Health promotion is one part of the Thai health system that has evolved over nine decades since 1918 when His Majesty King Rama VII founded the first health department in the Ministry of Interior. Initially, the department stressed individual health promotion and sanitation related to latrines, water supply, and hygiene. Services were delivered according to the "welfare” paradigm, i.e., from "provider” to "recipient”.
The reliance on a single government department and its staff meant that services could not expand in proportion to the increase in population over the ensuing decades and, thus, there were large gaps in service coverage. Accordingly, there was a shift in the health service paradigm in 1980 toward a more "people-to-people” service model. This primary health care approach gained acceptance from individuals and agencies within and outside the Ministry of Public Health (MOPH) as a key strategy to address poverty alleviation, and represented an expanded view of "health” as a basic human need and right that everyone should have access to, and which is the responsibility of all agencies to support.
Over the years, the Department of Health (DOH) has also evolved and adapted from the role as "host-provider” of health promotion, sanitation, and environmental health to a more collaborative role by sharing the process of analyzing, planning, and implementing activities in partnership with the beneficiary population. In the primary health care era the DOH has had to modify its role into a more limited "technical department” function in accordance with the national strategy of decentralization to local administrative organizations beginning in 1999. Continuing reform of the government in general, and health in particular, has occurred ever since, and the DOH has evolved accordingly in its role as a technical department and in accordance with the guidelines for health promotion as articulated in the Bangkok Charter of 2002 which called for the active participation and collaboration of all sectors of society.
The results thus far are proof of the effectiveness of this approach, and the DOH is accepted as the principal Thai agency for health promotion and environmental health to help all Thais attain optimal health status.
Despite these advances, the constant changes that society is experiencing on an unprecedented scale, and which includes not only those factors which impact on health alone, but the roles and capabilities of the staff, the resources of the local administrative organizations, development potential of the communities, the system and strategic initiatives of the government agencies under the guidelines of the specifications of the health charter, and general socio-economic and political fluctuations --- all these present a major challenge to the DOH to adapt to and keep pace with the times.
Therefore, the DOH has had to review and adjust its methods to make them better suited to the changing environment. To aid in this process the DOH created a conceptual map of its strategic approach to help integrate the thoughts, guidance, targets and roles of different agencies so that they are linked in a rational and mutually complementary fashion. Such an integrated plan can help facilitate implementation and evaluation of the results.
In developing the strategic plan, the DOH gave consideration to the fundamentals of the organizational vision, role, and culture along with the overarching administrative government development plan, the relevant ministerial plans, past results, knowledge of the workforce, and risks and challenges confronting the work. This new approach to strategic planning employed the use of three dimensions in conceptualizing the DOH plan for 2010-2013 i.e., The Ottawa and Bangkok Charters, Six Key Functions, Public Sector Management Quality Award (PMQA).
To this end, the DOH considers that these core values and the principles articulated in the Ottawa and Bangkok Charters along with the Six Key Functions are all mutually compatible and reinforcing. They demonstrate attention to the needs and satisfaction of the population, give appropriate importance to knowledge acquisition and network building, support local participation of partners from all sectors (government, private, technical), support communication to the public, the local administrative organization and the community, emphasize results that are evidence-based, and stress the importance of good governance. Thus, the DOH has integrated these values and principles into its strategic master plan.