Impact and sustainability of USAID assisted health activities in Thailand, 1951-1989

provided over $100 million to the Royal Thai Government for some 30 separate health projects. Activities were primarily in malaria eradication and control, population and family planning, rural water and sanitation, medical education and health training, primary health care, and nutrition. This evaluation concludes that, although there have been some failures at the project level, the impact of A.I.D. assistance has been outstanding at the policy and program levels. Highlights include: a reduction in malaria from the primary cause of death in the 1950"s to a minor cause; a significant drop in birth rates and a contraceptive prevalence rate equal to that of the industrialized nations; continued expansion of the Chiang Mai medical school; and rapid expansion of potable water and sanitary latrines. The sustainability of these programs is largely due to the Ministry of Public Health"s highly motivated and technically competent staff and strong management and planning capacities. The Ministry has prefered an experimental, flexible approach with emphasis on community participation. The projects also benefited from the economic stability and recent prosperity of the country, which ensured budgetary resources and increased demands for new health care interventions.