The way forward: experiences of health promotion development in Thailand.

A landmark in health promotion in Thailand came in 2001 with the launching of the Universal Health Coverage Scheme at the cost of approximately USD 2 billion a year. Another important event was the establishment of the Thai Health Promotion Foundation (ThaiHealth) as a health promotion funding mechanism that draws upon a 2 percent surcharge levied on alcohol and tobacco excise tax, approximately USD 50-60 million a year. The most significant institutional development is the promulgation of the National Health Act in 2007. The Act embraces the principle of human rights and key principles of the Ottawa Charter in 2005. It is a result of five years of extensive public dialogues on important health issues that enhanced public awareness and nation wide networking on health promotion. ThaiHealth regards itself as a catalyst for health promotion. The organisation collaborates with all sectors of the society, from the national to the grassroots level, and is the most notable organisation for health promotion in Thailand. ThaiHealth funds programs on health risks/issues such as alcohol, tobacco, accidents, exercise, as well as area or setting based programs, for example, school, work place, community, and programs that target specific population groups such as the youth, the elderly, Muslim community. The open grants program invites proposals from all kinds of organizations/groups interested in launching health promotion initiatives. The endeavour has started to bear fruit. Smoking and alcohol consumption rates have dropped and more people have become health conscious and do more exercise. However, much remains to be done as some population groups especially the youth have become susceptible to various kinds of health risks. This remarkable start must be sustained and reinforced by the continuation and expansion of knowledge generation and dissemination, relentless policy advocacy and creative public campaign, with a strong health promotion network as the most critical success factor.

Integrated health promotion strategies: a contribution to tackling current and future health challenges.

This paper was presented as a technical background paper at the WHO sixth Global Conference on Health Promotion in Bangkok Thailand, August 2005. It describes what we know about the effectiveness of four of the Ottawa Charter health promotion strategies from eight reviews that have been conducted since 1999. The six lessons are that (i) the investment in building healthy public policy is a key strategy; (ii) supportive environments need to be created at the individual, social and structural levels; (iii) the effectiveness of strengthening community action is unclear and more research and evidence is required; (iv) personal skills development must be combined with other strategies to be effective; (v) interventions employing multiple strategies and actions at multiple levels are most effective; (vi) certain actions are central to effectiveness, such as intersectoral action and interorganizational partnerships at all levels, community engagement and participation in planning and decision-making, creating healthy settings (particularly focusing on schools, communities, workplaces and municipalities), political commitment, funding and infrastructure and awareness of the socio-environmental context. In addition, four case studies at the international, national, regional and local levels are described as illustrations of combinations of the key points described earlier. The paper concludes that the four Ottawa Charter strategies have been effective in addressing many of the issues faced in the late 20th century and that these strategies have relevance for the 21st century if they are integrated with one another and with the other actions described in this paper.