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International Health Policy Program -Thailand 1 Health Policy นพ.ทักษพล ธรรมรังสี Thaksaphon Thamarangsi International Health Policy Program (IHPP) Ministry.


งานนำเสนอเรื่อง: "International Health Policy Program -Thailand 1 Health Policy นพ.ทักษพล ธรรมรังสี Thaksaphon Thamarangsi International Health Policy Program (IHPP) Ministry."— ใบสำเนางานนำเสนอ:

1 International Health Policy Program -Thailand 1 Health Policy นพ.ทักษพล ธรรมรังสี Thaksaphon Thamarangsi International Health Policy Program (IHPP) Ministry of Public Health, Thailand

2 International Health Policy Program -Thailand 2 What is ‘policy’? a course of action or inaction (Heclo 1972) a course of action adopted and pursued by a government, party, rulers, statesman (Oxford English Dictionary) a set of interrelated decisions … concerning the selection of goals and the means of achieving them within a specified situation … (Jenkins 1978) decisions taken by those with authority and responsibility for a given policy area (Buse et al 2005) any course of action followed primarily because it is expedient or advantages in a material sense Policy Strategy Plan Program of work นโยบาย ยุทธศาสตร์ แผน

3 International Health Policy Program -Thailand 3 What is ‘public policy’ Public policy is whatever governments choose to do or not to do. Failure to decide or act on a particular issue also constitutes policy (Dye 2001) Public policy is the policy originated through the decisions of governmental agencies including legislative institutes to retain the status quo or to introduce changes in a policy domain (Howlett and Ramesh 2003) นโยบายสาธารณะ (public policy) หมายถึง ความตั้งใจ (intention) หรือคำ ประกาศ (statements) หรือการกระทำหรือละเว้นไม่กระทำอย่างใดอย่างหนึ่ง โดย Government หรือ ผู้ปกครอง (Parsons 1995) ‘the most important choices’ (Lasswell, 1951) ‘an action which employs governmental authority to commit resources in support of preferred value’ (Considine, 1994) ‘a particular object or goal, a desired course of events, a selected line of action, a declaration of intent and an implementation of intent’ (Ranney, 1968)

4 International Health Policy Program -Thailand 4 Differentiating Policy By importance High politics issues Low politics issues By level International level Regional level National level Local level By type Distributive Regulatory Self-regulatory Re-distributive By instrument Statements Regulations Laws

5 International Health Policy Program -Thailand 5 ระดับของนโยบาย นโยบายของรัฐบาล-แถลงการณ์ของนายกฯ กฎหมาย พรบ พรก กฎกระทรวง ประกาศ แผนพัฒนาเศรษฐกิจและสังคมแห่งชาติ แผนแม่บทแห่งชาติ บัญชียาหลักแห่งชาติ ชุดสิทธิประโยชน์ของระบบประกันสุขภาพ กฎหมาย กฎระเบียบในระดับจังหวัด แนวทางระดับเขตตรวจราชการ มติของคณะกรรมการจังหวัด อำเภอ แนวทางการคัดเลือกเวชภัณฑ์ของโรงพยาบาล Clinical Practice Guidelines, Standard Operating Procedures (SOP) เช่น Laboratory manuals การจัดงานประชุมวิชาการ นโยบายระดับชาติ นโยบายระดับพื้นที่ นโยบายระดับองค์กร

6 International Health Policy Program -Thailand 6 Types of policy Distributive Redistributive Regulatory Distributive Public campaign, Vitamin supplementary, support research Redistributive Vegetable Tax cut/ increase tax on non vegetable & fruit to raise fund Regulatory Ban of snack diet Example: how to tackle the problem of low vegetable and fruit diet ?

7 International Health Policy Program -Thailand 7 What is bad policy? Let’s discuss ….

8 International Health Policy Program -Thailand 8 What do we mean by ‘good policy’? Six dimensions of good policy Effectiveness Efficiency Adequacy Equity Responsiveness (Accountability) Appropriateness (inc. feasibility) Dunn, 1994

9 International Health Policy Program -Thailand 9 Policy diagram InputProcess By product Input  Human resources  Financial resources  Instruments  Technical knowledge Output Outcome EffectImpact Short term Long term

10 International Health Policy Program -Thailand 10 The Policy Triangle Walt G and Gilson L, Reforming the health sector in developing countries: the central role of policy analysis, Health Policy and Planning 1994; 9: 353-70 Actors Context Content Process

11 International Health Policy Program -Thailand 11 Development Models Resource allocation models Trigger-down effect Pro-poor/ For-underprivileged policy Discussion  Establishing a new dentistry school (public/private)  Allocation of dental unit/ equipment

12 International Health Policy Program -Thailand 12 OOP as % monthly income by per capita income deciles, prior to UC (1992-2000) and after UC 2002 Source: Data in 1992-2000 from Thailand Health Profile 1999-2000. Data in 2002 from analysis of Socio-Economic Survey 2002 conducted by NSO. Remark: Health expenditure of household was percentage out of income.

13 International Health Policy Program -Thailand 13 กระบวนการนโยบาย policy process ขั้นตอนของกระบวนการ การตั้งวาระนโยบาย agenda setting การออกแบบนโยบาย Policy formulation การประเมินผล Evaluation การนำไปปฏิบัติ Implementation ผู้มีส่วนเกี่ยวข้อง Policy actors บริบทของนโยบาย Policy context

14 International Health Policy Program -Thailand 14 Agenda setting is the process by which problematic conditions come to receive governments’ attention, and the potential for policy alteration Kingdon’s - 3 Stream model No Change Problem Policy (Solutions) No Change Politics (Political will) ACTION Policy agenda setting

15 International Health Policy Program -Thailand 15 Policy formulation 2-pronge process: options formulation, decision making (legislation) Rationalism – What do we mean by ‘rational policy decision’ – Evidence-based policy Incrementalism – Significant change is the accumulation of small changes The roles of non-policy makers

16 International Health Policy Program -Thailand 16 Research-policy nexus งานวิจัย>> ข้อมูลเชิงประจักษ์ >> การตัดสินใจเชิงนโยบาย Young J, Research and policy: parallel universe?, Oversea Development Institute Annual Report 2002/3 กลไกการเชื่อมโยงระหว่างภาค วิชาการกับนโยบาย Link between policy and research communities บริบทของการ ตัดสินใจ Political context ความน่าเชื่อถือของข้อมูล Credibility of evidence The power of discourse & format

17 International Health Policy Program -Thailand 17 Policy implementation The role of policy implementer as ‘mediator’ The role of policy makers as ‘system administrator’ ‘implementation failure’ or ‘implementation deficit’ Top down: focus on how effective the policy is implemented? Bottom up: focus on the role of implementer

18 International Health Policy Program -Thailand 18 Policy actors Is policy process manipulable? Who can influence/ manipulate policy process? Who is policy actors? Power and interest The concept of actors: policy network, interest groups The role of mass media? How those voiceless people can involve in policy process? The confusing state of GO and NGO: (full-blown GO, GO-like NGO, NGO-like GO, full-blown NGO) Discussion: who are stakeholders in the problem of caries in children

19 International Health Policy Program -Thailand 19 Policy evaluation  Monitoring and evaluation  When does policy evaluation start?  What to be evaluated?  policy in different dimensions (i.e. equity, effectiveness, efficiency, etc)  component of policy process (i.e. input, process, output, by product) MonitoringEvaluation Alternative terminology Formative evaluation Summative evaluation PriorityEffectiveness of implementation Achievement of policy output Focus onInformationValue

20 International Health Policy Program -Thailand 20 CONTEXT Systemic factors which may have an effect on policy Situational factors (transient, impermanent), e.g. war, economic recession, droughts Structural factors (relatively unchanging elements), e.g. political system, type of economy, wealth, demographic features, technological advance Cultural factors, e.g. religious, hierarchies, social norms International or exogenous factors (Leichter 1979)

ดาวน์โหลด ppt International Health Policy Program -Thailand 1 Health Policy นพ.ทักษพล ธรรมรังสี Thaksaphon Thamarangsi International Health Policy Program (IHPP) Ministry.


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