“Health for All” or “Health by All (?)” Developing Health Management Capacity Indicators for Local Governments in Thailand

Abstract

Local government authorities serve an important role in public health and preventive medicine. Currently, Thailand and other decentralizing countries focus their efforts on developing local governments’ administrative and fiscal capacities to manage public health programs. Current research on community development and decentralization emphasizes local governments’ administrative and fiscal capacities. However, these local authorities are also expected to work closely with their constituents in fulfilling the public service responsibility. In contemporary public health practice, citizens are not only service recipients; they are important stakeholders in identifying priority needs, implementing policies and programs, and monitoring government performances

            This case offers a description of the dilemma facing the National Decentralization Committee—one of Thailand’s national policy planning agencies charged with formulating the country’s decentralization reform plan. An emphasis is placed on the key aspects of local governments’ management capacity that must be nurtured prior to the transfer of basic public health functions. Four community cases from Northeast Thailand are included in this case study to provide comparative insights into the administrative, fiscal, and social dimensions of health-related management capacity.

            The purpose of this case is to enhance students’ understanding of the complex policy making process in Thailand, particularly with regard to decentralization. Also, students are expected to understand the complexity confronting Thai local governments, as they attempt to optimize resource utilization to serve their constituents. In this case, students are required to identify the key management capacity indicators that must be included in a checklist of local governments’ preparedness measures for the next step in Thailand’s public health decentralization reform.