Abstract
The devolution of Sub-district Health Promotion Hospitals (SHPHs) and the 60th Anniversary
of Queen Sirikit Health Stations to provincial administrative organizations marks a significant shift in
Thailand's health system management. This change aligns with the 2008 Decentralization Plan aimed
at enhancing local governance in health services. The drug supply system is a critical area requiring
development to ensure efficient health service delivery during this transition and the long-term
sustainability of local health service mission. This led to a research project in 2023 aimed at designing
a drug supply chain management system, conducted by the College of Pharmacy Administration of
Thailand and supported by the Health System Research Institute (HSRI) in 2023. The study employed
a mixed-method approach to gather relevant facts from academic data and field surveys to identify
factors for designing an efficient drug supply chain management model, providing recommendations
for provinces to implement.
The research findings indicate that the decentralization policy of primary health services is in
trend with many developed countries. The devolution process in Thailand is aimed to ensure quality
health services accessibility and equitably for local community. Moreover, the strategy would
enhance local governors the freedom to manage health services in their own areas. This includes the
expansion to cover higher levels of health services and enabling the participation of private sector.
However, managing the drug supply chain is a complex aspect of health service provision that
involves multiple dimensions of operation concerning compliance with standards and legal
requirements and budget allocation. Provincial administrative organizations (PAOs) must be capable
to coordinate their mission with various organizations and stakeholders, including how to comply
with the existing regulations, standards, and legal requirements. Consequently, these will affect the
management of drug supply efficiency and availability for local health service of PAO. In the
meanwhile, the research successfully designed selective drug supply chain management models
based on the contextual facts found and by using the Vendor-Managed Inventory (VMI) concept to
enhance efficiency. This provides 3 options based on the drug supplier of choice (vendor): CUP
hospital, outsource party, or the PAO manage themselves, including recommendations for practice
of service delivery models, funding sources, and supporting personnel. All the 3 options were
considered feasible based on the evaluations from stakeholders and experts. Moreover, the research
has developed a drug data connection model which will be an important factor in developing a
seamless health service system for provincial healthcare system.
However, the implementation of the drug supply chain management models for PAOs still
had the concern of budget spending constraints in accordance with legal regulations. It requires
support from the Department of Local Administration, NHSO and the local health committee to set
development policies and guidelines.
