National Health Assembly and
Health for All
Churnrurtai Kanchanachitra
Thailand
PHA, Cape Town
10 July 2012
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10/07/55
30 years of advocacy for participatory
public policy
1978
HFA
1986
Ottawa
2007
PHC
Are we there yet?
2008
SDH
3
Wrong deeds in public policy decision
and how to go over
• Lack of
knowledge
• Lack of widescale
participation
• Lack of morality
Prof. Dr.Prawase Wasi
• Technical
process
• Social process
• Moral process
4
National Health Act B.E 2550 (2007)
• Major turning point in the Thai health system
• Expand from the medical and public health
sector to all sectors
• “All for Health and Health for All” “Health
system Governance” is a major component in
directing and monitoring the health system in a
more desirable direction
5
“The
Triangle that Moves the Mountain”
Strategy
Knowledge (K)
NHA
Social
(S)
Political
Involvement (P)
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6
10/07/55
Three types of Assemblies
• National Health Assembly
▫ Agenda on health and related
▫ Annual basis
• Area-based Assembly
▫ Agenda related to area
▫ No particular time limit
• Issue-based Assembly
▫ Agenda on specific issues
▫ No particular time limit
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10/07/55
National Health Assembly
• Involve in all policy
development process
from agenda setting to
implementation and
evaluation
• Deliberative democracy
President of NHA comes from
3 sectors
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National Health Assembly is a year-long
process
Call for
agenda
Agenda
selection
Drafting
technical and
resolution
Circulate for
constituency
consultation
Revise
document
Stakeholder
constituency
consultation
National
Health
Assembly
Submit to
Cabinet
Implement
ation and
evaluation
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National Health Assembly is soft power
on policy formulation—no legal binding
Agenda
Setting
Proposed from 200
constituencies—
government, academic,
civil society, community
Committee on monitoring
Monitoring
Ministries, communities
Policy
Formulation
Implement
Draft resolution and tech
doc, adopt in NHA (more
than 1,200 attended),
submit resolutions to
Cabinet
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Agenda setting, policy formulation and
implementation– 3 cases
• Participation in FTA negotiation
process (1)
• Equity in access to essential health
care (1)
• Medical Hub (3)
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Participation in FTA negotiation
process (1)
Agenda • Proposed by civil society (FTA Watch)
setting
Policy
formulation
• Public hearing
• Impact assessment
• Set up mechanism to monitor impact on international
trade
• Set up National Commission on Trade and Health Study
• Members from MFA, MC, Chamber of Commerce, NGO,
Implement
Academic
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Equity in access to essential health
care (1)
Agenda
setting
Policy
formulation
Implement
• Proposed by government (Ministry of
Justice)
• Propose to harmonize to reduce inequity of 3
health insurance schemes
• stateless people eligible for health insurance
• Set up National Health Financing Committee
• Cabinet approve stateless people to be eligible
for health insurance under UHC
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Medical Hub (3)
Agenda
setting
• Proposed by private sector (Chamber of
Commerce and Prema-Multi-national drug
company)
Policy
formulation
• BOI will not support or special tax or investment
privileges to health services which are business
interest oriented
Implement
• BOI reviewed their decision on supporting
private hospital
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2 dimensions, 4 values, 5 strategies
Participatory
Democracy
Participatory healthy
public policy
Participa
tory
healthy
public
policy
process
Social
empowerment
Social
Move
ment
Interactive
Learning through
action
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5 Strategies
 Increase participation from all 3 sectors and build
ownership
 Develop the Assembly System that are systematic
with clear pattern but with flexibility
 Use inclusive approach to involve all stakeholders
 Support downstream process to bring policy to
implementation
 Link National Health Assembly to Thailand Reform
Assembly and Assembly at International level
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Please visit our website at
http.en.nationalhealth.or.th
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We are the leaves of one tree
The time has come for all to live as one
We are the leaves of one tree