Community financing: Thailand's experience

This paper attempts to explain the basic concept behind the development of various community financing schemes for health in Thailand. It gives a brief review of four major schemes, as well as the factors contributing to their success and failure. In Thailand, various community financing schemes were developed through the process of primary health care. These are considered as part of the total community development rather than a mere source of financial support for health services. While the coverage of community funds amounted to almost 50% of the rural villages, the total amount of the funds was less than 1% of the total health expenditure of the country. Village drug funds were the first scheme to be developed in 1980. These were very successful, with a continuation rate (until 1988) of up to 80.94%. The coverage of rural villages was almost 50%, and the total fund amounted to 60 million bahts. The nutrition fund was the least successful scheme, due to its particular activities, low acceptance among the people, and limited capital appreciation. It now no longer exists. Sanitation and health card funds are fairly successful. They have higher capital appreciation and diverse sources of income. They contribute to the higher provision of environmental sanitation and basic medical services. Many single purpose funds were diversified into multipurpose health development funds or into multipurpose village development funds. Four major factors which have contributed to the success/failure of community financing schemes: government policy, support from health personnel, community infrastructure, and type of funds, are explored.