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

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 Strategy 5 Promote and empower Thai indigenous healers and civil society for health care Strategy 4 Knowledge generation and management for HRH development 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 The Strategic Plan for the Decade of National Human Resources for Health Development in Thailand

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”