Transformational Leadership in District Health Systems: Thailand’s experience

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Walaiporn Patcharanarumol
Rapeepong Suphanchaimat
Apisit Thamrongvarangkul
Thinakorn Noree
Varan Wangjitchian
Yothin Thanormwat


Background: Access to healthcare in rural and remote areas in Thailand is an important element in ensuring that Universal Health Coverage is achieved. The presence of a trained and motivated health workforce in these areas is therefore an important factor for health system development in Thailand. Transformational leadership plays an important role in establishing well-performing health teams. This article draws lessons from the Thai experiences and provides evidence on the pivotal role of transformational leadership from the medical doctor, the leader the health team.

Methods: Document reviews and key informant interviews from health staffs in three provinces upcountry were performed:  (1) Samutsongkram province, (2) Khon Kaen province, and (3) Tak province. Thematic analysis was applied using four components of transformational leadership.

Results: The District Health System is a primary care network in all districts in the country, serving as a firm basis for achieving Universal Health Coverage. The multidisciplinary health team consists of a wide range of health professionals, such as doctors, nurses, pharmacists, other professionals and public health officers. The function of the multidisciplinary health team involves not only facility-based health staff, but also non-professional staff, such as health care volunteers, and community residents. In the three settings studied here, health teams with a transformational leader displayed good performance in terms of (a) improving provision of a comprehensive health service package and (b) improving well being beyond health through considerations of sustainable livelihood, wealth and equity through advocating for the marginalized.

Conclusion: Commitment and transformational leadership by medical doctors, particularly those in rural areas, are key factors that help the multidisciplinary health team garner support from various stakeholders, such as NGOs and academicians for building up 'healthy' communities that go beyond good physical health and support other aspects of 'well-being'  for everyone on Thai soil.

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