The role of traditional Thai medicine (TTM) in Thailand

Abstract

Thailand’s National Health Policy set a minimum target of 5% for the use of TTM in 2011, but after concerted efforts from the government and commercial interests this target has not yet been reached. The literature suggests that TTM adoption in Thailand has not been as successful as expected due to Thai citizens’ low degree of recognition regarding TTM’s benefits and usage. It is clear that the understanding of and beliefs about TTM have not yet been systematically investigated in existing health-based research, which has focused on simple measures of consumption and access. Furthermore, what TTM means in both the public healthcare system and marketplace has not been investigated. There is also an absence of research investigating the role of communication in the adoption of TTM. Consequently, the knowledge and beliefs of Thai citizens in relation to TTM need to be explored within a societal framework, in which social relationships, culture, lifestyles and healthcare in Thailand are all inter-related. This qualitative study explores the roles and meanings of TTM for Thai citizens in their lives, to assist in the government’s promotion in Thailand. The research comprised 57 consumer participants in focus groups and 14 in-depth interviews with representatives of the health professions across the public and private sectors. It draws upon the Knowledge, Attitude, and Practice (KAP) framework in order to investigate these aspects based on the informants’ experiences in order to ensure that the overarching themes, evidenced across all groups, can be identified. The findings indicated a diversity of understanding about TTM, which will have a significant bearing on how the government can effectively promote its use. TTM meanings included household treatments, holistic treatments, and medicinal pots; as well as its representation as Thai wisdom, traditions, and culture including individual beliefs, which incorporate knowledge from both China and India that has been combined with established moral and ethical Buddhist principles. Consumers demonstrated a high level of awareness of TTM in its ‘traditional form’, a low level of awareness of the availability of TTM in its ‘finished form’ (tablets, capsules, etc.) in the marketplace, and a low level of usage. The findings also indicated that consumers had only a superficial knowledge of both forms of TTM, and that their current beliefs about TTM’s ‘traditional form’ were that it has become obsolete, devalued, and is no longer proper to use. Conversely, the ‘finished form’ competes with Western-style medicines, but it cannot show ‘relative advantages’ equal to conventional medicine in terms of quality, efficacy, and accessibility. Whether the consumer participants had used both forms of TTM depended on six important influential factors: 1) traditional and individual beliefs, culture, and history; 2) individual knowledge, attitudes, and perceptions; 3) social factors; 4) accessibility and convenience; 5) the consumers’ demographics; and 6) the promotion of TTM and drug advertisements. It appears that all of these factors have led to either success or difficulties for TTM adoption, for progress in the marketplace, and in Thailand’s public healthcare system. Findings also showed that conventional doctors had experienced the following: 1) a lack of awareness about the body of TTM knowledge and wisdom; 2) a lack of skills in carrying out TTM treatments, and 3) a lack of understanding about TTM products. Furthermore, the biases against TTM by medical doctors had caused TTM products to be overlooked and to only be used as ‘a massage treatment’. These factors have caused TTM to fall short of its national target for TTM usage by a wide margin. This thesis suggests that TTM is faced with ‘a cultural and national identity conflict of TTM’, resulting from: 1) an Intergenerational knowledge and attitude conflict, 2) a Socio-economic conflict, and 3) a Communication conflict. These conflicts represent potential obstacles to adopting TTM in Thailand, which has led to the anti-consumption of TTM by both consumers and medical professionals. The practical implications of these three conflicts are that the awareness and availability of TTM for consumers are largely constrained based on a lack of TTM knowledge by medical professionals and poor-quality information that circulates via commercial advertising and poorly targeted official communications from the MoPH. An appendix to this thesis includes recommendations derived from the findings and a discussion of how the MoPH can develop an appropriate strategic communication plan.

Date of Award	2019
Original language	English
Supervisor	Glen FULLER (Supervisor), Jerry Watkins (Supervisor), Joanna Henryks (Supervisor), Barbara Walsh (Supervisor), Mathieu O'NEIL (Supervisor), Bethaney TURNER (Supervisor), Raveena Singh (Supervisor) & Kate HOLLAND (Supervisor)