Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these—such as diabetes, cancer, and inherited inborn metabolic diseases—have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems.

Background: The consumption of herbal and food supplements attributing to health expenditures in Thailand has been increasing over the years. However, information on herbal and food supplement products can make it difficult for some people with limited health literacy to use. Evidence from previous studies outside Thailand shows that SES disadvantaged groups are more likely to have limited health literacy compared with their counterparts with advantaged SES. The present study adds to this body of knowledge through an exploration of health literacy competencies related to herbal and food supplement consumption to determine what competency would be most problematic among Thai people. The study also investigated the influences of demographic and socio-economic factors on the most problematic health literacy competency on herbal and food supplements. Methods: The THL-S used a stratified three-stage-sampling to draw a sample of Thais aged 15 years and above. Participants were interviewed with a questionnaire of 34 items measuring health literacy and 8 items measuring behavioural practices. Responses to questions on accessing, understanding, communicating, and making decisions related to herbal and food supplement consumption were analysed. A logistic regression model was used to explore the association between having difficulties in accessing information and participant’s socio-economic factors. Results: Levels of difficulties the participants experienced varied among their health literacy competencies. Accessing reliable information was found to be the most problematic health literacy competency faced by respondents (48%), followed by asking healthcare providers about herbal products and food supplements (41%). Significant differences in the ability to access reliable information on herbal and food supplements were found to be based on differences in: education, income levels, occupation, insurance scheme coverage, age, sex, reading ability, writing ability, chronic diseases, wearing eyeglasses or lenses, hearing impairment, and having a community leading role. Conclusions: Accessing reliable information on herbal and food supplements has been found to be the most difficult health literacy competency among respondents to the survey, particularly vulnerable consumers in the society such as people with hearing impairment or having limited overall literacy competencies. Therefore, health literacy programs might be developed to build health literacy competencies and empower vulnerable consumers for reasonable use of herbal and food supplements.

Introduction. Many countries have introduced pay-for-performance (P4P) models to encourage health providers and institutions to provide good quality of care. In 2013, the National Health Security Office of Thailand introduced P4P, based on the UK Quality and Outcomes Framework (QOF), as a mandatory programme for primary care providers. This study aims to review the first year of the Thai QOF policy, focusing on the key features of its formulation and implementation stages. Methods.This study used a mix of data collection approaches, such as literature review, in-depth interviews with QOF managers, and focus-group discussions with health officers and practitioners. Data were collected between June and August 2015 and transcribed and analysed using qualitative content analysis (interpretation of the content of text data through the systematic classification process of identifying themes or patterns). Two consultation meetings were organised to verify the preliminary findings. Results. Based on the UK model, the Thai QOF was formulated without formal consultation with key stakeholders. Additionally, programme managers adopted a ‘learning by doing’ approach, since Thai authorities were already aware of health system limitations, such as insufficient human and financial resources and unreliable databases. There were also problems with QOF implementation, as follows: 1) deducting the budget from the annual payment for ambulatory care made the policy unjustified because providers did not receive full subsidisation of their service delivery; 2) lack of key stakeholder engagement resulted in miscommunication, and subsequently misunderstanding and inadequate coordination, for the translation of QOF policy into action; and 3) the unreliability of the IT system led to inaccurately-reported data on service delivery, thereby adversely affecting performance. Conclusion.There is still room for improvement in formulating and implementing the Thai QOF programme. Policy makers and programme implementers at both the national and international levels can benefit from this study for ensuring effective policy transfer and implementation of future QOF programmes.

Background: Behaviour related to injection drug use such as needle and syringe sharing and unsafe sex contribute to the transmission of blood-borne viral infections such as Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV). Therefore, it is recommended that ongoing Injection Drug Users (IDUs) should receive screening for HIV, HBV and HCV at least once every 6 to 12 months. This study aims to estimate prevalence of HIV, HBV and HCV testing uptake among IDUs living in Songkhla Province, Thailand, and explore its associated factors. Methods: A cross-sectional study was conducted among 157 male IDUs living in Songkhla, in southern Thailand, between July 2013 and January 2014. Participants were recruited through a snowball technique where they were given a unique coded coupon. Face-to-face interviews were conducted using a structured questionnaire. Results: The most common test reported was HIV (72%), followed by HBV (44.6%) and HCV (39.5%) respectively. Over one quarter (26.1%) reported not having been tested in the past 12 months while 35.7% reported having been tested for all three viruses. IDUs who had visited an NGO-run drop-in centre, knew the risks of injection drug use, had completed secondary or higher education, had used heroin or amphetamine less than weekly, had received targeted information or education, or were married, and had a greater likelihood to report receiving all three tests. Discussion and conclusions: There is room for improvement in the utilisation of testing for blood-borne viral infections. More attention must be given to those participants who have never visited a health facility or a dropin centre, do not know the risks of injection drug use and do not receive targeted information or education. Particularly, IDUs who use drugs more frequently should be the first priority.

Background Primary care serves as an entry point in the Thai health care system. Whilst effective interventions are provided in the primary care setting, the quality of the services have not been measured or tracked. A number of initiatives were undertaken to improve primary health care quality including the use of financial incentives to reward adherence to performance indicators. However, there were concerns that the current quality indicators had not been developed in a systematic, participatory, and evidence-based manner. Therefore, this study aims to develop new quality indicators for use in subsequent iterations of the program. Methods The development of indicators follows a well-designed approach. Reviews of existing documents as well as secondary data analyses were performed and presented to key stakeholders. Disease areas were then prioritised. Recommendations from the Thai clinical practice guidelines on the prioritised areas were then used to formulate statements and templates for each indicator. Finally, the indicators developed were piloted for 3 months in 28 primary care units across the country. Results Indicators related to care for diabetes and hypertension, maternal and child health, and rational use of antibiotics received high acceptability, and information was available and collectable in the current administrative database. However, there were problems in implementing indicators for managing cardiovascular risk, care for bedridden patients, and asthma and COPD. Conclusions The development of quality indicators using a guideline-based approach is a useful way of generating evidence to support the effective implementation of a program. Indicator piloting is recommended prior to introducing indicators in the health system.

Background and Aims: The purposes of this study were to; 1) examine the results of using the Jeopardy Game to enhance English communication skills in all Thai primary-school learners, and 2) to determine the learners’ satisfaction after learning English for communication by using the Jeopardy Game. Methodology: This study employed both quantitative and qualitative methods for collecting data, which were then analyzed statistically for the results. The samples of this study were twenty-six primary school students learning in grades 4-6, who learned English for communication with the Jeopardy Game for a certain range of assigned time. The instruments included a set of appareled pre-tests and post-tests, a questionnaire, and classroom observation. The data of the pre and post-test and questionnaire were collected, and the dependent t-test, the mean, and standard deviation were used to analyze the quantitative data such as the test and questionnaire and the content analysis was used for the interview as the qualitative data. Result: The data analysis, indicated that the mean score attained by the participants in the post-speaking test significantly surpassed the mean score attained in the pre-test. Additionally, it demonstrated that the learners enjoyed playing the game the most. Secondly, the learners required higher difficulty-level gaming activities used in the classroom. Thirdly, the learners were encouraged to speak English well. After the learners had learned English by playing the Jeopardy Game, their attitude toward learning English improved to a highly satisfactory level in terms of encouragement, attention, and fear reduction. It also showed that the learners obtained positive attitudes at high percentages, which are desirable factors of effective learning. Conclusion: The findings indicated that the Jeopardy Game had a positive effect on English learners. The game opened up the opportunity for the learners to speak English in meaningful conversations and situations, which made them speak English with less fear and learn unintentionally throughout the gameplay focusing on the eagerness and desire to win the game. However, continuity of learning English with fun games in the classroom should be undertaken in a variety of topics and skills.