Abstract
The health workforce is a fundamental resource that determines the success or failure of a
national healthcare system. Despite steady progress in producing core health professionals —
physicians, dentists, pharmacists, and registered nurses — Thailand continues to face persistent
challenges: inequitable urban-rural distribution, shortages in certain specialties, and ongoing
public sector attrition. These issues are further compounded by structural shifts including
population ageing, a rising burden of non-communicable diseases (NCDs), the devolution of Subdistrict Health Promoting Hospitals (SHPHs) to local administrative organizations, the universal
"one card, anywhere" health coverage policy, and the rapid advancement of digital health and
telemedicine — all of which are substantially reshaping patterns of healthcare demand and
workforce requirements.
In preparation for the next national health workforce strategic plan, this study aimed to: 1) report
on the health status of the Thai population; 2) review the current state of the national health
service delivery system; and 3) examine present conditions and future trends of the health
workforce. A conceptual framework linking three components — health demand, service delivery,
and health workforce — guided the analysis. The study employed a situational synthesis design,
combining a systematic literature review with in-depth expert interviews.
Findings reveal that Thailand is undergoing a clear epidemiological transition. NCDs —
cardiovascular disease, diabetes, cancer, and chronic respiratory conditions — now dominate the
disease burden as measured by Disability-Adjusted Life Years (DALYs). Mental health problems
are rising across all age groups, health-seeking behavior remains predominantly curative rather
than preventive, and social determinants such as socioeconomic inequality and geographic
location continue to hinder health equity.
The health service delivery system remains heavily hospital-centric, misaligned with the growing
needs of an ageing society for long-term care, community-based services, and home care.
Emerging models — telemedicine, home medication delivery, and community elderly care —
are gaining traction, particularly in urban areas, while interoperability of health data across
providers remains a critical gap.
On the workforce front, shortages in core professions have eased compared to previous decades,
yet geographic maldistribution persists, with concentration in Bangkok and large urban centers
while smaller and border provinces remain underserved. Professions with limited training capacity
— including radiologic technologists, psychologists, and occupational therapists — face
continued local-level shortfalls. Public-to-private sector attrition remains a concern driven by
disparities in pay, workload, and career prospects, and the workforce production system remains
poorly aligned with long-term health system needs.
These findings yield several policy recommendations. The Ministry of Public Health, working with
the National Health Workforce Committee, should develop a cross-sectoral workforce strategy,
strengthen primary care, and introduce performance-based incentives for new-generation health
workers. The Ministry of Higher Education and the Praboromarajchanok Institute should expand
workforce production through a "local recruitment – local training – hometown placement"
pipeline and embed digital literacy, systems thinking, and innovation across all health
professional curricula, alongside short-course training for community health workers. Professional
councils should revise regulations to facilitate interprofessional teamwork in primary care and
formalize pathways for non-licensed workers to deliver community health and social services.
Across all these efforts, the development of a unified health workforce information system is
essential for effective monitoring and strategic evaluation.
