Implementation of Thailand Social Investment Project - Research Proposal Example

An Evaluation of Past and Future Implementation of Thailand Social Investment Project by Financed by World Bank under the Concept of Buddhist Philosophy Chapter 1 Introduction 1. Introduction Theravada Buddhism is the dominant religion in Thailand which comprises 94% of the population practicing religion and 90% of all Thai population (US Library of Congress, 2007). Thai constitution stipulates to protect Buddhism as its religion along with other religion further stipulating that the government shall patronize it (Section 37 of Thai Constitution, cited in US Library of Congress, 2007, p. 11). Thus, religious instruction is mandatory in its public schools to encourage assimilation of its principles as a benchmark to entrust ethical lifestyle among its populace. Buddhism contributed greatly to the lives of Thais. In fact, the King of Thailand is a prominent Buddhist and the prominent figure in the country upholding Buddhism Faith. Buddhist monks play crucial roles in Thai society. In rural areas, in particular, they are treated as examples of ethical behaviors while Buddhist monastery and temples are centers of social activities and interaction (Kusalasaya, K., 2005, p. 20). The political fraud and corruption faced by the Thai Parliament under the auspices of former Prime Minister Thaksin and his subsequent successor has been considered by many of the Thai populace as against the teachings of Buddhism. It has been seen by the middle class population to have influence the electoral decision of the poor Thais resulting to vicious cycle of corruption since those corrupt government leaders are continuously elected by the major electoral populace comprise by the poor. This resulted to political disputes between anti government sector that calls for change in governance and pro government sector that believes in the corrupt government. Thus, the country is again face with a political crisis that affects the provision of government social programs just like what happened during the financial crisis of 1997 and subsequent natural and political crises that followed. These crises led to the implementation of Social Investment Project that seek external funding to help the government deal with dwindling funds to support its social projects particularly health services. 1.1 Statement and Significance of Problems The Asian Financial Crisis in 1997 adversely affected the Kingdom of Thailand. The Royal Thai Government or RTG anticipated increasing unemployment as one of the major social repercussion of the crisis. Estimated unemployment rate in February 1998 was 2.8 million accounting for 8.8% of total labor force. This number was approximately fifty-percent higher than the previous year. The effect of the crisis was massive particularly to poor Thai population since both long term and seasonal employment were affected particularly in the financial and construction sector (World Bank, 1998). As a result, there was a sharp increase in access to public health facilities since the unemployed populace, particularly the poor, has no choice but to give up their private health care insurance. Social assessments conducted with key informants from the social sector such as non-government organizations or NGOs, labor unions, and urban poor corroborated these statistics shared by the government to assess the impact of the financial crisis. It alarmingly showed that in order to add to household income, families tried to resort to child labor and children dropping out of school. Further, it indicated that there was prevalence of illegal activities just to increase household income. However, the Thai government has been experiencing reduced fiscal revenues as a result of unemployment and closure of businesses consequently reducing government financial support to social services and activities such as health care. (The World Bank, June1998) In order to protect its people, the RTG accessed the services of The World Bank to help develop and finance a Social Investment Project or SIP to combat the negative effects of the financial crisis. The Ministry of Public Health Program or MPH is a sub-component of the project that supported two programs under the SIP namely, (1) the “Public Assistance Scheme” and (2) the “Community Based Auto Immune Deficiency or AIDS Program” (The World Bank, April 1998, p. 2). The former expanded health card scheme to low income families to ensure continuous access of the unemployed sector to health care. The latter financed activities pioneered by NGOs to address the prevention and attention of HIV/AIDS at the community level. These two programs has been supportive to the poor and vulnerable groups in the community but were put at risk by the effects of the financial crisis. Activities in these programs require higher fiscal budget allocation but were subject to cost cutting as a result of the crisis; hence its continuity was put at risk. The SIP financed by World Bank has been completed in April 2004. However, the impact of the current political crisis to tourism and other employment opportunity of Thais revive the need for another round of SIP to ensure that the public health services to the people particularly to the poor and vulnerable will not be disrupted. Also, to avoid further deterioration in the values of governance particularly in project implementation, incorporating the Philosophy of Buddhism into the planning and implementation of SIP is crucial for its success and sustainability. This is significantly important since it is in line with the philosophy of sufficiency economy espoused by the Majesty King which focuses on social integrity at all levels of government and stake holder project implementation (Inside Thailand Review, 2007) 1.2 Research Questions The central research question of the dissertation is: How to integrate the Buddhist Philosophy into the future implementation of health care programs under the Social Investment Project? The following are the specific research questions of the dissertation: a. What are the salient Buddhist Philosophies applicable to health care programs? b. What are the relevant policy theories applicable to health care programs? c. Are these policies able to correlate with Buddhist Philosophies? d. Is there a manifestation of the Buddhist Philosophy in the implementation of the Ministry of Public Health of the health care programs of the Social Investment Project particularly the implementation of the public assistance scheme and community based AIDS program? e. What is the evidence that Buddhist Philosophy has been integrated in the implementation of these projects? f. What are the policy measures needed to ensure incorporation of Buddhist Philosophy in the implementation of health care programs and activities of the Ministry of Public Health? 1.3 Research Objectives The following are the research objectives in parallel with the research questions of the dissertation: a. To discuss the salient Buddhist Philosophies and relate its application to health care program implementation. b. To present relevant policy theories related to health care program implementation. c. To evaluate the manifestation of Buddhist Philosophy in the implementation of the health care programs under the SIP particularly the implementation of the public assistance scheme and community based AIDS programs. d. To present the evidence that Buddhist Philosophy has been integrated in the implementation of the health care program under the SIP. e. To present necessary policy measures that will incorporate Buddhist Philosophy in the implementation of health care programs and activities of the Ministry of Public Health. 1.4 Scope of Study The dissertation covers an evaluation of the Buddhist philosophy in relation to implementation of policy and programs related to health care under the provision of SIP as funded by the World Bank. Thus, theories related to policy process and implementation will be studied. 1.5 Limitation The study will be limited to cover a specific area in Thailand to gather relevant data wherein the presence of the health programs of the Ministry of Public Health are widely present both for public access scheme and community based AIDS programs. This will address the limitation on time and time financial resource of the researcher to gather data and conduct the investigation. 1.6 Definition of Terms The following are the terms that will be constantly used in the dissertation: Buddhist Philosophies are the salient teachings of Buddha focused on the four noble truths of Buddhism. Ministry of Public Health is the government office tasked to supervise the implementation of the health care programs as sub-component of the SIP funded by World Bank. The World Bank is the international financing institution that helps finance the social development undertaking of the Government of Thailand in developing and implementing the SIP. The Social Investment Project or SIP is the project funded by the World Bank as proposed by the Government of Thailand to counter the effect of the financial crisis of 1997. It is referred in the dissertation as the project being discussed wherein the Buddhist Philosophies will be incorporated to implement its sub-sector which is health care programs namely public access scheme and community based AIDS programs. 1.7 Benefits of the study The results of the study will benefit the overall Thai society particularly in lifting the duality between policy formulation and implementation and the teachings of Buddhism which is the prominent religion of the country. It will help create a policy process that help implementers and beneficiaries to practice their own faith, particularly that of Buddhism, in their professional and everyday life creating a sense of wholeness in their existence. Further, the study will help address the prevention of acts or temptation of corruption among policy formulators and implementers through the conscience focused incorporation of Buddhism principles. Its results will help provide a proof that Buddhism philosophy is not limited within the walls of Buddhist monasteries and temples but its importance and applicability to secular life particularly in policy implementation. Chapter 2 Review of Literature and Conceptual Framework The review of literature and the development of conceptual framework mainly cover three variables namely (a) policy theories and concepts, (b) Buddhism philosophy and (c) health care programs under the SIP funded by the World Bank. 2.1 Variables of concepts and theories used in the study The three main variables used in the study are policy process, Buddhist philosophy and health care programs of the Ministry of Public Health under the SIP funded by the World Bank. The independent variable among the three is the Buddhist philosophy which means that it can stand on its own independent from the two other variables. On the other hand, the policy process and the health care program are dependent on each other and needs the intervention of the Buddhist principle for the study to generate its objective. 2.2 Concept and theory of dependent variable There are a total of two dependent variables based on the above overall presentation of concepts of the study. However, these dependent variables have sub variables. The policy process variable has two sub variables in the two forms of two concepts or theories namely street level bureaucrats and linear modeling process. Health care program variable has two sub variables namely the public access scheme and community based HIV/AIDS program. These two variables will also generate specific data that will serve as sub variables. 2.3 Research finding 2.3.1. Policy process Street-level bureaucrats The implementation of policies and projects relies heavily to the so called street-level bureaucrats identified by Michael Lipsky (1980, cited by Wong, 2007, p. 2). This type of bureaucrats is represented by government employees that constantly in contact with project beneficiaries in the implementation of government programs. Doctors, health workers, social workers, police officers, and lawyers are examples of street-level bureaucrats. They are crucial in policy implementation since they are at its tail end; they are the one in the front lines directly dealing with beneficiaries and seeing their actual situations. Individually they comprise a small segment of policy implementation but collectively they have a greater impact to the success of policy programs and projects of the government (Lipsky, 1980, cited in Wong, 2007, p.3). Thus, integrity and commitment of these bureaucrats to effectively implement policy programs is crucial to its success. Linear model of policy process The linear model of policy process as shown in the figure below comprises three major phases in the policy implementation to address reforms in policy issues. Agenda, decision and implementation are the three phases involved in this type of policy process. Prior to these phases, the model recognize or identify first the issue that needs policy attention before identifying agendas or potential actions to address the policy issues. These agendas will then be analyzed based on its advantages and disadvantages as basis for going towards the decision phase wherein the best solution is selected. This solution will then be implemented subject for evaluation of its outcome. (Sutton, 1999, p. 9). Due to its progressive nature, linear model of policy process is criticized to be out of reality since there some critiques view the policy process as complex. However, the rational process of linear model allows for looking at things objectively and within scientific context that is useful for creating decisions for future policy evaluation and formulation (Overseas Development Institute, 2005) 2.3.2. Buddhism Philosophy As a philosophy, Buddhism tries to understand the complex nature of humans and their actions. It tried to set this understanding in recognizing a certain organization in the world. The Four Noble Truths i.e. suffering, its cause, its end and the way to reach the end are manifestations of the law of cause and effect as stated in the principle and control of Buddhism or what it calls as Dhamma-vinaya which states that the world is pervaded by a deep and unshakeable logic (Bullitt, J., 2007). These Dhammas or doctrines are not just taught but learned and must be put into practice to lead to appreciation of truth (Mahathera, N., 1995) just like science where facts or knowledge are observed. Thus, Buddhism correlates with science given that its doctrines are realized truths that should be experienced or practiced and not only learned through historical study. One must experience it to be able to realize such doctrines. The Four Noble Truths recognize the presence of suffering and its cause. Attachments are form of suffering caused by craving for sensual power which can be in the form of money, authority or opportunity. These sufferings can be ended or annihilated through the eight paths of right understanding, right thoughts, right speech, right action, right livelihood, right endeavor, right mindfulness and right concentration. These paths will lead one to discernment and reflection that will eventually lead to positive changes in lifestyle and behavior. 2.3.3. Health care program under the Social Investment Project funded by World Bank The project completion report of the World Bank (2005) evaluated the subcomponent programs of the Ministry of Public Health to be satisfactory in terms of meeting its objectives of (a) targeting intended beneficiaries particularly the poor and vulnerable sectors of the community and (b) enhance the management and efficiency of service delivery of the Public Assistance Scheme. A total budget of US$ 23.80 million was spent for this subcomponent which was used to finance health card scheme to low income populace accessing 47 public hospitals in six provinces of Thailand. A total of 1.15 million people benefit from the funds allocated for this activity. This figure comprises 75% of the total target beneficiaries. The funds were also used to improve the performance of the Public Assistance Scheme by introducing efficient payment method and install a model of budgeting based on performance. On the other hand, the completed activities or projects under the community based AIDS program which support NGO led activities to prevent and HIV/AIDS cases surpassed the number of activities or projects targeted nationwide. Higher participation of beneficiaries with HIV/AIDS, lesser discrimination against them, and increase awareness of the issue among local organizations and improved competence of NGOs to deal with the issue were the benefits derived from the health care programs of the Ministry of Public Health under the SIP funded by World Bank. In fact, the health care programs were one of the sectors with the most successful implementation under the SIP. However, problems on staffing and readiness of local organizations were met along the process of its implementation resulting to its delay and risk sustainability of the programs. (World Bank, 2005) Social funding such as the SIP is reliant on development that is motivated by the community. Letting people or the target beneficiaries participate in the social investment process or planning will ensure sustainability and avid participation to the project undertaking since they themselves are accountable for its implementation. Thus, the social impact of the project is long term since there is increase understanding on the attributes and deepening importance of “long term community-driven development theory” (Van Domelen, J., 2003). 2.4 Conceptual framework The success of the future implementation of the health care program of the SIP implemented by the Ministry of Public Health depends on the policy process that is planned and implemented efficiently by street-level bureaucrats and evaluated by independent auditors. The infusion of Buddhist philosophy in its planning, implementation and evaluation will ensure that public health programs under the SIP operates within the bounds of moral and ethical standards. The above conceptual framework shows that Buddhist Philosophy encircles the whole policy process and the variables operating within it to effectively plan and implement health care programs under the SIP as supervise by the Ministry of Public Health. Using the Buddhist principles in the planning, implementation and evaluation of health care project process will help it become more successful and sustainable with street level bureaucrats offering their services in line with their Buddhism beliefs. The influence of Buddhism philosophies will allow for higher integrity in the implementation of health care projects resulting to higher outreach of target beneficiaries and their overall satisfaction for the services granted to them. The conscious application of Buddhism philosophies particularly the process of annihilating suffering through understanding and discernment at every stage of policy process within the linear model will make the model itself helpful in making the policy makers and implementer mindful in their actions and the behaviors of the beneficiaries. Added to that is the community driven approach of social investment projects which ensures planning is relevant to target beneficiaries or stakeholders since they themselves are participants to the planning stage. Thus, in the end, effective implementation with higher social integrity will be achieved. 2.5 Hypothesis Hypothesis 1: Buddhist philosophy will influences street level bureaucrats to effectively and ethically implement health care programs under the Ministry of Public Health. Hypothesis 2: Buddhist philosophy will not influence street level bureaucrats to effectively and ethically implement health care programs under the Ministry of Public Health. Hypothesis 3: The success of delivery of service of health care programs under the Ministry of Public Health sub-component of the SIP funded by World Bank was influenced by Buddhist philosophy Hypothesis 4: The success of delivery of service of health care programs under the Ministry of Public Health sub-component of the SIP funded by the World Bank was not in any way influenced by Buddhist philosophy. Chapter 3 Research Methodology This section outlines the proposed research methodology that will be followed in the conduct of the dissertation. It covers the methods to be used, population and samplings, method of analysis, data collection and data analysis. 3.1 Qualitative Method The research methodology mainly uses the qualitative method of data gathering using the research questions, conceptual framework and hypothesis as basis for designing the qualitative research instruments to be used for data gathering. 3.1.1 Documentary research Each variable in the stated in the conceptual framework and hypotheses will be presented in detail using documentary research from pertinent desk documents, reports, evaluation, and research from the World Bank, the Ministry of Public Health, government regional offices, participating NGOs and Buddhist knowledge centers to provide detailed information on (a) health care programs particularly the programs on public access scheme and community based HIV/AIDS, (b) Buddhist philosophy, and (c) policy processes variables such as street level bureaucrats and linear model of policy process. Each variable will be allotted one chapter in the final dissertation. 3.1.2 Onsite observation Observation within the organizations mentioned above will be conducted while desk research is being conducted. In particular, assessment of behaviors and manner of talking about the health care programs among street level bureaucrats and top management policy implementers from these organizations will be focused of the observation. It will provide insights whether such actions and speech manifest any trace of Buddhist philosophy. 3.1.3 Participation The researcher will immerse in the situation of the street level bureaucrats as well as beneficiaries of the health programs while collecting and analyzing data. This will allow the researcher to directly work with them, share their thinking and empathy towards the project and the beneficiaries and vice versa. Thus, researcher will do of “on the job training” with these organizations to be able to experience what the street level bureaucrats are experiencing with their jobs as well as mingle with beneficiaries. 3.1.4 Focus group Focus group discussions will be conducted inviting representatives from the top management policy implementers and street level bureaucrats from the Ministry of Public Health, regional or provincial offices, hospital representatives and NGOs. A separate focus group discussion will be conducted for selected beneficiaries most probably those considered point persons by the NGOs in touching base with their fellow beneficiaries. Also, a separate focus group discussions will be conducted with monks in selected rural areas where there are health projects implemented under SIP. Questions will be asked by the researcher during the focus group discussion wherein answered derived from the discussion will be analyzed during data analysis. 3.1.5 In-depth Interview In depth interviews will be conducted using an a mixture of close and open ended questionnaire with respondents coming from the Buddhist monks, street level bureaucrats, top management implementers and representatives from World Bank that handled the SIP loan of the Royal Government of Thailand, if possible. General information to be gathered during the interview is the following: Respondents In-depth information to be gathered Buddhist monks/scholars Buddhist principles in secular setting, how Buddhism can be implemented in professional and organization set up and projects Top management implementers Factors that influence them to formulate and implement health care policies under the SIP Are their actions and considerations in the formulation of these policies and programs influenced by their Buddhist religion? Street level bureaucrats Factors that influences them to implement health care programs under the SIP Dealing with beneficiaries particularly those with HIV/AIDS are governed by Buddhist religion or not. Source of their dedication and commitment to their jobs. Representative from World Bank Are they open in the idea of including Buddhism philosophy in their evaluation of health care projects that World Bank is financing in Thailand? 3.1.6 Population and Samplings In depth interview of street level bureaucrats will have at least 100 sample populations. In-depth interview of key informants from top management implementers will have a minimum and maximum sample population of 25 and 50. At least 10 interviews from highly regarded Buddhist monks in Thailand or rural areas where the health care program of SIP was operating will be gathered. At least two to three representatives from World Bank that directly handled and member of top management that approved the loan agreement for the implementation of SIP will be conducted. Ten focus group discussions will be conducted with minimum of 5 and maximum of 10 participants each scattered throughout the selected regional areas where health care programs under SIP operated. 3.1.7 Analysis method Inductive analysis will be used in the analysis method wherein analysis is generated from the smaller spectrum towards the bigger spectrum. Selection of samples will be done using random sampling using database from the above offices. 3.2. Data Collection The data will be collected from selected regional areas and offices wherein health care programs under SIP were operated. The following are the detailed timeframe for data collection. Qualitative data Where to find Timeframe Documentary research Official reports, evaluation, research and data base from World Bank, Ministry of Public Health, regional or provincial offices, NGOs, Buddhist centers 45 days Onsite observation -do- 45 days Onsite participation -do- 45 days Focus group discussion -do-, beneficiaries 10 days In depth interview -do- 45 days Sampling selection and contact -do- 5 days Analysis -do- 15 days 3.3. Data Analysis Evaluative as well as descriptive analysis will be used to analyze the data collected from sample population. Although, qualitative method of data gathering will be conducted wherein data analysis will be based on the research questions formulated which require an assessment of responses as well as comparison and contrast. Statistical tools will be used to aid the analysis of data particularly the use of standard deviation. References Bullitt, J. (2007). “Frequently Asked Questions: Is Buddhism a religion or a philosophy?” Access to Insight Website accessed at http://www.accesstoinsight.org on 20 December 2008. Inside Thailand Review (2007). “Sufficiency Economy and Social Integrity”. Accessed from http://thailand.prd.go.th/ebook/review/content.php?chapterID=56&PHPSESSID=dfaca279bf7539c1779e69e661d8364d on 20 December 2008. Kusalasaya, K. (2005). Buddhism in Thailand: Its Past and Its Present. Wheel Publication, No. 85. Buddhist Publication Society. Mahatera, N. (1995). Buddhism in a Nutshell. Buddhist Publication Society. Accessed at http://www.accesstoinsight.org/lib/authors/narada/nutshell.html on 20 December 2008. Overseas Development Institute (2005). Theoretical Models. Overseas Development Institute Website. Accessed at http://www.odi.org.uk/RAPID/Tools/Theory/Theories_Linear.html on 21 December 2008 Sutton, R. (August 1999). The Policy Process: An Overview. Overseas Development Institute. Portland House, London. The World Bank (1998, 15 June). Report No. 17785 TH: Project Appraisal Document on a Proposed Loan in the Amount of US$ 300 Million to the Kingdom of Thailand for a Social Investment Project. Washington, D.C. The World Bank (April 1998). Report No. PID 7979: Thailand-The Social Investment Project. Washington, D.C. The World Bank (2005, February 15). Report No. 30237: Implementation Completion Report on a Loan in the Amount of US$300 Million to Thailand for a Social Investment Project. Washington, D.C. United States Library of Congress (July 2007). Country Profile: Thailand. Federal Research Division Van Domelen, J. (2003). Social Capital in the Operations and Impacts of Social Investment Funds. The World Bank. Washington, D.C. Wong, W. (2007). Report on Micheal Lipsky’s Street Level Bureaucracy: Dilemmas of the Individual in Public Services. . Read More