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