Reproductive Health Services in Thailand 2019

Abstract

This research of a cross-sectional study aimed at examining the provision and rationale for contraception, safe abortion, youth-friendly health services (YFHS), and reimbursement for reproductive health services according to the benefit packages. Data were collected using questionnaires in public hospitals, under and outside the Ministry of Public Health, between June and September 2019. Descriptive statistics were used to analyze the data.

The study found that hospitals provided contraceptive services for all treatment rights, with 98.6 percent coverage under universal health coverage. The most commonly provided services were combined hormonal contraceptive pills and injectable contraceptives, at 99.4 percent. Long-acting reversible contraceptive services were less provided due to their expense and unpopularity, as well as a lack of personnel to provide the services. There were 29.9 percent of hospitals that provided termination of pregnancy services. Most hospitals provided termination of pregnancy services at the gestational age of 12-20 weeks by dilatation and curettage, with fetal death as the main indication. The main reason of terminated pregnancy services was a lack medical doctor. Moreover, the YFHS were mostly shared with other clinics and available during office hours, with hospitals' telephones serving as an additional channel. 

Reimbursement of service fees according to the benefit package found that the highest amount of reimbursement was for long-acting reversible contraceptive services provided for women under 20 years. The reasons for the lack of reimbursement for services were because services were terminated, the lack of personnel who can provide long-acting reversible contraceptive services, and the lack of awareness that the services were reimbursable. Suggestions from this research are that hospitals should be encouraged to purchase medical supplies for long-acting reversible contraceptives and reimburse for the services according to the benefit package, increase coverage in capacity building for personnel to have skills in providing long-acting reversible contraceptive services, promote positive attitudes among medical personnel involved in termination of pregnancy, and expand access to youth-friendly health services via community and online channels.