A decade of health-care decentralization in Thailand: what lessons can be drawn?

This paper reviews the progress of implementation of health-care decentralization in Thailand since the promulgation of the Decentralization Act 1999, draws lessons learnt and provides recommendations. This review was carried out because of the delay in health-care decentralization, as compared with what was indicated in the Decentralization Action Plan, and to identify the possible causes of delay. The review also analyses other issues that affected implementation of this policy such as consensus on models of health-care decentralization, and other government policies being implemented during the same period. It is recommended that decentralization is not a panacea for health system development and its concept should be applied carefully, based on the country context.