plueme/wizJson huggingface dataset:
Objective: To explore policies and effects of Free Trade Agreement on nursing workforce.
Research design: Qualitative research design Methods: 1. Relevant documents were collected; content was attracted and classified into research questions. 2.Ten key informants were interviewed under semistructured
questions to summarize policies, state plan, problems and effects of FTA, AFTA, AFAS and
AEC related to health care services and nursing workforce. Results: This study revealed that Thailand had
a good potential to be a World Class Health Care Hub. Notable cost, quality of medical care and Thai
hospitality led to a rapid increasing number of foreigners who came to Thailand seeking for medical
treatment. Number of registered nurse working in private hospitals in 2010 had increased for 66.08 %
comparing to the year 1999; the highest increasing rate was 83.59% in 2007. On the other hand, it deteriorated
nurse shortage in Thailand and un-equivalent accessibility to health care among Thai people. The
Priority Integration Sectors (PIS) of AEC targeted in 2015 facilitates travelling across boarder among ASEAN
people but two anticipated problems were identified; 1) aggravating the increasing number of patient
seeking medical treatment and worsen the situation of nurse shortage, and 2) nurse migration from ASEAN
countries. As nursing education systems are much different among ASEAN countries, problems of unequivalent
education of nursing personnel are encountered and may harm patients. Preparation for FTA
in health care services in Thailand has not been very well arranged. Strategic plan, action plan and hosting
organization were not clearly identified resulting in fragmentation of work of related parties and imbalance
services provided to Thais. Policy implications: Leading organization is essential for driving nation
strategies of the government. Ministry of Public Health, Ministry of labor, Ministry of Education and
Ministry of Commerce must be liable. Roles and responsibility of private hospitals must be heightened
and be integrated with the government to balance benefit and loss from being World Class Health Care
Hub for better health service system and good quality of life of Thai people, ultimate goal of the nation.
Background WHO Framework Convention on Tobacco Control (WHO FCTC) was the first ever
global public health treaty under the auspices of the World Health Organization. The FCTC is the treaty
that emphasizes on the right of public health by providing a framework for tobacco control measures.
Thailand as the Party to the WHO FCTC has obligations to develop and implement national tobacco
control strategies, plans and programs in accordance with this Convention including Article 5.3 focusing
on protecting public health policies from commercial and other vested interests of the tobacco industry.
Objective To analysis and evaluation of the preparedness of Thailand to implement FCTC Article
5.3 and best practices in Canada, Philippines and Kenya. 
Method Qualitative methods were employed for the study including: literature review and documentary
analysis and in-depth interview.
Results The findings are Thailand has some progress in implementing WHO FCTC Article 5.3, for
example, the Department of Disease Control, Ministry of Public Health issued the regulation regarding
measures to limit interactions with the tobacco industry. The comparison studies of Canada, Philippine
and Kenya show that all of these countries have the best practices and more progress than Thailand in
some aspects. Thai government and Ministry of Public Health should revise laws, regulations and issue
some measures regarding WHO FCTC article 5.3, for example, the Regulation of Prime Minister’s Office
concerning the article 5.3 and propose new tobacco control law in order to set up the national tobacco
control board.
Unhealthy diets consumption in particular early starting in children is a crucial determinant of health
conditions and diseases. There is less research on diet purchasing and eating behaviors among children in Thailand. The objectives of this study were to explore food and beverages purchasing and eating behaviors
of primary grade 6 students. A hundred of students were randomly selected from 453 students in two
provinces. The students were asked to complete a self-administered questionnaire on food and beverages
consumption. They received a certain amount of cashes to buy any food and beverages in convenience
stores; type and prices of food and beverages they bought together with purchasing behaviors were observed.
To gain more understanding of students’ eating and purchasing behaviors, 39 out of them were
drawn for semi-structured in-depth interview. Descriptive statistics and content analysis were applied to
these data. Of total 100 students, most of them had good eating behaviors as consuming breakfast (89%)
and vegetables and fruit (97%). The proportions of students reported eating unhealthy diets: snack, bakery,
fast food, candy and sweetened beverages were 100%, 98%, 97%, 90.9% and 90.9%, respectively. In
purchasing part, the most bought unhealthy food and beverages were sweetened beverages (91.7%), followed
by snack (67.9%), bakery (46.4%) and candy (39.3%) which expenses were between 21 and 40 baht.
It was explained that not only food and beverage taste and personal preference but also environmental
factors as family roles, availability and location of outlets around schools, and ease to access as arrangement
in front of the counter together with advertisement of unhealthy food and beverages had potentially
influence on students’ eating and purchasing behaviors. The findings of this study illustrate that children
substantially consume unhealthy food and beverages. Therefore, there are needed for more attentions and
measures at both individual and environmental levels.
All poisonous patients presenting to the hospital always have medico-legal aspects. The medicolegal
evidences in forensic toxicology are very important for the legal viewpoint concerned especially
with reference to concepts of “proof“, “causality” and “blame“. The health care providers must concern
their role and responsibility to protect the medico-legal evidences obtained from the poisonous patient as
well as treatment especially in the primary care hospital. The knowledge with technique in forensic toxicology,
chain of evidence, and related legal rules should be applied to deal with all poisonous patients for
reliability, accuracy, and legal fairness.
This report aims to analyse and link between sub- studies under the research project entitled ‘the
development of health promotion and disease prevention policies for children aged 0-5 years old in
Thailand’. The two sub-studies employed in this analysis include the list of prioritized health problems
among children aged 0-5 years, review of relevant existing interventions and policies in Thailand, and the
studies of interventions and policies in five selected countries. The study of international experiences
aims to provide lesson learned that might be useful for the development of related policies in Thailand. Results: Basic care packages for children aged 0-5 years old and pregnant women are similar. Developmental
screening tests are mostly based onthe Denver Developmental Screening Test-II. All countries
provide vaccines against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps and rubella. Neonatal
screening for congenital hypothyroidism is implemented in every country, whereas screening for
other conditions in the neonates and pregnant women are varied. Screening for hearing loss in the neonates
is provided in the United States of America, Canada, Taiwan, and the United Arab Emirates. Legislative
measures are used in many countries for ensuring access to health promotion and preventionservices,
reduction of low birth rate, prevention and treatment of genetic diseases and metabolic disorders, control
of artificial fertilization and obesity, prevention of child abuse and quality control child care centers. Canada
has a comprehensive system for empowerment of parents for child care. Recommendations for the betterment
of well-being of Thai children from good practices in these countries have been proposed.
Strategies for health promotion in Taiwan were developed based on the Ottawa Charter for Health
Promotion. The main health projects are broadly implemented in hospitals and health stations in communities
as well as in cities, schools, and workplaces. Health projects that are related to infants and young
children include the newborn screening program for 11 genetic metabolic disorders, child health check-up
preventive services, vaccination services, early detection and reporting of children with retarded development,
and management of rare diseases. At birth, every newborn is screened for 11 common genetic metabolic
disorders. An infant who has any of these metabolic disorders would be sent for further diagnosis,
treatment and monitoring. Expenses related to medication and nutrition supplements are supported by
the National Health Insurance system as specified under the conditions of the Rare Disease and Orphan
Drug Act. Moreover, the early intervention service (EIS) for children with developmental delay is an integrated and inter-discipline service. The implementation of screening and prevention of developmental
delay is started from antenatal period and continued to the age of seven years old. Suspected cases of
children with developmental delay will be referred to special health centers for further investigation and
treatment. The immunization coverage rate is as high as 95 percent due to an efficient national immunization
information system. Taiwan is also the first nation that uses a “stool color card” in a well child visit
book. The screening helps with the early detection and treatment of infants with biliary atresia.
In conclusion, health promotion policies in Taiwan aim at increasing birth rates, providing early
screening, and maximizing the child’s potential development. However, most references in this review
were from the government, a situation which may reflect only favorable aspects of public health policies.
The primary objective of this study is to assess and compile lessons learned in respect to impacts of health center devolution policy. Focus of the assessment is on administration and management, response to local health needs and increase access to health care of the devolved health centers. This study also aims to analyze contextual factors that explain the impact differences. Qualitative approach relying on data collection methods like in-depth interview, observation and documentary review was employed where study sites included 28 health-center- devolved areas. Data collection was carried out during the months of November 2011 and May 2012.
The study reveals that situation of the devolved health centers varied from area to area. Overall, about two-third of the health centers (16), their roles were not different from those during the period prior to the devolution. Only one-fourth (7) could fulfill the ideal roles (i.e. the provision of primary curative services, doing health promotion and prevention campaigns and inventing innovations to specifically respond to the local people’s health needs). In respect to transfer preparation, time and efforts for making both health center staff and local government’s officials and leaders prepared were found too short and less systematic. Problems of career development, capacity building and budget support from Contracting Unit for Primary Care-CUP abounded yet improving. No specific structure and system had been set up to curve the problems; most of the devolved health centers their vacant positions were mostly unfilled.
From the evidences gathered, it could be inferred that impacts of the devolution on health conditions, more equitable and easy access to health services were uneven. In the area where the transfer was smooth and health workers and local leaders could work harmoniously, a variety of innovative projects were created making services more accessible to the needy especially the chronically ill and the elderly. In some area doctors was employed as part-time staff. Yet, for the rest, insignificant difference of the service before and after the devolution was common.
This study concludes and recommends that 1)lessons learned from the 28 devolved health center shows successful tendency of health decentralization 2) Department of Local Administration-DLA and Ministry of Health-MOH have to seriously develop special policy and mechanisms to help make the devolution realistic especially the filling of vacant positions in the transferred health centers, 3) it is necessary for the policy bodies- DLA, MoH and the National Health Security Office-NHSO to have a clear and more committed policy direction to push forward the devolution of health centers; standard of practice guidelines and clear signal requiring CUP to support the devolved areas should be made explictely.
Decentralization is an important management strategy to improve local government efficiency and services. However, such efficiency will not occur without the self-governing ability of local authorities and communities. This study analyzes the capacity and preparedness of local administrative organizations and communities in taking over the healthcare responsibilities from the national government. The local health management capacity is divided into two (2) elements. First, institutional capacity refers to a local administrative organization’s ability to offer high-quality and adequate health services. The institutional capacity consists of three (3) dimensions: (1) political leadership and local executives’ attitude towards healthcare, (2) organizational structure and adequacy of local healthcare personnel, and (3) local fiscal capacity. Second, community capacity refers to a local community’s ability to participate meaningfully in the local policy-making process. This consists of two (2) dimensions: (1) local citizens’ attitude towards their health and (2) forms of citizen participation in social and political activities. Based on these two (2) elements of local health management capacity, this study examines six (6) local administrative organizations: Nongbua Lumphu Provincial Administrative Organization, Udornthani Provincial Administrative Organization, Udornthani Nakorn Municipality, Nongbua Lumphu Muang Municipality, Naphu Tambon Administrative Organization, and Nasee Tambon Administrative Organization. 
	This study finds that the three (3) “model communities” –including the Nongbua Lumphu Provincial Administrative Organization, Udornthani Nakorn Municipality, and Naphu Tambon Administrative Organization—demonstrate more institutional capacity than the other three (3) local administrative organizations. The model communities’ mayors exhibit positive attitudes towards healthcare responsibilities and the need to collaborate with the Ministry of Public Health and civil society.  Also, research findings indicate that each model community has         a local health department with adequate healthcare personnel to serve its constituents. Nonetheless, all six (6) local administrative organizations in this study encounter difficulty with revenue collection. Even the model communities still rely heavily on intergovernmental transfers to finance their operations and services. 
	In terms of community capacity, the model communities are more prepared than the other three (3) local administrative organizations. This is due to the diversity and enthusiasm of civil society organizations that offer a variety of health-related activities in the model communities. Such diversity and enthusiasm come from a wide range of news media outlets and other information sources that make local citizens aware of the importance of maintaining healthy lifestyle. Also, the local healthcare personnel’s proactive approach plays an important role in inculcating health awareness among local citizens.
Thailand, especially the south, more frequently faced natural disaster with more
severity which cause loss of life and property of affected population and also have
effect on public health system. Development of disaster management system is of
paramount importance to minimize such effect, however, no study of public health
disaster management in Thailand was found. This project studied 3 southern provinces
that have past experience on disaster management namely Phuket, Nakorn Sri
Thammarat and Songkhla to learn from their direct experience in order to recommend
disaster management for public health sector. The study included disaster prevention,
preparedness, response, mitigation, recovery and development during pre-disaster,
disaster and post-disaster phases. Methodology used in the study was mixed method,
quantitative and qualitative. This study also emphasized on the participation of the
participants from public health and relevant organization to build their capacity in
disaster-related data collection, management, analysis and utilization and team learning
by sharing experience among multi-disciplinary participants. Data collection was carried
out by document review, focused group discussion, in-depth interview and questionnaire
survey among executive, practitioner and the affected people.
The study found that the 3 provinces had developed from passive disaster
management focusing on public health service to active, integrated disaster management
with collaboration with relevant organizations at various levels from local, national to
international. Phuket had its forte in disaster preparedness especially with capacity
building and resource management and collaboration with academic sector. Its strong
leaders can also mobilize resource and link to national and international authorities.
Nakorn Sri Thammarat had strength in disaster response with multi-sectoral collaboration
and civil society participation while Songkhla excelled in community engagement to
prevent and mitigate the disaster with its strong community self-sustainable identity and
participatory public policy mechanism. However the three settings still had room for
development in the area of risk communication, information and early warning system,
systematic, effective aid management, long-termed recovery that integrated with
community development and knowledge management to improve disaster management
in the future.
The challenging recommendation to public health system from the experience of
these three settings is; public health system has to shift its paradigm from “medical
disaster management” to “health disaster management”. It should be more actively
engaged in integrated multi-sectoral disaster management with the multi-disciplinary
relevant organization including the civil society. Public health system, its facility and its  human resource have to be inclusive as a part of the community in disaster
management especially in prevention and preparedness.
While direct non-medical costs (DNMc) are inevitable for healthcare seekers, little is known about the magnitude of the economic burden on the household. The study aims to estimate the DNMc of outpatients
at Suratthani hospital and four primary care units (PCUs) in Suratthani’s municipal area. In addition,
the DNMc of patients were compared across different health centers as well as the patients’ household
areas.
We interviewed 200 patients/caretakers at the out-patient department at Suratthani hospital and
147 patients/caretakers at 4 PCUs in the municipal area from 24 October to 21 December 2012. All cost
data were collected and calculated using 2012 as the base year. Statistical analysis, including t-test and
ANOVA, was performed to compare the DNMc between subgroups, with a statistical significance level of
0.05.
The average DNMc of patients at PCUs, 76.7 baht, were significantly lower than those incurred by
patients at the hospital, 585.6 baht. Within this latter group, the DNMc of those who lived in the municipal
area, outside the municipal area, in Suratthani, and outside Suratthani were 248.3, 774.8 and 1,719.4 baht,
respectively, with statistically significant differences.
The study quantifies the household cost for out-patients, demonstrating potential economic barriers
faced by health care seekers. Information from this study can be used when designing a treatment and
referral system that seeks to minimize the financial burden on the patient.
This study aimed to assess the management and the operation of health facilities under ”Health
Insurance Policy for People with Citizenship Problems, the Cabinet Resoluion on 23rd March 2013“, which
enabled the target population to have better access to essential health services, through a case study in
Ranong province. Qualitative methods: in-depth interviews, group interviews, observations and document
reviews, were applied. Thematic analysis was employed for data analysis. The results revealed that, before 23rd March 2013, healthcare services were provided for people with
citizenship problems through “Health Card for Displaced Persons”. After the policy was implemeted, the
province set up its own managerial systems by allocating a due proportion of the budget for disease
prevention and health promotion activities, specifying the amount remibursed to be varied by the quantity
of services at the facilities, and encouraging proactive works through “Alien Health Officers” and
“Alien Health Volunteers”. Yet, in practice, there remained problems, e.g., communication insufficiency,
limitation in budget use, failure in registering populations who ever held the health card, and lack of
technical supports in legal academia.
In conclusion, though local mechanism for operating the policy is devised, its effectiveness should
be leveraged through several measures: expanding population coverage in concordnace to their actual
residence, increasing legal knowledge support, elucidating the budget regulation, and endorsing regular
monitoring systems. However, this study still holds some limitations, e.g. a sole approach through providers’
perspectives. Further studies are recommnded to explore the possibilities in developing recommendations
to a real practice.
Drug expenditure in the Civil Servant Medical Benefit Scheme (CSMBS)’s Direct Billing System shows
an increasing trend. The study aims to identify the measures in 34 hospitals for promoting the rational use
of drugs in high-cost therapeutic classes and for controlling their expenditures. The study found that most
hospitals placed a priority measure for proton pump inhibitors (PPIs), non-steroidal anti-inflammatory
drugs (NSAIDs) and Coxibs, antihyperlipidemics, angiotensin-2 receptor blockers (ARBs), glucosamine
and anti-osteoporosis by requesting physicians to comply with rational indications. The priority measure
for anti-platelet aggregates, angiotensin converting enzyme inhibitors (ACEIs) and anti-cancers was requirement
of written statement for reasons in prescribing non-essential drugs. An increase in the number
of hospitals encouraging the prescribing of generic drugs in 2012 as compared to 2011 was found for antiplatelet
aggregates, NSAIDs, antihyperlipidemics, ACEIs and ARBs. However, the generic and therapeutic
substitution policy was not imposed in most hospitals. For non-essential-drug prescriptions, most hospitals
did not require prior authorization by hospital administrators nor did they require patient’s out-ofpocket
payment for later reimbursement. In conclusion, hospitals did not enforce a restrictive measure for
promoting the rational use of drugs featured on the priority list of the Comptroller General Department’s
CSMBS.