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Case Study on HRH Management in Thailand
Nichakorn SirikanokvilaiMinistry of Public Health,Thailand
Major HRM Problems
Maldistribution
- Doctors : The majority of doctors is in urban
and big cities
- Nurses : Distribution is improved, density in
urban and big cities is still persistent Shortage of HRH Moral and productivities New policy initiatives
Human Resource Management Framework
Strengthen Human Resource Management
Production
• Physician
• Dentist
• Pharmacist
• Nurse
• Health Officers
Capacity Building
• Long-term for specialist, PhD
• Medium-term fellowship
• Short-term for academic study visit
Administration
• Incentive
• Retention plan
• One District One Doctor/One Tambon One Nurse
Challenges
• Decentralization and autonomous body
• Medical liability
• Public-private mix
• FTA and medical hub
• Emerging diseases
• Crisis management
• AEC
Measures for Manpower Distribution1. Compulsory measure Since 1973 all newly graduated doctors have worked for
govt. services for 3 years, if not, they would be fined by paying 12,500 US$
Since 1989 have started using measure to new dentists to work for govt. services for 3 years, if not, they would be fined by paying 12,500 US$
Since 1989 this measure have also extended to new pharmacists to work for govt. services for 2 years, if not, they would be fined by paying 7,800 US$
2. Special type for productionCPIRD , ODOD, ONOT
Measures for Manpower Distribution
3. Incentive measureReset allowance for health personnel who working in
different areas, remote rural area and urban area in order to maintain our major categories of manpower in rural area and to ensure that our people could access to health care facilities
4. Non incentive measureAdjust for higher level of personnel classificationPromote for more continuation education and trainingReward
Universal Coverage 2002Primary health care fund : invest more on manpowerDirect support for production of assistant dentist and
physical therapistIndirect support by support budget to hire doctor to work in
PCU which the rate of payment between urban and rural PCU are different, hire PT to work for rehabilitation in the community
Support budget to nursing colleges to conduct training for Nurse Practitioner to work on Basic Medical Care in PCU
Support budget to Regional/ General/Community Hospitals to be a place for training on Family Medicine and pay for doctors during training on FM
Development of People Participation
In 1977 the 4 th Health Development Plan, started to develop Primary Health Care
In 1978 Alma Ata Declaration In 1990 developed PHC assistant to be Village
Health Volunteer (VHV)In 2005 developed VHVs expertIn 2010 provided 600 Baht per month to VHVsPresent, there are more than 1 million VHVs to
work at the community level and one VHV will take care 10 households
GoalHRH in the right number, right quality, equity distribution,
working with moral principles and satisfaction
Strategy 1Mechanism to developpolicy and strategies
Strategy 2Reorient production
and developmentsystem
Strategy 3Reorient managementand supportive system
Strategy 5Promote and empowerThai indigenous healers
and civil society forhealth care
Strategy 4Knowledge generation
and managementfor HRH development
Strategic Challenges1. Dynamic of health needs2. Reorient of roles and responsibilities of human resources for health3. Bridge the gap between policy and practice
The Strategic Plan for the Decade of National Human Resources for Health Development
in Thailand 2007-2016
Strategy 1 : Mechanism to develop policy and strategies
National Committee on HRHCommittee at provincial level (under development)
Strategy 2 : Reorient production and development system
Focus on Rural Recruitment , local Training and Hometown Placement for the purpose of distribution
Strategy 5 : Promote and empower Thai indigenous healers and civil society for health care
Strategic development Plan on Thai wisdom
Prepare suggestion and recommendation that related to manpower development plan on community health care, particularly for disable persons, chronic patients who stayed in beds at home