Based on the conclusions the following recommendations can be made:
1. The MoPH of Thailand to urgently formulate and implement a policy that directly addresses the promotion of rational drug use by consumers at all levels. The existing national drug policy has to place serious emphasis on the appropriate use of drugs in self-medication. To facilitate any attempts to solve the existing irrational drug use problem, the regulation and strict control of distribution, particularly of prescription, drugs, must be enforced. Besides, such policy should include other accompanying measures such as: (a) the promotion of essential drugs, specially in the private sector; (b) the reduction of the range of non essential drugs; (c) education of consumers in appropriate use of drugs; (d) regulation and control of drug advertisements (both in writing and on TV/film). The recent regulation which requires all drugs available in the market to have their generic name clearly shown is a contributing measure that should be seriously enforced.
2. Education of the public toward appropriate use of drugs must address the causes of inappropriate drug use by consumers. This implies that provision of information on potentially harmful side-effects and contra-indications of drugs must be conceptually phrased in the terminology of people’s drug use culture, take into account people’s own interpretations of the causes of illness and be tailored to the nature of the morbidity pattern in the specific rural or urban conditions. To develop such drug use education requires a participatory approach. Further, it is necessary for the effectiveness of drug use education that measures which curtail the abundant and easy availability of potentially harmful drugs in the villages, as mentioned in recommendation 1, are strictly implemented.
3. The present situation of provision and consumption of drugs in the villages lacks an agent which monitors what happens in this field and provides the necessary education and information required for enhancement of appropriate use of drugs by consumers, A decentralized consumer organization may be able to fill this gap.
4. Under the presently prevailing socio-economic conditions in the rural areas a sustainable and effective government induced village health worker scheme which is based on the premise of voluntary provision of time and labour will be very difficult to achieve, It is, therefore, essential that the government studies ways to develop community level primary health care which is better adjusted to the perceived needs and professionally defined health requirements of village populations.