Role and function of local government units in financing and providing health services in two selected provinces in Thailand

Abstract

        The objectives of this study were to assess the current situation and   trends of the role of Local Government Units (LGU) in financing and provision of general health services and for HIV/AIDS services in two selected provinces, namely Nakorn Panom and Lampang. Quantitative data was collected using a structured questionnaire. All LGUs in selected  provinces (N = 208) were asked to fill in data concerning their annual  revenue, expenditure, healthcare expenditure, and HIV / AIDS services  during the fiscal year 2006-2008, The response rate was 82%,

        During three fiscal years (FYs), the average annual revenue ranged  between 25 and 31 million Baht per LGU, Healthcare spending was at an  average of 1.2, 1.7, and 2.5 million Baht per LGU in the FY2006-2008 respectively, In FY2008, the percentages of health expenditure to all   expenditures in Nakorn municipality, Muang municipality, Tambon municipality, and Tambon Administration Organization (TAO) were 8,8,  4.9, 14.0, and 15.4 respectively, Likewise, the percentage for HIV/AIDS  activities support to total health expenditure in Nakorn municipality,  Muang municipality, Tambon municipality, and TAO were 0.4, 3.7, 3.4  and 7,0 respectively. It emphasized that spending on health services in
all types of LGU s was not a large compared to annual total expenditure.

        This study has highlighted the current situation in the field of decentralization and healthcare provision. The continuation of further researches in the field of decentralization affecting equity in financial
contribution, access and use of health services are recommended.