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首页> 美国卫生研究院文献>BMJ Global Health >Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand
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Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

机译：普遍健康覆盖的参与性和反应性治理：泰国立法规定分析

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Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.
机译：普遍健康覆盖范围（UHC）系统的参与性和反应性治理协同作用，确保公民的需求受到保护和满足。在泰国，UHC构成了三个公共保险计划：公务员医疗福利计划，社会健康保险和普及覆盖计划。每种计划都通过个别法律治理。本研究旨在识别，分析和比较三个公共卫生保险计划内与参与性和响应治理有关的立法规定，并在其在UHC的立法过程中汲取对其他低收入和中等收入国家的课程。使用来自关键文献的概念框架分析了每个政策文件的立法规定。结果发现，UHC立法规定促进公民代表性，参与UHC治理，实施和管理，支持公民声音的能力，改善UHC，保护公民获取信息，并确保获得和提供优质护理。参与性治理在33个部分中立法，其中23个属于普遍覆盖计划，4人在社会健康保险中，没有公务员医疗福利计划。响应性治理在24个部分中立法，其中18个是普遍覆盖计划，2人在社会健康保险中，4名公务员医疗福利计划。因此，在泰国UHC中存在关于参与性和反应性治理的若干立法规定，并非所有方案都同样有撑起的公民参与和政府反应能力。此外，由于立法仅仅是实现因素，就有充分的实施能力和对立法规定的承诺同样重要。

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