

15

20

25

301,9

69

1,9

71

1,9

73

1,9

75

1,9

77

1,9

79

1,9

81

1,9

83

1,9

85

1,9

87

1,9

89

1,9

91

1,9

93

1,9

95

1,9

97

1,9

99

2,0

01

2,0

03

Pe

rce

nta

ge

Year

Source: Bureau of Budget

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H

ea

lth

Vital statistics 2010

1. Total Population 63,776,000

1.1 Population by Sex

Male 31,408,000

Female 32,368,000

1.2 Population in Urban Areas 23,036,000

1.3 Population in Rural Areas 40,740,000

1.4 Population by Region

Bangkok Metropolis 6,639,000

Central (excluding Bkk Metropolis) 15,563,000

Northern 11,757,000

Northeastern 21,305,000

Southern 8,512,000

Vital statistics 2010

1.5 Population by Age Group

Children (under 15) 13,229,000

Labor force (15-59) 43,010,000

Elderly (60 and over) 7,537,000

School ages (6-21) 15,297,000

Women in RH ages (15-44) 17,809,000

Vital statistics 2010

2. Crude Death Rate (per 1,000 pop) 7.0

3. Crude Birth Rate (per 1,000 pop) 12.6

4. Infant Mortality Rate (per 1,000 lbs) 12.8

5. U5MR (per 1,000 live births) 14.5

6.Maternal Mortality Ratio (per

100,000 lbs)

41*

7. Life Expectancy at Birth (years)

Male 69.5

Female 76.3

8. Total Fertility Rate (per women) 1.5

Millennium Development Goals

Current situation concerned with poverty alleviation

Government's response/policy initiatives to improve MDG achievement1. Policies guidelines and budget allocation have been designed in response to differences of areas and population groups

2. Development of social protection system that covers all population groups: currently, policy focus is being on the extension of social protection system to cover all vulnerabilities particularly fragile vulnerable groups e.g. informal labors, which are mostly worked in the agricultural sector.

3. Preparation for the aging society: social protection program and preparing elderly to be capable to join the job market and encouraging job creation in communities

4. Restructuring towards green and creative economy with broaden base for majority Thais especially in agriculture and services

Challenges:

1. Increase the quality and service coverage of the social protection program such as the program for education, health and social security under the fiscal stress:

Improve quality of education in all areas Improve maternal & child health in mountainous northern & three southernmost provinces,

Expand access to reproductive health

Halt, prevent new spread of HIVS/AIDS & tuberculosis

2. Increase opportunities for women in significant decision making

Good PracticesHealth Sector

The Universal Health Care Coverage Policy-universal coverage, single standard, and sustainable system

-to ensure the effectiveness of the system, strong emphasis has been placed on both resource and technology efficiencies, underpinned by adequate and stable budget allocation to secure the system’s financial affordability.

-National coverage has been achieved within one year

-the impact of UC policy could be shown as that the burden of household health expenditure has been reduced in the poorest quintile than the richest quintile as shown in the following slide.

Health Insurance Scheme

• 30 Bath scheme (Universal Coverage) 48 m• General People• Vulnerable Groups

• Social Security scheme 10 m• Civil Servant Medical Benefit scheme 6 m• Others

National Health Security Scheme

Impact of payment for health care on household impoverishment

Change in poverty headcounts

after payment for health care

Household

living standardBefore UC

(2000)

After UC

(2002)

Poorest quintile 6.7% 2.0%

Richest quintile 0.6% 0.8%

All quintiles 2.1% 0.8%

Source: NSO’s SES 2000 and 2002

Inve

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alth

1) The policy has been adopted and implemented incrementally,in terms of area and comprehensiveness of the policy package.

2) The policy content seems to have a sound direction which is aresult of accumulated experience and knowledge in Thaisociety.

3) Rapid policy implementation has threatened the policysustainability to some extent since existing healthinfrastructures, including health personnel, have limitedcapabilities to perform their new roles and functions.

4) There are still problems of under-funded and less-than-idealquality of medical services. The challenge is how to keep thesystem sustainable and to meet the people’s expectations ofhealth services.

Lessons Learnt

Good PracticesHealth and Social Welfare Collaboration

The Japan-Thailand Technical Cooperation on the Development of a Community Based Integrated Model for Health care and Social Welfare Services for Thai Older Persons (CTOP) is an example of collaboration between Health and Welfare sectors. This project is a 4 year project started in 2007, aimed at the sustainability in providing integrated services for elderly in the community in the four pilot regions.

The lesson learnt from this project is expected to the model for national wide expansion in the near future.

1) Participation of communities are greatlysignificant to complete policies and measureson elderly.

2)The roles of local government are veryimportant for the sustainability of the elderlyneeded services

3)International cooperation, sharing bestpractices, and networks essentially enhancethe better quality of services for elderly

Lessons Learnt

Social Welfare Secure Housing (Baan Mankong)

•Launched in January 2003•Aim to solve urban poverty housing problem by upgrading living condition of the urban poor, slums, and squatters.•Housing security problem leads to other problems

•No proof of housing registration•No electricity•No clean water•No proper infrastructure

Good Practices

•Main concept•To get communities involved in the upgrading project by themselves.•The program channels government funds, in the form of infrastructure subsidies and soft housing and land loans, directly to the poor communities.•Communities will decide, make plan and carry out improvements of their housing, environment, basic services, security, and budget management.

•In June 2010, poor communities have been upgraded in 74 provinces 276 cities, 1,689 communities, and 90,983 families.

Secure Housing (Baan Mankong)

SummaryAccording to the progress in Thailand achievement in poverty reduction, it is due to the inclusive strategies:

-public policies and programs introduced by the government to support grass root communities, social investment and strengthen formal social safety net.

-universal health care coverage scheme and social welfare fund.

Remaining Challenges to be focused on: 1) Reduce poverty especially in the Northeast, the North,

and the three Southernmost provinces,

2) Improve the quality of education,

3) Increase the role of women in decision-making in all

sectors and at all levels,

4) Improve maternal and child health, especially in highland

areas in the North, and the three Southernmost provinces,

5) Expand access to reproductive health services to all

population groups,

6) Halt and prevent the revival of HIV infection and TB,

7) Expand health promotion to counter the threat of cancer

and coronary artery disease. 8) Enhance the effectiveness of natural resource and

environmental management for sustainability.