Case Study on HRH
Management in Thailand
Nichakorn Sirikanokvilai
Ministry of Public Health,
Thailand
Major HRM Problems

Maldistribution
- Doctors : The majority of doctors is in urban
and big cities
- Nurses : Distribution is improved, density in
urban and big cities is still persistent
 Shortage of HRH
 Moral and productivities
 New policy initiatives
Human Resource Management Framework
Strengthen Human Resource Management
Production
• Physician
• Dentist
• Pharmacist
• Nurse
• Health Officers
Capacity Building
• Long-term for
specialist, PhD
• Medium-term
fellowship
• Short-term for
academic study visit
Administration
• Incentive
• Retention plan
• One District
One Doctor/One
Tambon One
Nurse
Challenges
• Decentralization and
autonomous body
• Medical liability
• Public-private mix
• FTA and medical hub
• Emerging diseases
• Crisis management
• AEC
Measures for Manpower Distribution
1. Compulsory measure
 Since 1973 all newly graduated doctors have worked for
govt. services for 3 years, if not, they would be fined by
paying 12,500 US$
 Since 1989 have started using measure to new dentists to
work for govt. services for 3 years, if not, they would be
fined by paying 12,500 US$
 Since 1989 this measure have also extended to new
pharmacists to work for govt. services for 2 years, if not,
they would be fined by paying 7,800 US$
2. Special type for production
 CPIRD , ODOD, ONOT
Measures for Manpower Distribution
3. Incentive measure
 Reset allowance for health personnel who working in
different areas, remote rural area and urban area in
order to maintain our major categories of manpower in
rural area and to ensure that our people could access to
health care facilities
4. Non incentive measure
 Adjust for higher level of personnel classification
 Promote for more continuation education and training
 Reward
Universal Coverage 2002
 Primary health care fund : invest more on manpower
 Direct support for production of assistant dentist and
physical therapist
 Indirect support by support budget to hire doctor to work in
PCU which the rate of payment between urban and rural
PCU are different, hire PT to work for rehabilitation in the
community
 Support budget to nursing colleges to conduct training for
Nurse Practitioner to work on Basic Medical Care in PCU
 Support budget to Regional/ General/Community
Hospitals to be a place for training on Family Medicine and
pay for doctors during training on FM
Development of People Participation
 In 1977 the 4 th Health Development Plan, started
to develop Primary Health Care
 In 1978 Alma Ata Declaration
 In 1990 developed PHC assistant to be Village
Health Volunteer (VHV)
 In 2005 developed VHVs expert
 In 2010 provided 600 Baht per month to VHVs
 Present, there are more than 1 million VHVs to
work at the community level and one VHV will
take care 10 households
The Strategic Plan for the Decade of National Human
Resources for Health Development
in Thailand 2007-2016
Goal
HRH in the right number, right quality, equity distribution,
working with moral principles and satisfaction
Strategy 1
Mechanism to develop
policy and strategies
Strategy 2
Reorient production
and development
system
Strategy 3
Reorient management
and supportive system
Strategic Challenges
1. Dynamic of health needs
2. Reorient of roles and
responsibilities of human
resources for health
3. Bridge the gap between
policy and practice
Strategy 5
Promote and empower
Thai indigenous healers
and civil society for
health care
Strategy 4
Knowledge generation
and management
for HRH development
Strategy 1 : Mechanism to develop policy and
strategies
 National Committee on HRH
 Committee at provincial level (under development)
Strategy 2 : Reorient production and development
system
 Focus on Rural Recruitment , local Training and
Hometown Placement for the purpose of distribution
Strategy 5 : Promote and empower Thai
indigenous healers and civil society for health
care
 Strategic development Plan on Thai wisdom
 Prepare suggestion and recommendation that related
to manpower development plan on community
health care, particularly for disable persons, chronic
patients who stayed in beds at home
“Sawasdee”