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Key Success Factors of the National Policy Implementation for Rehabilitation ServicesSirinart Tongsiri MD PhDWachara Riewpaiboon MD

1World Report on Disability Symposium, 5 December 2011, University of SydneyThis study can be viewed as a real-life example of the implementation of the National Disability Strategy. The take-home message is the policy process should not be overlooked. Main comments from P Wachara are 1. State the semi-actor as a local actor (because it is the matching fund between the state and local state actors as part of the decentralization). This should be clarified for users. 2. Include NL as the 8th RHSO 3. Include CBR matrix as one of the recommendations1OutlineRecommendation 3 of the World Report on DisabilityAim of the study Background FindingsConclusions

2Recommendation 3 in Chapter 9Adopt a national disability strategy and plan of action

Stakeholders should be involved in the development, implementation and monitoring of a national strategy using prevalence of disability, needs for services, social and economic status, gaps in current services and environment and social barriers

3This study aims toReport the policy process of the PWDs capability-oriented database development in Thailand 4

BackgroundAn ICF-based questionnaire is used to develop a PWD database to identify health needs, guide resource allocation and monitor rehabilitation services

Two provinces: NP and NL under the 8th RHSO separately implemented the database development

Then the 7th RHSO (including 4 provinces)NP was the first province as a research-based area. NL was the second province to develop the database implemented by the local government (after realizing the database potential). 5Key actorsState actor: the 7th RHSOLocal government actor: the Provincial Rehabilitation Fund (PRF) in the NL provinceNon-state actor: Disabled Peoples Organization (DPO) in the NP province 6The 8th RHSO is not regarded as a state actor here because the NL and NP province implemented the database development by its own will (NL as a research-based and NP as a collaboration between the state actor and the local government)67

NL province The 7th RHSO Khonkaen Roi-Et Kalasin Mahasarakham NP provinceThe 8th RHSOOther provinces in the 8th RHSO: Sakonnakonr, Udonthani, NongKhai and Bungkarn7FindingsThe 7th RHSO quickly implemented the survey by health personnel of the state healthcare providers

FindingsThe 7th RHSO quickly implemented the survey by health personnel of the state healthcare providersThe NP province is slowly moving forward to participatory continue the survey after finishing the research

FindingsThe 7th RHSO quickly implemented the survey by health personnel of the state healthcare providersThe NP province is slowly moving forward to continue the survey after finishing the research, in participation with other organizationsThe NL province started the survey by health volunteers with partial financial supports from outside funders

What we have learnedTo implement rehabilitation policies: key actors should be identified

State, local government and non-state actors, particularly the civil society, play crucial roles 1111What we have learnedState actor with higher control of authority, financial and human resources

Local government with limited resources but able to work across different organizations

DPO with insights of PWDs needs

What we have learnedICF can be used as a conceptual framework and communication tool among actors should the services are to be implemented

The CBR matrix can serve as a comprehensive monitoring tool of improving quality of life and enhancing equalization of opportunity of PWDs1313To achieve the Recommendation 3 Who play what roles in a big picture

State: higher control of resources and have good link with state healthcare providers

Local government: bridge the gaps between health, education, livelihood, and social support services

Non-state: particularly DPO could voice specific interests of its members to guide the policy development; a good platform for empowerment and equalization of opportunities for PWDs

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Contents of this slide can be used in the manuscript as well. 14