Primary Healthcare Issues in Thailand

Running Head: HEALTH ISSUES IN THAILAND
PRIMARY HEALTHCARE ISSUE IN THAILAND
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Author’s Note

HEALTH ISSUES IN THAILAND1
Introduction
The issue of social determinants is prevalent in every country, be it a developed or a
developing country. The health status of a country can be determined by its population,
economy, literacy, its distribution in the social level, and its health policies. These factors play a
major role in a country’s progress and its position in a global context. The effects of the social
determinants on the health are complex because it is interconnected to several areas such as
governance, socioeconomic factor, public and social policies (Johnson & Svara, 2015). Thailand
has several prevailing health issues that are affecting their public health all over the world, such
as the issue of poor diet and physical inactivity. This is the cause of a chronic lifestyle disorder
known as obesity in which a person has excess fat in their body that causes several health
conditions. A person with a higher BMI over 30 has obesity. The epidemiology suggests that
Thailand has been a target of such diet-related diseases due to several factors, which will be
explained in detail. WHO’s 5 principles of health is found in the primary health care of every
country, in Thailand as well. It includes equity, access, empowerment, self-determination and
inter-sectoral collaboration. In primary health care, a nurse works on such issues as it is their
responsibility to make people aware and serve them when the public is going through a health-
related dilemma. Cultural competence is another factor that affects the role of a nurse in a
primary healthcare. The issue of social justice and health inequity contributes to the prevalence
of disease as well as the control of the epidemic, which makes it an important issue (Thippayana,
2014).

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Discussion
The social determinants of health are the conditions in which a person lives that include
their birthplace, financial conditions, and lifestyle, and in Thailand, it is the socio-political
inequalities, economic, literacy, equity and social justice. Certain determinants of demand were
seen during the implementation of health card in Thailand. New legislation and policies were
designed to reduce the ill effects of the determinants and the health inequity is managed by
taking action according to the disease control plans and treating the existing health issues. Health
equity is achieved in recent years in Thailand, as seen in the empirical evidence (Supakankunti,
2001). The health systems have four dimensions that include health status, health care utilization,
health financing, and health risk behaviour. The population health indicated that the prevalent
issues were under-five mortality rate, the prevalence of child (pneumonia and diarrhoea) and
malnutrition, which is divided into 3 parameters known as wasting, stunting and underweight.
The health risks indicate that smoking and consuming alcohol is prevalent in the country, the
healthcare utilizations look after the hospital admissions and ambulatory visits that are specific to
healthcare privileges. Health financing means that it is monitored by the direct payment for the
health of households when compared to the government who should be paying (Teerawattananon
& Luz, 2017). The equity stratifiers such as demographic, geographical, economic and social
characteristics of the population are used as a criteria for the concentration of health dimension.
Thailand has a universal health coverage that covers 90% of the population with the help of 3
public health schemes, disparity in certain health dimensions that means health resource
utilization is demonstrated in every chronic disease found in Thailand. The social determinants
of health known as equity and social justice is an important factor for the prevalence of the major
health issue seen in Thailand. Poor diet and physical inactivity could have been decreased with

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the help of equity and social justice and that is the essential step taken by the government of
Thailand (Jitnarin et al., 2011). Health insurance of Thailand including voluntary insurance is
under development that has questioned the idea of equity. In the last 5 years, the health care
expenditure has elevated to a high level but there is no evidence of patient quality and safety.
The increase in the healthcare expenses and the provision of healthcare services has raised
question amongst the public regarding health equity because only the financially privileged can
access these services, which widens the gap of inequality. The government needs to intervene in
such matters and provide healthcare subsidies, public health policies for the underprivileged and
giving finance-related health services to the vulnerable populations including the delivery of
such services with the help of government facilities and staff. Social justice is the act of
maintaining a social balance in the society in which people of every class achieves the
government facilities, health services and distribution of opportunities. Obesity and other diet-
related disorders are a cause of equity and social justice in Thailand (Phanphairoj & Loa, 2017).
Thailand has an increasing rate of obesity and overweight, as seen in the epidemiological
studies. Overweight in children under the age of 5 has been increasing every year because it was
1% in 1987, 8% in 2006, and 11% in 2012, but there was a decline of 8% from 2015-2016.
Overweight and obesity in adult is always on a rise especially in women than men because it is
found in 17% of women and 12% of men. In recent years, the prevalence is 26% in men and
33% in women in the year 2014. In 1990, 1% of men and 3% of women were found to be obese
and now in the present time, 6% of men and 11% of women were known to be obese in 2014.
Another aspect of poor diet is the issue of malnutrition in children but from 1993 to 2012,
stunting declined to 23%, 44% decline was seen in the underweight, wasting was 7% in 2012 and
overweight increased to 132% in 18 years. Thailand has tried several approaches to reduce