Engaging local governments in health promotion and chronic disease prevention activities: the case of Local Health Security Funds in Thailand
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 761 - 770
DOI: https://doi.org/10.5372/1905-7415.0906.448
Keywords
© 2015 Sudarat Lijutipoom, Somrat Lertmaharit, Piya Hanvoravongchai
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Health care systems should use community-driven activities to promote health and prevent disease to address the challenges from noncommunicable diseases (NCDs) such as diabetes mellitus and high blood pressure. In Thailand, Local Health Security Funds (LHSF) are an initiative to encourage local governments to play a more active role in promoting health. Universal Health Coverage provides funding for this initiative. However, the effectiveness of such initiatives has not been fully assessed.
Objectives
To investigate the effectiveness of LHSFs in conducting activities to promote health and prevent disease related to diabetes and hypertension.
Methods
We administered a questionnaire to local governments responsible for LHSFs in April 2014 to survey information about their communities, leadership, and activities to promote health.
Results
Complete answers to our questionnaire were provided by 1,144 respondents (98.4%). About 94% of those surveyed had already joined LHSFs. Most LHSFs implemented a variety of community activities to promote health, and prevent diabetes and hypertension. We classified these activities into 5 main areas according to the Ottawa Charter. LHSFs most commonly strengthened community action, while building a local health policy was least common. Only 20.8% of the LHSFs had implemented activities in all 5 areas. A number of factors were associated with the activities, including the development of networks and personal skills.
Conclusions
LHSFs are useful for engaging local governments in promoting health, and preventing diabetes and hypertension in their communities. Good relationships between local government leaders and public health officers are linked to more effective LHSFs.