The Clearinghouse on International Developments in Child, Youth and Family Policies

at COLUMBIA UNIVERSITY

Thailand*

 

(Last updated June 2006)

Introduction and Overview

Known as Siam until 1939, the Kingdom of Thailand, covers approximately 198,455 sq. miles (slightly more than twice the size of Wyoming), is the only Southeast Asian country never to have been taken over by a European power. A bloodless revolution in 1932 led to a constitutional monarchy. Located in Southeast Asia, bordering the Andaman Sea and the Gulf of Thailand, Thailand shares borders with Laos, Cambodia, Malaysia and Myanmar.  

Thailand is composed of four main regions. The northern mountainous region contains numerous ruins and temples, the ancient city of Chieng Mai, and Thailand's highest peak, Doi Inthanon. The north-east of Thailand occupies the semi-arid Korat plateau, the most desolate and least-visited part of the country. An interesting blend of Thai, Lao, and Khmer influences characterize the culture of the Korat. Central Thailand, which consists of the fertile plains, is the country's most populous region and its rice basket. Thailand's alluring and congested capital city of Bangkok is located here. The southern region of Thailand, which stretches for hundreds of miles along the Malay Peninsula, abounds with stunning beaches and scores of tropical islands. 

Since the 1932 revolution, which marked the transition from absolute monarchy to constitutional monarchy, the King of Thailand has little direct power under the constitution but is a symbol of national identity and unity. King Bhumibol Adulyadej has been on the throne since 1946. The King commands enormous popular respect and moral authority, which he has used on occasion to resolve political crises that have threatened national stability.

Beginning with a brief experiment in democracy during the mid-1970s, Thailand’s political landscape alternated between bloodless military coups and democratic elections until 1992. Since then, there have been five national multiparty elections. In January 2005, the current Prime Minister, Thaksin Shinawatra, was elected democratically and leads a coalition government dominated by his own Thai Rak Thai party. Amidst political unrest and mass rallies against him, between April and May 2006, Prime Minister Thaksin Shinawatra called a snap election which was boycotted by the opposition and was subsequently annulled, leaving a political vacuum. The next election is tentatively scheduled to be held in October 2006.

The legislature consists of the 500-member House of Representatives (the lower house) and a fully elected 200-member Senate (the upper house). The lower house consists of 400 constituency members of parliament (MPs) and 100 MPs from party lists.

The legal system has remained an amalgam of the traditional and the modern. In several southern provinces, for example, Islamic law and custom are applicable to matrimonial and inheritance matters among the Muslims. A large part of the modern legal system is made up of criminal, civil, and commercial codes. The judiciary provides for three levels of courts: the courts of first instance, the Court of Appeal, and the Supreme Court.

Thailand is divided administratively into provinces, districts and subdistricts. Thailand has 73 provinces (changwat), including the metropolitan area of Bangkok. The provinces are divided into 642 districts (amphoe), 78 subdistricts (king amphoe), 7,236 communes (tambon), 55,746 villages (muban), 123 municipalities (tesaban), and 729 sanitation districts (sukhaphiban). The Department of Local Administration, under the Ministry of the Interior, is in charge of provincial and local administration. [Microsoft Encarta, 2006]

Thailand has a market economy and welcomes foreign investment. Exports feature textiles and footwear, fishery products, rice, rubber, jewelry, automobiles, computers and electrical appliances. Thailand has recovered from the 1997-98 Asian financial crisis and was one of East Asia's best performers in 2002. Increased consumption and investment spending and strong export growth pushed GDP growth up to 6.3% in 2003 despite a sluggish global economy. The highly popular government has followed an expansionist policy, including major support of village economic development. 

Services (45.6%) and industry (45.1%) contributed about the same to the GDP of Thailand in 2005. Agriculture contributed the least (9.3%) but employed the largest number of persons (49% of the labor force). Services (37%) employed the second largest number of persons followed by industry (14%). The unemployment rate declined from2.2% in 2003 to 1.4% in 2005. Between 1990 and 2003,  less than 2% of the population lived on less than $1 a day (World Bank line for poverty); and 32.5% lived on less than $2 a day (World Bank line for near poverty).  [CIA World Fact Book, 2006]   

In 2002, 73.5% of the total population was in the labor force,  approximately 34.2 million people. 81.5% of the total male population and 65.6% of the total female population were in the labor force during this period. Of the female population in the labor force, 53.6% were involved in agricultural activities and 46.4% in non-agricultural activities in 2002. The majority of the labor force  (72.1%) worked in the informal sector and only a minority (27.9%) worked in the formal sector in 2002. Social security in Thailand is still at an early stage of development and covers a minor proportion of the population. The national social insurance program is compulsory under the Social Security Act in all establishments with 10 or more workers. Recently, though on a voluntary basis, it has been extended to cover the self-employed. Benefits provided under the program are restricted to medical care and cash benefits in case of sickness unrelated to work, disability, child birth, and funeral assistance. The program is financed by tripartite contributions—employer, employee and government—each contributing 1.5 percent of the wage bill. Those not covered by any social security program can still resort to voluntary insurance, or rely on government or private assistance programs. [Kanjanaphoomin, 2004]

As a signatory to the Convention on the Rights of the Child, Thailand is committed to meeting the basic rights of all children. The profile of child rights was raised markedly in the early 1990s when Thailand became a party to the CRC. While a number of national laws and policies pertain to children, Thailand does not yet have a comprehensive Children's Code to cover broad aspects of child rights. A number of laws affecting children are also antiquated and need to be reformed.

The situation concerning children has improved on several fronts. Infant mortality was in decline for many years prior to the advent of HIV/AIDS, and there has been extensive vaccination against basic diseases. However, these achievements in child survival are being undermined by the threat of HIV/AIDS. With respect to child development, access to primary school is high, at over 90%. However, child protection issues are critical, and these involve primarily situations of violence, abuse, neglect and exploitation. Child protection issues also involve other groups such as the children who have to face the juvenile justice system, street children, refugee and displaced children, the children of minorities and indigenous communities, and children with disability. [Muntarbhorn, 2000]

The eighth National Economic and Social Development Plan (2001–2006) gave priority to human development, including child protection and participation. Indicators such as Social Indicators (Basic Minimum Needs), Indicators on Child and Youth Development and Indicators on Child Rights were introduced as guidelines for the effective protection of children’s rights.
   
Since the disaster of the Tsunami that struck on 12/26/2004, it is estimated that more than 90 per cent of the children are back at school (Plan International). The children who have not returned have moved to live with relatives in other provinces and there may be a few who are injured or still not ready to resume school after losing their loved ones. Schools have received sufficient short-term assistance in terms of school uniforms, supplies, books, furniture and financial assistance for the children who lost family members and homes. Numerous pledges for material and physical reconstruction of school buildings have also been received from private and public sources. The Department of Mental Health, UNICEF and others are providing psycho-social support to the children.

In the schools where damage to buildings was extensive, temporary structures have been erected whilst preparations for permanent school buildings have started. Most assistance has been flowing top-down with little consultation and participation by the communities and children concerned. Social support structures such as school boards and PTAs which used to link schools and communities are severely disrupted with some schools reporting the loss of key members. Most of the affected communities are in temporary shelters at the moment and the construction of houses and boat repairs are taking place in many communities. [Plan International, 2005]

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Government Agencies

A number of federal ministries are involved in child and family social policies. They include:  

  • The Federal Ministry of Education is responsible for promoting all levels and types of education as guaranteed under the Constitution. The Ministry is assisted by four commissions (described below in Child Education section) that provide guidance on policies and programs on specific areas of education.

  • The Federal Ministry of Public Health is the core agency in the Thai public health system, managing the health care system and formulating national health policies. The major functions of the Ministry of Public Health include the promotion, support, control and coordination of all activities related to physical and mental health including wellbeing of the people, and the provision of health services.

  • The Federal Ministry of Social Development and Human Security is the core ministry responsible for social affairs. The Ministry is comprised of governmental agencies, state enterprises as well as public organizations such as the Department of Public Welfare, National Youth Bureau, Office of the National Commission on Women’s Affairs, Department of Community Development, Department of Accelerated Rural Development, National Housing Authority, Public Pawnshop Office and Community Organizations such as the Development Institute. The Ministry works to promote social development and create public equity and social justice. The Ministry has three departments: the Department Social Development and Welfare; Office of Women’s Affairs and Family Development; and the Office of Welfare Promotion, Protection and Empowerment of Vulnerable Groups. The Office of Welfare Promotion, Protection and Empowerment of Vulnerable Groups which houses the Bureau of Child Promotion and Protection and the Bureau of Youth protection and Promotion, has the function of developing policies and programs to further the needs of vulnerable groups including children.

  • The Federal Ministry of Labor and Social Welfare aims to develop labor skills; promote job creation and increases in income levels; and, build a welfare base for the work force. It includes seven departments including the Department of Labor Protection and Welfare. It covers the areas of labor protection (including child labor), safety at work, labor relations, labor development, labor welfare, labor studies, labor statistics and equal employment opportunities to men and women. The Department set up a National Committee on Promotion and Protection of Home-based workers which works towards improving the working conditions and protection of home-base workers who are usually females, an extremely vulnerable group with not more than elementary level education.

  • The National Commission on Women’s Affairs administers prospective policies and planning for the development of women in Thailand. The commission developed a twenty-year plan which is integrated into every five-year social and economic plan, in order for gender issues to become part of national policy with budget allocation for the implementation of women’s programs.

  • The National Statistical Office is the core body responsible for Thailand's statistical activities including the collection, compilation, and dissemination of basic statistical data. The office also provides recommendations on statistics-related matters, organizes training courses in statistical methods and computer data processing and serves as the statistical data bank of the country. [Government of Thailand Websites]

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Non-Governmental Agencies

Non Government Organizations (NGOs) in Thailand have to be registered either as foundations or associations under the Civil and Commercial Code, which specifies the legal purpose and method of governance of the organization. In addition to registered organizations, unregistered organizations and international organizations that work in areas such as community development and public welfare are also part of the NGO sector. NGOs in Thailand are involved in a range of activities including rural development, children-related welfare activities and environmental issues.  

Co-ordination and interaction between NGOs and the Royal Thai government has been established through both official and unofficial channels. The National Council of Social Welfare was set up in 1960 to co-ordinate development efforts of NGOs and the government sector. The National Council of Buddhist Youth Associations and the Office of the National Committee on the Promotion and Co-ordination of Youth Affairs were formed to facilitate the dialogue between the government and NGOs in youth development efforts. A national level NGO Coordinating Committee on Rural Development and NGOs networks in different regions was formed during the 1980’s, mainly to improve communications and co-ordination among NGOs. These networks also provide an important link between the NGOs and government agencies.

Thailand has, over the past few years strongly supported NGOs in their assistance to national development and has integrated the participation of the NGO sector in the national development process. The first Thai NGO, Thailand Rural Reconstruction Movement, was established in 1969. In 1997, there were approximately 10,000 local NGOs and about 27 International NGOs with a wide diversity of interests. Besides health and education, many NGOs support community development projects including the promotion of agro-forestry and environmental issues.

Though NGOs have been somewhat successful in making their voices heard by the government, a nation-wide NGO umbrella organization that networks the various organizations, however, does not exist. Networking among the NGOs themselves seems loose and ad hoc. NGOs come together for a special issue, work on that for some time and drift apart after finishing their tasks. This is especially true when it comes to advocacy, where lobbying and campaigning plays a big role. Some of the NGOs with stronger ties have, however, formed groups, such as NGO-Cord, Thai Volunteer Service Foundation, The Local Development Institute (LDI)/ Local Development Foundation (LDF) and Its Networks, and various informal networks.

International funding is estimated to account for 70-90 % of the budget of most NGOs. This percentage is however declining and the NGOs have to find new national means for funding their activities. The constraints facing the NGOs are usually connected to: shortage of funds; lack of capacity with regards to number of staff, competence and professionalism; poor exchange of information and co-ordination with other NGOs; lack of adequate evaluation measures; and lack of recognition of NGO work by the government. [Riska, 1997]

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Demographic Profile

The population of Thailand is 64 million (2006). It is an increasingly urban country. The urban population increased from 18.7% to 31.1% in a period of 10 years (1990 – 2000). Population density of Thailand varies greatly between regions. While Bangkok has the highest population density with 4028.9 persons per sq. km.; Mae Hong Son in the northern region has the lowest with 6.5 persons per sq. km. On an average, in 2000 the population density in Thailand was 118.1 persons per sq. km.  

Thailand experienced one of the steepest declines in fertility among South East Asian Countries. Thailand's total fertility rate declined from 6.42 children per woman during 1960-65 to 2.60 between 1985-90 indicating a 59.5% decline during this period, far greater than its neighbors.  Thailand’s fertility rate has further declined since 1990 and was 1.89 in 2004. In 1960, the government launched a vigorous family planning program and made contraceptives freely available all over the country. This is considered one of the most important reasons for the decline in population growth rate from 2.7% in 1960-70 to 0.91% in 2004. This entire development was further supported by the significant economic development that Thailand experienced during the 1990’s. 

With a median age of 31.9 years, Thailand has a relatively old population. 22% of the population is comprised of children between the ages of 0-14, 70% of the population is comprised of persons between the ages of 15-64 and 8% of the population is made up of persons over the age of 65. Though the total dependency ratio (persons aged 0-14 and 65 and above) of Thailand declined from 91.84 in 1975 to 43.24 in 2000, the old age dependency ratio has increased from 8.8% in 1960 to 14.4% in 2000 and is expected to further increase to 23.5% by 2020 indicating an increase in the old age population of the country. The over 65 population has increased from 4.6% in 1960 to 8% in 2006 and is expected to increase and comprise 15.28% of the population by 2020. This increase in old age population and a decline in birth (16.04 births per 1000 population in 2004) and death rates (6.94 deaths per 1000 population in 2004) has resulted in the reduction in the child dependency ratio and increase in old age dependency ratio.  

Thailand’s population is relatively homogenous. The population is comprised of Thai (75%), Chinese (14%) and other groups such as Malay-speaking Muslims, Vietnamese, the Khmer; the Mon, and smaller mountain-dwelling tribes such as the Hmong and Mein, the Karen comprise 11%. Thai is the official language taught in schools and used in government communication. Thailand is a Buddhist country with Buddhism followed by 95% of the population. Other religions practiced include Islam (3.8%), Christianity (0.5%), Hinduism (0.1%) and other religions (0.6%). 

Thailand has given high priority to reducing maternal and infant mortality. In 2001, the maternal mortality ratio (MMR) was 44 per 100,000 live births. The commonest cause of maternal death is haemorrhage followed by toxaemia of pregnancy and sepsis. Infant Mortality Rate (IMR) declined from 74 per 1000 live births in 1970 to 24 per 1000 live births in 2002. The under-five mortality rate too declined during this period from 102 per 1000 live births to 28 per 1000 live births. Between 1998 and 2002, 9% of infants born were diagnosed as low birth weight. The percentage of undernourished people (as % of total population) decreased between 1990/92 and 1999/2001 from 28% to 19%.  

In a span of 10 years (1990 -2000) population with sustainable access to improved sanitation increased from 79% to 96%. The population with sustainable access to an improved water source also increased, during the same period from 80% to 84%. [National Statistical Office, 2000; CIA World Fact Book, 2005]

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Social Protection

Current social security programs in Thailand cover private enterprises employing at least one or more workers, civil servants and self-employed professionals under the Social Security Act of 1990 which is part of the Ministry of Labor and Social Welfare. Unemployed persons are not covered under this social insurance program (see below). The insurance program covers a range of benefits including:

  • Sickness or Injuries Benefit consists of medical treatment free of charge at a registered hospital and cash benefits due to sick leave

  • Maternity Benefit consists of cash benefit and lump sum for delivery (See the Maternity Benefits section for details).

  • Invalidity Benefit consists of medical treatment and cash benefit
  • Death Benefit consists of funeral grant and survivors allowance.
  • Child Allowance, monthly allowance paid to the first two children, under 6 years of age, of the insured person
  • Old Age Benefit: lump sum or monthly pension. The insured person receives old age lump sum benefit or old-age pension benefit.
  • Unemployment Benefit came into force on January 1, 2004. The laid-off insured person will receive an allowance of 50% of wages for not more than 180 days in 1 year. Only 15% of the labor force are covered under this benefit and these  are largely working in Bangkok.

The pension system in Thailand is different for the private and public sector. The compulsory defined benefits scheme for the private sector (establishments with one or more employees) is called the Old Age Pension Fund (OAPF). This fund does not cover self-employed persons, persons working in the informal sector, and teachers in private schools. The Social Security Act defines the combined contribution rate for old age pension and child allowance to be collected from 3 parties: employer, employee and the government, at a rate which altogether does not exceed 9% of wage (employer 4%, employee 4% and government 1%).  

All of these contribution rates are subject to a minimum of 1,650 Baht per month (US $43) and ceiling of 15,000 Baht per month (US $389). The contributions paid to the Social Security Fund by employers and employees are tax deductible and the benefits are tax exempt. To be eligible for the pension/provident fund, the insured person should retire at the age of 55 and should have contributed for not less than 180 months prior to retirement. A refund of the employee’s contribution is paid in a lump sum if the insured person has less than 12 months of contributions. If the insured person has more than 12 months but less than 180 months of contributions, a lump sum refund consisting of the employer’s and the employee’s contributions plus interest is paid. 

Private Teachers’ Provident Fund is the mandatory defined contribution plan for teachers and headmasters of private schools under the Private School Act. The contributions are 3% of salary from teachers or headmasters and 3% of salary from school owners while the government contributions are 6% of salary. Civil servants are covered under the Government Pension Fund Act of 1996.   

Supplementing social security are 2 voluntary defined contribution plans (Pillar III): Provident Fund and Retirement Mutual Fund (RMF) that are similar to 401(k) and Individual Retirement Account (IRA) in the US respectively.  

In the private sector, less than 5% (1.4 million) of the Thai labor force (32.5million) were members of provident fund in 2003 and only 22.8% (7.4 million) of total private labor force are covered by OAPF. [Social Security Administration, 2002; Kanjanaphoomin 2004]

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Child, Youth and Family Policy Regimes

Maternity Benefits

All women workers working in the private/formal sector (establishments with one or more employees) and public sector (civil servants and state-owned enterprises), private school teachers, have access to maternity benefits under the Social Insurance System . Women working in the informal sector, including domestic workers, are not eligible for maternity benefits under the law.   

All insured persons contribute 1% of their wages with additional contributions from the employer (1% of payroll) and the government (1% of wages) towards the social insurance system which finances maternity, disability and survivor benefits. This contribution is required for at least seven months in the fifteen months prior to the date of the treatment. Women receive 50% of their wages and up to 90 days of leave for each child birth. In addition to this, a lump sum of 4,000 baht (USD 104) is available as a childbirth grant to cover the cost of medical treatment during childbirth. This benefit is limited to two child births. [ILO, 2002]

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Early Childhood Education

The current 1997 Constitution of Thailand embodies new ideas about child and youth development which emphasize the importance of early childhood education for better adult development. However, early childhood education is neither compulsory nor free in Thailand.

In Thailand, as in most countries school-aged children receive far more policy and program attention than preschoolers. The early childhood education available is primarily for 3-5 year olds, administered under the auspices of the Minister of Education. In 1998, 81.32% of the early childhood education centers were operated by government agencies and 18.68% were operated by the private sector and NGOs. It was reported that 85% of children in the 3-5 age group received some form of out-of-home care service during the year. The very limited care available for 0-3 year old children is offered by four governmental agencies: the Ministries of Education, Public Health, University Affairs, and Interior. UNICEF and several NGOs are also involved.

There are mainly three types of preprimary education available for children aged 3-5: pre-school classes, kindergartens and child-care centers. Private schools offer a three-year kindergarten program. There are two types of pre-school education available in public schools: two-year kindergarten and one-year pre-school classes attached to primary schools in rural areas. The current trend is to expand the one-year pre-school classes to two-year kindergartens nation-wide.

Despite a miscellany of ad hoc ECCE initiatives, there is no clear picture regarding coverage of preschool-aged children in ECCE centers in Thailand. A 1996-97 survey revealed that 54.2 percent of these children nationwide were cared for at home while 37.3 percent were enrolled in centers. Generally, children were cared for by their mothers (53.1 percent) or relatives (19.7 percent) but there seems to be some overlap in these figures.  

During 1977-2001 several programmatic initiatives for children and families were launched, coordinated by the Council for Children and Youth Development. These included: ECCE initiatives; child welfare initiatives; and protection of children's rights across different systems. Most of these initiatives, however, are operative only in big cities. There is still no extension to rural areas but it is expected that these areas will get more attention in the future, as will child and youth issues generally. [UNESCO, 2002; Sankhariksha and Sumethsenee, 2002]

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Child Education

In 2002, the adult literacy rate was 92.6%,  94.9% - males and 90.5% - females. The Youth Literacy Rate in Thailand is close to 98%.  

All children in Thailand enjoy the right to education. Thailand’s present Constitution states that “a person shall enjoy an equal right to receive the fundamental education for the duration of not less than 12 years which shall be provided by the State thoroughly, up to the quality, and without charge.” In accordance with this, children have access to free, compulsory education for 9 years from the age of seven to sixteen.  

Almost ninety percent of primary school children attend either public schools or those run by Buddhist monasteries. Net Primary enrollment increased from 76% to 86% between 1990/91 and 2000/01.

Public expenditure on education increased from 3.3% of the GDP in 1995 to 4.3% in 2000 and declined slightly to 4% of the GDP in 2004. In 2004, the education budget constituted 24.4% of the national budget. Public expenditure on pre-primary and primary education declined from 56.2% to 42.3% as percentage of all levels between 1990 and 2001. One of the reasons for this decline in public expenditure on education was as a result of the economic crisis of 1997, which saw a decrease in government spending on social services, generally.  

The National Education Act promulgated in August 1999 and amended in 2002 serves as the fundamental law for the administration and provision of education and training; and is administered and implemented by the Ministry of Education. The administrative structure of the ministry includes the National Council of Education; the Commission of Basic Education; the Commission of Higher Education and the Commission of Vocational Education.  

A National Education plan was developed covering the 15-year period from 2002 to 2016. The plan serves as a framework for formulating development plans pertaining to basic education; vocational education; higher education; and religion, art and culture. It also provides guidelines for formulating operational plans for educational services and educational institutions. 

There are basically three types of education: formal, informal and non-formal. Formal education is provided through public schools, private schools, and schools under the jurisdiction of Buddhist or other religious institutions. The current system of formal education consists of four levels of education: one or two years of pre-school education; nine years of free compulsory basic education (6 years of primary and 3 years of lower secondary from age 7-16 or till Grade 9); three years of higher secondary education, and higher education.  

Special education is provided for children with various physical handicaps. Other groups of children  who access special education services include those with specific learning-disabled, autism, emotionally/behaviorally disordered, as well as gifted and talented children. The teaching and learning of special education is organized in both special and inclusive schools.  

The Ministry of Education decentralizes authority in the areas of educational  administration and management regarding academic matters, budgets, personnel and general affairs administration directly to educational institutions. In each educational institution providing basic education, there is a board composed of 7-15 members who are the representatives of parents, teachers, community organizations, local administration organizations, alumni and scholars. The board of each educational institution takes charge of the following responsibilities:  

1) Approve the policy and budget of educational institutions/schools;

2) Promote academic matters and the development of teachers and educational personnel;

3) Mobilize resources for education;

4) Promote internal quality assurance and external quality assessment;

5) Participate in the monitoring, appraisal and assessment of the administrators of educational institutions; and

6) Promote and support the performance of educational institutions/schools. 

A large out-of-school population has access to education through non-formal streams of education. The total number of participants in non-formal education rose from 3.5 million in 2001 to 4 million in 2002. Non-formal education services are provided by both public and private bodies to those outside the school system, i.e. early childhood population, school-age population who have missed formal schooling and over-school-age population.  

The average years of education received by Thai people aged 15 and over have increased gradually (from 7.1 to 7.8 years between 1999 and 2003) as a result of greater efforts to provide both formal and non-formal education to all people. [Ministry of Education, 2004]

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Child Health

Health expenditure in Thailand, as a percentage of the GDP, has steadily increased from 0.9% in 1990 to 3.9% in 1998 but  declined to 3.1% in 2002. Thailand has a health care delivery system comprising 92 regional/general hospitals (1996), 707 community hospitals at district level (1996), and 9559 health centers at sub district and village level (1999). In addition, a network of 61,432 rural community PHC centers (1996), 808 urban community PHC centers, and 51,737 village public address towers provide community support. Despite this impressive infrastructure hierarchy, some of the major issues that the health system faces are a weak referral system, mal distribution of personnel and wide disparity across the regions with the highest availability in Bangkok. A medical services welfare scheme for the poor and the disadvantaged, covering 25 million or 41.4% of the population, is intended to ensure equitable access to health care for the disadvantaged. 

The Infant Mortality Rate in Thailand has decreased from 84.3 in 1964 to 40.7 in 1984 and to 23 per 1,000 live birth in 2003. Though lower than the global average (56 per 1,000 live birth), Thailand’s infant mortality rate was yet higher than that in the same region, such as Singapore (2.28 deaths per 1000 live births) and Malaysia (18.35 deaths per 1000 live births). The rate of low birth weight newborns (less than 2,500 grams) has also dropped from 10.2 in 1990 to 8.1 percent in 2001. 

The mortality rate of children aged under 5 years old declined from 102 per 1000 live births in 1970 to 26 per 1,000 live births in 2003. However, the first period of economic crisis intermittently increased the death rate of children under 5 before it began gradually decreasing again. This can be attributed to a large extent to the important political and administrative changes  that have taken place since March 1996 with the decentralization of authority to local village administrative organizations, along with delegation of financial authority. In addition to this, the health policy of the government has continued to emphasize extending service coverage to all population groups so as to efficiently respond to peoples' needs.  

These developments can be attributed to a large extent to the important political and administrative change that have taken place since March 1996 with the decentralization of authority to 2760 local Tambon (village) Administrative Organizations, along with delegation of financial authority. During these organizational reforms, the health policy of the government continued to emphasize extending service coverage to all population groups so as to efficiently respond to peoples' needs.  

Health services in Thailand are classified into three types (Primary, Secondary and Tertiary) based on the level of care. Primary health care services include those organized by the community in providing services related to health promotion, disease prevention curative care and rehabilitative care. The medical and health technologies applied at this level are generally in response to the community's needs and culture. Service providers are those people in the area, voluntary heath workers or other non-governmental volunteers. Primary Health Care units include community health posts; health centers at the sub-district and village level; health centers of municipalities; outpatient departments of public and private hospitals at all levels and private clinics; and drug stores.  

Health care at the secondary level is provided by medical and health personnel with various degrees of specialization. Generalized and specialized facilities include community hospitals (located at the district or sub-district level), regional or large public hospitals and private hospitals. Tertiary health services are provided by medical and health professionals, mostly with specialized expertise. Tertiary care facilities include university hospitals and large public or private hospitals.  

Some of the major problems plaguing the public heath system in Thailand include

  • regional inequities in medical and health services;
  • health service system inefficiency including greater emphasis on treatment and drug over-utilization compared to preventive care;
  • lack of access to emergency services; and
  • inadequate investment in hospital beds. [WHO, 2004]

HIV/AIDS:

There are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale, but Thailand is an exception. A massive program to control HIV has reduced visits to commercial sex workers by half, raised condom usage, decreased STDs (Sexually Transmitted Diseases) dramatically, and achieved substantial reductions in new HIV infections.

Thailand has achieved a stunning 83% reduction in new infections, dropping from the 1991 peak of 142,819 new infections per year to an estimated 21,260 in 2003. In 2003, an estimated 570,000 people were living with HIV/AIDS and approximately 58,000 HIV/AIDS deaths were reported in Thailand. Of this, 12,000 (2.1%) were children between 0-15 years of age and 200,000 (35%) were women between 15-49 years of age. At the end of 2003, an estimated 1.7% of the adult Thai population was infected with HIV. [UNAIDS, 2004]

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Special Groups of Children

Children in Thailand, similar to those in other countries, are faced with new threats to their right to life, survival, development, well being and welfare.   Several measures such as law reform and international co-operation have been continuously introduced to cope with these crimes and violations against children. These include the enactment of the Act Concerning Measures of Prevention and Suppression of the Trafficking in Women and Children to combat syndicates of organized trafficking both nationally and internationally; the Prevention and Suppression of Prostitution Act to toughen the punishment of those who exploit children aged below 18 years regardless of consent; the Amended Criminal Procedure Code concerning pornography to cover offences committed on boys as well as girls. Furthermore, other preventive measures such as education programs and social measures, including the rehabilitation of the child victims have been implemented. Thailand passed the Child Protection Act, B.E. 2546 in 2003. However the details of the act are not widely known and enforcement is minimal.

Child Labor

The legal minimum age for employment is 15 years. The law permits the employment of children between the ages of 15 and 18 only in "light work," where the lifting of heavy loads and exposure to toxic materials or dangerous equipment or situations is restricted. The employment of children at night (from 10p.m. to 6a.m.), or in places in which alcohol is served, is prohibited by law.

In 2003, it was estimated that approximately 1 million children out of a child population of approximately 15 million nationwide worked on family farms. NGOs report that 2 to 4 percent of children between the ages of 6 and 14 years work illegally in urban areas; such children are at risk of becoming victims of other abuses of labor laws. Most underage workers in urban areas work in the service sector, primarily at gasoline stations and restaurants. Child labor is not evident in larger foreign-owned or domestic export-oriented factories.

A 2002 survey by the National Statistics Office reported 10,728 children were employed in domestic work. NGOs reported child domestic workers were predominantly foreign, migrating from Burma, Cambodia, and Laos. Most were in the country illegally, increasing their vulnerability to exploitation. Minimum wage and age provisions of the 1998 Labor Protection Act do not apply to domestic workers, many of whom are believed to be under 15 years of age.

The Labor Protection Act codifies the worst forms of child labor. Although not all child domestic workers fell under the worst forms, many were at risk due to their age, gender (predominantly female), legal status, and working conditions. The law specifically prohibits forced or bonded labor by children; however, forced child labor still exists. In 2003, NGOs and the ILO reported thousands of underage boys and girls were brought into the country for labor on farms, in sweatshops, and very young children were used to work in street begging gangs. [US Department of State, 2003]

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Child Trafficking

The law prohibits trafficking in persons; nonetheless, trafficking in persons is a serious problem. Thailand is a source, transit, and destination for trafficking in women and children for a variety of purposes, including indentured servitude, forced labor, and prostitution. The 1997 Prevention and Suppression of Trafficking in Women and Children Act increased the penalties for trafficking in women and children for the purposes of prostitution or slave labor, and provided for wide powers of search and for assistance to victims. There are also anti trafficking provisions in the 1996 Prostitution Prevention and Suppression Act. However, enforcement of these laws is not very effective.

Young boys and girls are trafficked chiefly from Burma and Cambodia primarily for sexual exploitation and to work in begging gangs. Young children, either orphans or those sold by their families, are among the children trafficked. For example, very young Cambodian children are employed by begging gangs in Bangkok. Occasionally entire families are trafficked for labor in sweatshops. Underage boys reportedly are brought into the country for specialized work in which small size is an advantage. According to domestic NGOs, girls between the ages of 12 and 18 years continue to be trafficked from Burma, southern PRC, and Laos to work in the commercial sex industry.

Several NGOs, both local and international, and government agencies work with trafficking victims. The government has established two national committees to combat trafficking, and these committees coordinated and cooperated with NGOs as well. The National Committee on Trafficking in Women and Children (NCTWC) is concerned primarily with counter trafficking efforts within the country, while the National Project Committee on Trafficking in Women and Children is focused on regional efforts.

The Department of Social Development and Welfare runs regional shelters to accommodate child and adult victims of trafficking. The Department has shelters for children and women separately. In May 2003, a series of Memoranda of Understandings between government agencies and domestic NGOs provided for some detailed procedures to assist with the problem of trafficked persons being detained by the authorities. The agreement stated that the training of police officers would include instructions to treat such persons as victims of human trafficking rather than as illegal immigrant workers. Rather than being deported, they become the responsibility of the Welfare Department.

In order to implement the new policy of humane treatment for victims of trafficking, the Department of Social Development and Welfare officials tried to refer underage and foreign women arrested for prostitution to one of the government shelter houses.

The children’s shelters of the Department of Social Development and Welfare do not repatriate foreign children trafficked into Thailand until they have found a contact person – either a family member or another NGO – in the second country who will be able to meet the repatriation team at the border. The International Organization for Migration assists the Department of Public Welfare in the safe return and repatriation of foreign children by transporting trafficked children to their homes or receiving NGOs in Cambodia, Laos, and Burma. [US Department of State, 2003]

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Notes

 * Research and Reported by Manita C. Rao

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