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Building equity in chronic disease management in Thailand : a whole-system provincial trial of systematic, pro-active chronic illness care

journal contribution
posted on 2011-01-01, 00:00 authored by N Wanitkun, Roy Batterham, C Vichathai, G Leetongin, Richard Osborne
Thailand has a history of implementing innovative and proactive policies to address the health needs of its population. Since 1962 Thailand has implemented initiatives that led to it having a health system characterized by a primary care focus, decentralization and mechanisms to maximize equity and universal access to basic care at the local level. Thai health structures initially evolved to meet challenges including infectious and developmental diseases and later HIV. Early in the 21st century chronic illness rapidly became the greatest cause of morbidity and mortality and the question has arisen how Thailand can adapt its strong health system to deal with the new epidemics. This article describes an effort to reorient provincial health services to meet the needs of the increasing number of people with diabetes and heart disease. It describes measures taken to build on the equity-promoting elements of the Thai health system. The project included; a situational analysis, development and implementation of a chronic disease self-management intervention implemented by nurses and alignment of provincial health services. The self-management intervention is currently being evaluated within a clustered randomized control trial. The evaluation has been developed to fit with the focus on equity in relation to both selection criteria and the outcomes that are being assessed.

History

Journal

Chronic illness

Volume

7

Issue

1

Pagination

31 - 44

Publisher

Sage Publications Ltd

Location

London, England

ISSN

1742-3953

eISSN

1745-9206

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2011, Sage Publications Ltd