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(Last updated
June 2006) |
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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:
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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.
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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.
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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.
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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.
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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.
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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:
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Sickness or Injuries Benefit consists of medical
treatment free of charge at a registered hospital and cash benefits
due to sick leave
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Maternity Benefit consists of cash benefit and lump
sum for delivery (See the Maternity Benefits section for details).
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Invalidity
Benefit consists of medical treatment and cash benefit
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Death Benefit
consists of funeral grant and survivors allowance.
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Child Allowance,
monthly allowance paid to the first two children, under 6 years of
age, of the insured person
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Old Age Benefit:
lump sum or monthly pension. The insured person receives old age
lump sum benefit or old-age pension benefit.
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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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