Implementing Traditional Thai and Alternative Medicine Policy at Provincial Level with the Concept of System Governance

Abstract

Objective: To study the implementation of Thai traditional medicine and alternative medicine policy among practitioners in the division of Thai traditional medicine and alternative medicine at provincial public health office, using the framework of system governance. Methods: This qualitative study conducted semi-structured group interviews with 40 practitioners in the division of Thai traditional medicine and alternative medicine from 12 provinces including (Thai traditional medicine practitioners, pharmacists, and public health professionals), between October 2023 and February 2024. The study developed interview guides on the practices in implementing the designated policy using the concept of system governance. The interview topics included 1) policy guidance and strategic plans, 2) Intelligence and oversight, 3) establishing mechanisms or tools for implementing policy, 4) collaboration and coalition building, and 5) accountability. The interviewees in each province were requested to provide an explanation of the approaches which their division employed to promote Thai traditional medicine and alternative medicine services, as well as herbal city policy. Results: The implementation of Thai Traditional Medicine and Alternative Medicine policy was in concordance with all five areas of system governance concepts. Notably, there was strong engagement and collaboration with both the private sector and civil society. For instance, local traditional healers were engaged to serve as key sources of tacit knowledge within the province; tourism entrepreneurs helped support the health economy policy; and the provincial administrative organization played a role in ensuring the continuity of Thai traditional and alternative medicine services in the decentralization period. Mechanisms and tools had been established to guide the implementation in accordance with local practices, and to generate knowledge to support these efforts. The Herbal City Provinces were more prominent than other provinces in establishing relevant local policy and roles of the committees at the provincial level that was consistent with the central Herbal City policy. Conclusion: After receiving the policy from the central government, the implementation of the policy by those in the division of Thai traditional medicine and alternative medicine at the provincial level involves the establishment of working mechanism according to the local context. Collaboration within and outside of the government sector, as well as knowledge generation to assist decision-making are related to improved performance in policy implementation.