plueme/wizJson huggingface dataset:
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: The Role of Key Stakeholders in the Introduction of the Government Use of Patents for Essential Medicines in Thailand 
abstract:In late 2006 and early 2007, the Thai government announced its intention to introduce the use by the
government of patents for three pharmaceutical products: two antiretrovirals (ARVs) and an anti-thrombotic
drug. This action, which was aimed at improving access to essential medicines in the public sector,
complied with the flexibilities of the Agreement on Trade-related Aspects of Intellectual Property Rights
(TRIPS). By employing qualitative approaches, this study assesses the involvement of key stakeholders in
the policy process. This analysis suggests that the idea of enforcing TRIPS flexibilities for expanded access to essential
medicines in Thailand was adopted as a public policy when the new government took office after a change
in the political system in September 2006. This policy obtained significant support from non-governmental
organizations in the health sector, patient groups and academics, both inside and outside the country.
However, the action by Thailand was strongly opposed by patent-holding companies, the multinational
medical industry and their national governments. The contributions from civil society were managed in
several forms, such as technical and information support and demonstrations to advocate the policy. Meanwhile,
powerful nations introduced trade retaliation and put political pressure on the Thai side. Global
concern about the unaffordable costs of patented medicines that hampered access to essential health care
in the South was beneficial to the enforcement of the government use provision. The potential diffusion of
this policy from Thailand to other developing countries triggered serious opposition from stakeholders
who lost their benefits.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Measuring Catastrophic Health Expenditures Using the Poverty Approach 
abstract:Recent studies on catastrophic health expenditures often use arbitrary and universally cut-off shares
(e.g., 10 percent) of health expenditures on household income (or on total household expenditure) as the
main indicator of catastrophic health expenditure. However, some empirical studies in Thailand which
employed such indicators ended up with counter-intuitive findings, e.g., a substantial percentage of households
in the richest quintile were found to be prone to catastrophic health expenditures, and more often
than not, at higher rates than those with lower income.
This paper uses the same set of data to demonstrate that the counterintuitive results resulted from
such faulty indicators. Using sophisticated household-specific poverty lines as a measure of household catastrophic expenditure, the study finds that, unlike households in the two lowest quintiles, it is extremely
rare for those with higher-than-median income to have their post-health-expenditure income fall
below the poverty line, a result which is completely opposite to those derived from the former indicator.
However, since the head count of health-related impoverished households is not sentitive for those
households that are already below the poverty line, the study proposes a supplemental indicator, that is,
changes in the normalized poverty gap due to health expenditure, as an indicator that measures the healthexpenditure
impact on poverty.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Capacity-building for Health Policy and System Research in Thailand 
abstract:Capacity-building for health policy and systems research (HPSR) is a vital component in supporting
health system capacity in order to achieve certain health goals. Currently, a number of obstacles prohibit
the use of HPSR in real policy decision-making. These include selective use of evidence to support previously
set policy agenda, inadequate funding and support for HPSR, inadequate human resources and
poor research capacity, resulting in low-quality research. It is belived that capacity-building for HPSR
would help break the above-mentioned vicious cycle.
This paper is aimed at informing all stakeholders about the potential approaches to build up HPSR
capacity. It was conducted by (a) reviewing the literature, (b) using a questionnaire survey of existing
research capacity within the Health Systems Research Institute (HSRI) network aimed at identifying capacity
gaps and the current practices in building up research capacity, and (c) in-depth interviews with
key persons of leading research institutes, namely, the International Health Policy Program (IHPP), Epidemiology
Unit of the Prince of Songkhla University, and the Thai Research Fund, to learn from their
experiences in capacity-building.
Definitions of capacity-building and HPSR, and the potential approaches for building research capacity
were given. Results from the survey indicated that there is an urgent need to build up research
capacity at both the individual and research institute levels through formal and informal education, networking,
involvement of policy actors and the public in setting up research agendas, conducting research
and disseminating the research results. Lessons learned from the leading research institutes revealed
several key successes, including leadership, long-term and flexible research grants, critical mass,
multidisciplinary teams, and relevant policy research. At the end of the paper, the information gathered
was used to construct recommendations for HPSR capacity-building in health research institutes.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Assessment of Primary Care in Thailand from the Providersû Perspectives 
abstract:The importance of primary care has increased since the recent health-care reform but no systematic
evaluation has been done. This study was aimed at assessing primary care in Thailand. The primary-care
system questionnaire originally developed by Barbara Starfield was used to assess nine primary-care
domains, namely, resource allocation, adequacy of facilities, first contact and co-payment requirement, longitudinality, comprehensiveness, coordination, family-centeredness, community orientation, and professional
personnel. Respondents were 77 primary care practitioners from 13 different provincial hospitals.
The findings showed a response rate of 53.25 percent. Providers stated that (1) the resource allocation
was not appropriately based on intimate needs, although there were some special provisions for
underserved segments of the population, (2) basic equipment and supplies were not adequate in some
regions, (3) consultation with a provider at the primary-care level was required before assessing to seek
other care, whereas the co-payment requirement was low, (4) most patients were seen by the same provider
team on every visit, (5) primary-care services are comprehensive although regional variations were
evident, (6) coordination, family-centeredness, and community orientation were satisfactory, and (7) nurses
were key providers at primary-care facilities.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Exercise Behavior among Type-2 Diabetic Patients in Bangkok: The Bangkholaem Urban Community Study 
abstract:Regular and proper exercise behavior was part of a method to control blood sugar levels in type-2 diabetic patients. This research was aimed at studying the exercise behavior of type-2 diabetic patients residing in urban communities as well as studying the effect of exercise on their health condition and diabetic complications. Volunteers in this project included type-2 diabetic patients who had received medical treatment from BMA Health Service Center 12 from February to June 2006. All the volunteers first completed the personal questionnaire form and exercise behavior questionnaire form, and underwent blood testing, anthropometric measurements, and diabetic complications check-up. The study found that 75 of 203 volunteers (or 36.9%) had regular exercise behavior; while 128 of 203 volunteers (or 63.1%) refrained from performing regular exercise; however, only 42 of the 75 volunteers in the regular-exercise group were within the standard criteria for regular exercisers. The regular exercise group had lower fasting blood sugar and triglyceride levels than those of the non-exercise group, with the statistical significance being (p < 0.05), and tended to have a lower proportion of occurrences of diabetic complications than those in the non-exercise group. The result of this study indicates that diabetes patients residing in urban communities had a lower level of regular and proper exercise behavior. To solve this problem, the body of knowledge on proper exercise and patterns of exercise behavior modification must be taken into consideration.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Health Research Expenditures of the Health Systems Research Institute 
abstract:The objectives of this study encompassed three elements to study: (1) the financial resources of the
Health Systems Research Institute (HSRI); (2) the budgetary allocation of HSRI; and (3) the relationship
between budget allocation and outcomes of HSRI. Data were collected from existing documents and studies on health research in Thailand and from financial data and activity reports of HSRI. The results showed
that (1) in the period 2002 and 2007, HSRI received 1,445 million Baht for health systems research, and
budgets from other sources dominated the government budget;  (2) the major research themes involved
data systems and knowledge generation;  and (3) the outcomes of HSRI activities, in terms of social movement and policy linkage, were related to the themes of research that received funds. The author recommends the following: (1) the private sector should play a greater role in supporting the national health
research system;  (2) the efficiency of a research funding agency should be measured by the proportion of
administrative costs to the total expenditures, and the real practices of staff of that agency compared with
the agency’s existing protocol on funding and terminating a project;  and (3) the effectiveness of a research
funding agency should be measured through total outcomes of that agency compared with the targets
mentioned in strategies rather than the figure of unit costs per program/project.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Health Research System for Sustainable Health Reform in Thailand 
abstract:During the past two decades health research has contributed substantially to health system development in Thailand. Health system has been increased its system complexity and thus increases demand for
health research for further development. This paper is aimed to explore the current health research system
in Thailand and its capacity to cope with the increasing demand. Literature review and in-depth interview of key informants were used for data collection. In addition, a series of brain-storming meetings and
a synthesis workshop were organized to help analysis and to draw recommendations for future development.
It was found that the national health research system was facing many problems including lack of
leadership, limited health research resources both research budget and health researchers with inefficient
use. Strengths of the system which could be a foundation for future development included an establishment of autonomous research funding agencies which created a productive working environment for
health researchers to work effectively and a new working model called “triangle that moves the mountain” which involved stakeholders and civic groups in the research management process which could
promote research utilization and health system change based on knowledge. In addition, capacity building has been shifted from a conventional formal training model to on the job training under mentorship of
senior health researchers.
It is recommended that capacity building of health researchers is urgently needed and this has to be
done on the job-training basis. Mobilization of additional research budget is needed not only for supporting more research studies required for on-going health system reforms but also for capacity building. A
possible solution for mobilizing addition research budget is through making research more responsive to
demand of other public organizations. Using earmarked budget, 1 percent of total health budget, by enactment of the National Health Research Bill could be a long term solution and needs a strong political
support. Research management system needs to be strengthened through competent research managers.
Increasing management capacity of these research managers needs a special training programme and
research management tools. Finally, strengthening leadership of national health research system needs a
structural reform. However, a temporary solution is to use an existing health research funding agency to
perform this leading function with an acceptance of other health research funding agencies
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Factors Influencing the Retention of Medical Graduates of Khon Kaen University in a Northeastern Community Hospital 
abstract:This research was aimed at investigating the reasons for and the motivation of medical graduates of
Khon Kaen University choosing to work in community hospitals in northeastern Thailand after completing
their compulsory three-year bonded period of work. The population comprised 557 physicians who
had graduated during the years 1979-2003. A total of 233 samples were selected by stratified random
sampling and the data were collected by questionnaire. The research findings were as follows:
1. The factors that were significant in the retention of medical graduates who were working in
community hospitals in northeastern Thailand were the usefulness of knowledge of the community, the
preference for rural life and the requirement to work in/near their place of birth, respectively. To compare
the retention factors, the subjects were classified by sex, type of entrance, age range, grade and work
place. It was found that (1) male medical graduates prefer to work in administrative jobs compared with
female medical graduates, and (2) medical graduates who were working in community hospitals prefer to
work in administrative jobs rather than medical graduates working in a regional hospital.
2. The significant factors to support medical graduates who worked in community hospitals were
the extra money, improvement in hospital facilities and physical social welfare improvement, respectively.
3. The order of magnitude of the factors for choosing or changing the location of work was related
to postgraduate education, children’s education and individual factors, such as distance from home, quality
of life, etc. In making a comparison of the factors, the graduates could be classified by sex, type of
entrance, age range, grade and workplace as follows : (1) male medical graduates gave a greater priority
to their children’s education than their female peers; (2) medical graduates who had gained entrance by
quota gave greater priority to postgraduate education more than the other group; (3) medical graduates
who ranged in age from 44 to 53 gave greater priority to the management system than those in other age
groups and medical graduates who ranged in age between 34 and 43 years gave greater priority to postgraduate
education and their children’s education than any other age group; and (4) medical graduates
who were working in community hospitals gave greater priority to their task than the other group.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Health Checks for the People under Health Insurance Project Amphur Tan Sum, Ubonratchathani Province 
abstract:The objectives of the research were to study the health risks and risk-related behaviors of 24,717
people aged 15 years or older who resided in Tan Sum district, Ubonratchathani Province. Information
related to illnesses was collected by asking about their health history, behaviors that made them prone to
health risks, and laboratory check-ups. The work was conducted in the period from October 2006 to September 2007, and the data were analyzed using the Health Check program. The results showed the following: that from the body mass index in 11 percent of the sample were overweight, and 2.29 percent were
obese; waist circumference was above normal in 18.87 percent, and was more prevalent in women than
men; blood pressure in 7.5 percent was in the risky category, among which 4.94 percent suffered high blood pressure, and 0.14 percent suffered severe high blood pressure; blood cholesterol levels in persons
aged 40 years and over showed high levels in 0.10 percent among the risk group (3.99 percent); blood
sugar levels were 16.24 percent in the pre-diabetic stage, and 4.15 percent had diabetes, which was most
prevalent in women; the hematocrit was 51.47 percent in the anemia stage; 6.29 percent of stool samples
contained worms, the majority of which were liver flukes; 21.85 percent had calcium deposits on their
teeth, 2.27 percent had caries and 5.49 had both conditions; 0.74 percent had cataracts; among 38.26 percent of women aged 35-60 who came for cervical cancer checks, 0.37 percent had positive results, and 0.02
percent were positive for breast cancer.
With regard to behavior assessment for health risks, it was found that 0.06 percent consumed alcoholic beverages daily, 3.59 percent smoked cigarettes habitually; 3.50 percent had previous accidents; 0.11
percent had extra-marital sex without using condoms; 0.65 percent of both men and women drank energy-boosting beverages; 34.75 percent exercised 3-5 days a week while 3.94 percent exercised more than
5 days per week; with respect to riding motorcycles and driving cars, 1.89 percent of motorcycle riders did
not wear helmets, and 2.41 percent of car drivers did not wear safety belts; women took steroid-mixed
drugs more than men, and women suffered stress more than men; 0.97 percent consumed raw meat frequently.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Reviewing the Literature on Governance in Health System 
abstract:The goal of Thai health system development is to achieve a balanced and sustainable society in which
all Thai citizens have the security needed to live a happy life in a healthy and better condition. The objective
of this study was to perform a literature review to form a foundation and knowledge base on good governance
in the Thai health system, analyze and plan for research mapping.
In this study, good governance in the health system was divided into 10 sectors: rule of law, ethics,
transparency, participation, accountability, value for money, human resources development, knowledge organization,
management and information technology. These were simultaneously analyzed in macro- and
micro-analysis systems that were influenced by economic, social and political conditions as well as the agency’
s role.
The literature review revealed that there were problems in every aspect of health governance. If these
problems were solved more effectively, that would generate better and improved services in the health-care
system. Consequently, it would create a sustainable society in which all Thai citizens would live a happy life
in a healthy condition.
The study found that governance is a function of the health system, that each governance principle
should be developed and adapted, and that governance issues should be identified at all levels. The problems
encountered in studying health governance were that the issue needs more research, especially that
undertaken with a qualitative approach and comparison of the international governance functions.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Competency Assessment of Personnel of Chiang Mai Provincial Health Office 
abstract:This research encompassed two objectives: (1) to assess the competencies of the personnel of the
Chiang Mai Provincial Health Office and compare these acquired competencies with expected competencies of the organization; and (2) to compare results of competency assessment by self-assessment with the
results of assessment by peers, by heads of sections and by the Competency Assessment Committee. The
target group comprised personnel of the Chiang Mai Provincial Health Office. Respondents were recruited
by the accidental sampling method during the days that the Committee collected data (between October
1, 2006 and March 31, 2007). The research tool was the competency assessment form adapted from the
competency assessment guideline of the Public Sector Development Commission, which comprised eight
dimensions. Data were collected from 147 respondents (94.2 % of the total staff).  Results showed that:
(1) in the deputy director group, the underdeveloped dimension was mentoring for personnel development; (2) in the assistant director group, heads of clusters and heads of sections/technical experts, the
underdeveloped dimensions were ethical issues, holistic thinking and proactive management; (3) in the
technical operator group, the underdeveloped dimension was proactive management; and (4) from the
overall competency scores, the self-assessment produced similar scores to those assess by the Committee.
These findings will be useful for formulating individual development plans.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Residential Radon Exposure and Lung Cancer: A Survey in Chiang Mai Province 
abstract:This survey was conducted in four districts in Chiang Mai Province as part of a multidisplinary
research study by academic staff of three universities, namely Chiang Mai, Songkhla and Khon Kaen
university, in collaboration with researchers from the Thailand Institute of Nuclear Technology and the
Royal Institute, with the aim of verifying the association between residential radon exposure and lung
cancer risk. The study was carried out by measuring radon gas levels in the homes of proven cancer
patients and in other homes as controls for the purpose of comparison. As the findings in both categories
of residences showed that the radon levels did not exceed the safety threshold (148 Bq/m3), it was concluded
that radon gas exposure in such a situation of low levels would likely not be a significant cause of
lung cancer, but rather attributed to the heavy smoking habit of the northern citizens.
location: nan, 'Thailand 
year: 2008 source: HSRI 
title: Lifestyle Modification in a Group at High Risk for DiabetesLifestyle Modification in a Group at High Risk for Diabetes 
abstract:Accumulating evidence from randomized controlled trials have shown that diabetes mellitus can be
prevented or delayed in high-risk individuals by an intensive lifestyle modification program. However, to
be meaningful for clinical practice in the real world, the results need to be both widely generalizable and
the methods practical and affordable enough to implement in a wide variety of health-care settings. This
review described some aspects of the intensive lifestyle modification program in groups at high risk for
diabetes. Topics included epidemiologic evidence about the relationship between lifestyle factors and
diabetes risk, clinical outcomes and cost-effectiveness of the intensive lifestyle modification program, and
predicting factors for its success. Some details of the three example programs, including the Chinese Da
Qing IGT and Diabetes Study, the Finnish Diabetes Prevention Study (DPS), the US Diabetes Prevention
Program (DPP) and Look AHEAD Study, were described. The information provided could be utilized in
the development of practical lifestyle interventions for diabetes prevention in Thailand.