Local level responses to budget allocations under the Thai Universal Health Care Coverage policy

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Weerasak Putthasri
Siriwan Pitayarangsarit
Supon Limwattananon
Sripen Tantivess
Roongthong Kharamanond
Viroj Tangcharoensathien

Abstract

        This study aims to explain how health care providers and health managers at district and provincial levels have responded to national changes in the budget allocations of the Universal Health Care Coverage (UC) Scheme; to determine the main factors that shaped these actors’ responses; and to explore the extent to which equity concerns were taken into account in decision making about budget arrangements at the local level. Buriram and Kamphaengphet Provinces were purposively selected for this case study. Both documentary analysis and in-depth interviews of health personnel at the local level were used.


        The study found that mobilization of the UC budget inclined to a bottom-up approach. Decision-making powers were delegated to provincial health boards and Contacting Unit for Primary Care (CUP) boards. The budget allocations depended largely on how the powers were distributed among members of the provider-manager networks and their formal and informal relationships. Responses of the local actors depended on the financial and service pressures they faced.


        When knowledge and experience of the central administration could not properly guide the implementation at local level, the local actors needed more time to learn how to execute the policy by trial and error. Major changes in the UC budget allocation system somehow pushed the local providers and managers to adapt their practices and organizational behaviors for achievable services and financial sustainability.

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How to Cite
1.
Putthasri W, Pitayarangsarit S, Limwattananon S, Tantivess S, Kharamanond R, Tangcharoensathien V. Local level responses to budget allocations under the Thai Universal Health Care Coverage policy. J Public Hlth Dev [Internet]. 2011 Mar. 4 [cited 2024 Apr. 15];9(1):39-54. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/104724
Section
Original Articles
Author Biographies

Weerasak Putthasri, International Health Policy Program (IHPP), Thailand

D.Sc.

International Health Policy
Program (IHPP), Thailand

Siriwan Pitayarangsarit, International Health Policy Program (IHPP), Thailand

Ph.D.

International Health Policy
Program (IHPP), Thailand

Supon Limwattananon, International Health Policy Program (IHPP), Thailand

Ph.D.

International Health Policy
Program (IHPP), Thailand

Sripen Tantivess, International Health Policy Program (IHPP), Thailand

Ph.D.

International Health Policy Program (IHPP), Thailand

Roongthong Kharamanond, International Health Policy Program (IHPP), Thailand

M.Sc.

International Health Policy Program (IHPP), Thailand

Viroj Tangcharoensathien, International Health Policy Program (IHPP), Thailand

Ph.D.

International Health Policy Program (IHPP), Thailand