Thai National Health Accounts Part 2 Institutionalizing National Health Account in Thailand

Abstract

The Thai National Health Account (NHA) was locally initiated in 1994, institutionalized by 2000 and sustained to date. This paper reviewed experiences in institutionalizing NHA divided into 4 phases: incubation, capacity consolidation, institutionalization, and diversification and assessed four dimensions of capacity, namely capacities to generate routine reliable expenditure data, produce regular NHA matrices which facilitate international comparisons, use NHA for policy analyses, and improve the reliability and diversify NHA to respond to other national priorities.

Results indicated that national interest and policy utility were fundamental in ensuring ownership and sustainability. A number of enabling factors were identified: continued local funding support in longer term; commitment of NHA team members though turn-over was unavoidable but continuity of lead agency was vital. Intersectoral collaboration, availability of and access to national household health expenditure datasets, involvement by and recognition of strategic partners in particular of National Statistical Office helped improvement of national household survey tools which accommodated NHA matrices and better assessment of household health spending. Capacity led to diversification of NHA to support specific health policies. Key messages are: NHA should be locally initiated with technical supports from outside expertise. Long term commitment by local partners and working in enabling environment are basis for institutionalization. There is no quick-fix solution for institutionalization by outsiders.