A decade of health-care decentralization in Thailand: what lessons can be drawn?

Abstract

This paper reviews the progress of implementation of health-care decentralization in Thailandsince the promulgation of the Decentralization Act 1999, draws lessons learnt and providesrecommendations. This review was carried out because of the delay in health-care decentralization,as compared with what was indicated in the Decentralization Action Plan, and to identify thepossible causes of delay. The review also analyses other issues that affected implementation ofthis policy such as consensus on models of health-care decentralization, and other governmentpolicies being implemented during the same period. It is recommended that decentralization isnot a panacea for health system development and its concept should be applied carefully, basedon the country context