Government initiatives in developing a health service system for the rural communities in Thailand can be traced back to the early 1960s. At that time some pilot projects which aimed to develop a health service delivery system for the rural areas were tried out with the support of WHO, UNICEF and USAID. Experiences from those projects were then discussed in two PHC-related national seminars. The conclusions from those seminars were presented at the international conference on PHC at Alma-Ata1.
The official adoption of the national PHC Programme in Thailand took place in 1979, when the cabinet approved the inclusion of the PHC Programme in the 4th National Economic and Social Development Plan (1978-1981), In November 1980, the Office of the Primary Health Care Committee, a division-level office, was set up within the MoPH2. Subsequently, the national PHC Programme was established. Many community-based projects were launched and implemented nationwide. The 5th Health Development Plan period (1982-1986), may be considered the golden period of Thai PHC, as many innovative PHC projects were developed and implemented. Among these were: 1) The Project for the National PHC Campaign Year 1984; 2) The Village Development Fund Project; 3) The Project for Developing the Quality of Life, Using the Basic Minimum Need (BMN) Process and Indicators; 4) The Project for the People’s Quality of Life Campaign Years (1985-1987); 5) The PHC Self-managed Village Project; 6) The Health Card Project; and 7) The Mini Thailand Project3.
Heggenhougen has stated that “many countries which signed the Alma Ata Declaration tend to consider the establishment of a CHW programme as synonymous with a national PHC effort”4. This is also true for Thailand. Since the beginning, the Thai National PHC Programme was predominantly oriented towards the training of VHVs and VHCs. In its first decade of implementation, 99% and 88% respectively of the PHC programme budget for the Fourth Health Plan (1977-1981) and the Fifth Health Plan (1982-1986), were spent on activities directed at training and supporting services and supervision of VHVs and VHCs5. As a result, national coverage of the VHVs and VHCs expanded rapidly within this period. Actual coverage, as reported in 1986, reached 99% of all villages. The total number of trained VHCs and VHVs were then 510,286 and 53,498 respectively6.