Country presentations Thailand Dr Country presentations Thailand Dr. Churit Tengtrisorn Bureau of Non Communicable Disease Department of Disease Control Ministry of Public Health

Five important In-patient NCDs in Thailand Per 100,000 pop 2004 2005 2006 2007 2008 2009 HT DM IHD CA Cerebal VD

Health System Structure Ministry of Public Health Public Health Development Cluster National Health Security Office (NHSO), Thailand Department of Disease Control Bureau of Non Communicable Disease Department of Health Thai Health Promotion Foundation Medical Service Development Cluster . Department of Medical Services Department for Thai Traditional and Alternative Medicine Development Department of Mental Health Public Health Services Support Cluster Department of Health Service Support Department of Medical Sciences Food and Drug Administration Government Pharmaceutical Organization Central administration. Regional administration. Office of the Permanent Secretary . Provincial Health Office Central / General Hospital District Hospital Local government Community Hospital / Health Station District Health Office Health Volunteers

Main Policies/Plan on NCDs and Risk Factors Healthy Thailand 2004-2015 Project Thailand Healthy Lifestyle Strategic Plan 2011-2020 (In process implementation) National Tobacco Control Strategic Plan 2010-2013 National Alcohol Consumption Control Policy 2010 Overweight and Obesity Management Strategic Plan 2010-2019 Ministerial NCD Policy 2011 Integrated DM and HT Prevention and Control Program (To cerebrate His Majesty the King’s 84th Birthday ) Thai People Flat Belly Project

Challenges on NCDs and Risk Factors KPI (2013) HT / DM 90% HT/DM screening in population (>15 yr.) 50% of HT/DM risk groups have the behavioral change (Diet, Exercise, Emotion, Tobacco & Alcohol consumption control) 70% of early development of quality NCD Clinic IHD death rate from IHD < 20/100,000 pop. CA (Liver) death rate from CA liver < 20/100,000 pop. Alcohol 50% decrease of new drinker Tobacco young smoker not more than 10% 100% of smoke free health service place

Competent Disease Control District (CDDC) Project 1. Disease prevention and control committee 1.1 disease prevention and control committee Order 1.2 reports of the committee meeting 1.3 operational plan and responsible agencies based on analyzed and reported community health problems 1.4 monitoring and evaluation of the operation by the committee 2. Good epidemiological surveillance system 2.1 a good epidemiological information system 2.2 Surveillance and Rapid Response Team (SRRT) 2.3 priority disease diagnostic laboratory in District Hospital

Competent Disease Control District (CDDC) Project [continued] 3. Disease prevention and control plan 3.1 goal and action plan for prevention and control of priority diseases or health problems (at least one disease) 3.2 integrated campaign activity with the community involvement 3.3 emergency plan exercise at district level (at least once a year) 3.4 Evaluation and review of operations to plan for next year 4. Integrated resources from stakeholders 5. Successful mobilization of resources for disease prevention and control

Successes, failures & challenges Integrated project (En Occ, CD & NCD) Integrate Resource (Man, Money, Management) Focus on Community failures Select some important problem may ignore some problem such as law enforcement in Tobacco & Alcohol prevention The project is similar to District Health System challenges Integrate with DHS

Meditation Therapy Center By DTAM Department for Thai Traditional and Alternative Medicine Development (Holistic Health Care Center) Holistic Health Care program in 3 target groups patient and their family health personal community Integrated activity practice giving activity Volunteer activity moral behavioral activity moral activity and NCD preventive behavioral mental development activity mindfulness meditation concentrate meditation NCD knowledge

Successes, failures & challenges It's a small success project for rural area. The content is relate to Buddhist Religion so it is easy to distribute to population in rural area It is a integrate learning between patient & health personal failures It's difficult to train the trainer because Buddhist is a specific science issue Religion issue is not wind accept by the science personal Challenges Integrate to Health Care Service such as in Hospital in Community

Health system reform National Health Authority : NHA (Regulator) many new health organization make chaos management in Health System related to WHO Framework (6 Building Blocks) Reform function & structure National Health Authority : NHA (Regulator) Structure Health & Service Health Promotion Disease Prevention & Control Health Consumer Protection Function 1. Strategic knowledge based 2. Health knowledge management 3. Monitor & evaluation on health policy & health technology 4. Accreditation of health service 5. Development of surveillance system for disease, health risk & health emergency response 6. health law 7. Global health and international cooperation 8. Monitor & evaluation of Government Regional & Private agencies 9. health financial system 10. One standardized health information system 11. Health personal management Purchaser Provider

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