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Faculty of Public Health Mahidol University Bangkok, Thailand Health Challenges of South-East Asia by Assoc. Prof. Dr. Nawarat Suwannapong Deputy Dean, Faculty of Public Health, Mahidol University, Thailand I. Health challenges related to Health Management • Urbanization: Pollution, crime, drug abuse, commercial sex worker, etc. • Ecological imbalance: Landslide, flood, ecological and environmental issues are neglected, low priority, etc. • Changing social structures: Increased elderly population, increased stress,etc. • Globalization: Trans-boundary diseases, SARS, Free Trade Area (FTA) • Quality Health Care I. Health challenges related to Health Management (contd) • • • • Healthy public policies and decentralization Equity in health care Lack of emphasis on health promotion/prevention Lack of coordinated information for basing policy decisions • Confusion about the control of communicable diseases • Poor capacity of health authorities to evaluate the outcome • Professional ethics and human right II. Public Health System • Lack of popular support to public health e.g. India, political support and technical commitment were lacking • Leadership crisis e.g. Most of health administrators are clinician • Violation of National Health Policy e.g. Environmental health was outside the domain of health authorities • Outdated organization of health ministries and departments e.g. Integration of public health and medical services had disintegrated the public health system II. Public Health System (contd) • Professional inadequacy and apathy e.g. Health authorities took away ad hoc actions with inadequate technical insight and competence, India -- one doctor: 20,000 population • Conservative bureaucratic administration: there was a tendency to maintain the status quo • Financial constraints e.g. The limited financial resources available were spent wrongly, misconduct III. Infectious Diseases • Malaria: – Mapping of Malaria risk – Monitoring of drug resistance – Development of combination therapies and new methods of administering medications – Use of Insecticide-treated materials for personal protection – Improvement of responses to malaria epidemics – Gender issues in diagnosis, treatment and prevention – Home and community-based action to reduce malaria burden III. Infectious Diseases (contd) • Emergence of new diseases and new epidemics e.g. Avian Flu • Measles: a re-emerging disease, exhibited a new strain virus that attacks kidney • TB: Indonesia, Bangladesh, Myanmar, India, • HIV/AIDS: India, Myanmar, Thailand • DHF: e.g.Thailand, Indonesia Health Challenges of Thailand • Changes of lifestyle – pattern of morbidity and mortality changed • Non-Communicable Diseases – – – – – Cerebrovascular Diseases Carcinoma: all forms Accidents Diabetes Overweight and Obesity Health Challenges of Thailand (contd) • Infectious Diseases – DHF – AIDS – TB (re-emerging) – Severe diarrhea – Malaria (re-emerging) Universal coverage(30 Baht policy) Hospital Accreditation Tobacco banned policy Drunk don’t drive Healthy Thailand etc. Thank you