In Thailand, primary health care (PHC) is the first point of access to health services for all Thai citizens within the district health system. This case study investigates the political economy factors that have influenced Thailand’s decades-long implementation of the PHC approach, reinforced by the Universal Coverage Scheme in its pursuit of universal health coverage.
Specifically, the study examines key policy decisions, including:
- The selection of health care providers for contracting primary care services (e.g., primary care facilities vs. hospitals).
- The purchasing mechanisms for primary care services (e.g., capitation vs. alternative provider payment models).
The analysis explores the roles, power dynamics, and interactions of policy actors in shaping these decisions. It also examines the challenges and solutions in sustaining district health system contracting for primary care services before (2001) and after (2002) the universal health coverage reform, offering lessons for other contexts. Additionally, the study applies strategic levers that support PHC and the effective implementation of universal health coverage.
The case study is part of the Political Economy Analysis of Primary Health Care–oriented Reforms Country Case Study Series of WHO’s PHC Implementation Solutions Initiative.