Vulnerability and risk management for sustainable livelihoods of farm households in Northern Thailand [Elektronische Ressource] : the role of health insurance in managing risk / von Thitiwan Sricharoen

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• Publié par: universitat_hohenheim
• Publié le: 01 janvier 2007
• Nombre de lectures: 37
• Langue: English
• Poids de l'ouvrage: 1 Mo

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FAKULTÄT AGRARWISSENSCHAFTEN

Aus dem Institut für Agrar- und Sozialökonomie in den Tropen und
Subtropen, Universität Hohenheim
Fachgebiet: Landwirtschaftliche Entwicklungstheorie und
Entwicklungspolitik


Prof. Dr. Dr. h.c.Franz.Heidhues





Vulnerability and Risk Management for Sustainable Livelihoods
of Farm Households in Northern Thailand-
The Role of Health Insurance in Managing Risk





Dissertation
Zur Erlangung des Grades eines Doktors der Agrarwissenschaften
vorgelegt
der Fakultät Agrarwissenschaften


Von
Thitiwan Sricharoen
Aus Chonburi, Thailand

2006 ________________________________________________________________________________ vii
PREFACE


During the last decade, the percentage of Thailand’s population living below the
poverty line has declined. However, the proportion of the poor who live in rural
areas has increased. Thus, rural poverty is still a massive problem. In addition to
poverty, households in rural areas are exposed to high levels of vulnerability
because they face manifold risks and have insufficient means of risk
management. Therefore, addressing the issue of poverty, vulnerability and risk nt in rural Thailand is important.

The complexity of the poverty phenomena in developing countries is
challenging. In this volume Thitiwan Sricharoen applies the concepts of poverty
and vulnerability in the uplands of Northern Thailand to assess the impact of
livelihood shocks and the reaction of the rural households in terms of adaptive
and coping strategies vis-à-vis risks. Households, not yet poor but having low
capacities in risk management may be confronted with a high poverty incidence
in the future. Health risks are a major problem. Yet, poor rural households have
limited access to quality health care. Health risks and subsequent expenditures
are a prime cause of poverty. Therefore, poverty reduction policies should
incorporate the provision of appropriate and adaptive risk management
strategies, not the least in view of health risks.

This work is closely linked to the Special Research Program (SFB 564)
“Sustainable Land Use and Rural Development in Mountainous Regions of
Southeast Asia”, also known as the Uplands Program at the University of
Hohenheim. This Ph.D. study at the University of Hohenheim was funded by a
Royal Thai Government Scholarship. The field research in the summer 2004
was financed by the Eiselen Foundation Ulm. All support is gratefully
acknowledged.






Prof. Dr. Dr. h.c. Franz Heidhues
University of Hohenheim
Stuttgart, Germany

ix
ACKNOWLEDGEMENTS


First and foremost, I would like to express a special thank to Prof. Dr. Dr.
h.c. Franz Heidhues and Prof. Dr. Gertrud Buchenrieder for their great help in
commenting on the drafts of this thesis, and their readiness to serve in the
evaluation committee of my dissertation. Moreover, I would like to express my
sincere gratitude to Prof. Buchenrieder for her help, guidance, encouragement
and recommendations. I can not count the number of times to say thank you to
her. I would like to thank Prof. Dr. Drs. h.c. Jürgen Zeddies for serving on my
examination committee. Also, I thank Prof. Dr. Drs. h.c. Jürgen Zeddies and Dr.
Beate Zimmermann for their kind help in smoothing life in Germany. I would
also like to thank Prof. Dr. H. Rüdiger Korff and Prof. Dr. Manfred Zeller for
many good suggestions.
Furthermore, I would like to thank the Royal Thai government scholarship
and Khon Kaen University very much for their support and grant to finance my
doctorate studies at the University of Hohenheim, Stuttgart, Germany.
Moreover, I would like to give many thanks to the Eiselen Foundation Ulm,
which was generous enough to provide the necessary funding for the empirical
research in Thailand in 2004.
When I felt that time put the most pressure on me, I received help from
Dr. Jirayuth, who donated his valuable time to lecture, commend and improve
my work and guide me through some academic challenges; I am most grateful to
you. The next person whom I would like to thank very much is Dr. Bampen
Kewwan, who helped me prepare part of my research field, gave me valuable
advice and many useful materials. Even more, I would like to thank all Thai
official departments such as the Ministry of Public Health and the Department of
Economics for supporting me during the empirical research phase in Thailand.
Many thanks go to my professors in Thailand, especially the professors from
Chulalongkorn University and Thammasart University - there are too many to
name individually. Furthermore, I would like to thank very much all the
households, village headmen, officers and staffs who devoted plenty of time and
endurance to my very long interviews.
I would like to extend my thanks to Erin and Deane, who spent many
evenings helping, criticizing and improving my work and presentation.
Moreover, I thank Michael and Akiko for their assistance in several computer
techniques. I would like to express my thanks to the staff members and friends
at the Department of Rural Development Economics and Policy (Institute 490a),
University of Hohenheim, for their support. Special thanks go to Anne
Schempp, Gudrun Contag and Coni Schumacher for their assistance in all
administrative processes and moral support during my studies. Many thanks go
to Prof. Heidhues, Prof. Buchenrieder, Coni Schumacher and Martin Grass who
edited my German summary chapter. After that, my thanks go to Varangkhana ________________________________________________________________________________ x
Sricharoen, who helped me in so many things. Then, I would like to thank June
Colwill and Siriphan Jarutheranart for mental support. Thanks also to Hubert
Waibel for a special time in Germany. My special thanks go to Wuttipong
Arjchariyaartong, who has been getting along with me from the beginning, and
his never ending attempts to help me solve some difficulties. Thanks to all my
friends who helped me in the critical times.
All in all, I am indebted to my family and relatives for keeping in touch
with me and their manifold support. I am very grateful to my beloved father,
who does not stay with me today. Finally, I thank God and Buddha very much.


Thitiwan Sricharoen
University of Hohenheim
xi
EXECUTIVE SUMMARY

This research attempts to explain the relationship between poverty,
livelihood difficulties, risk and risk management and vulnerability to poverty of
farm households in Northern Thailand. Furthermore, this study proposes a health
insurance concept for reducing idiosyncratic risks and poverty of farm
households. The survey underlying this study was conducted in Tambol Pong
Yang, Mae Rim, which is a mountainous district of Chiangmai province and is
representative of the northern mountainous region of Thailand. Nine villages
were interviewed in the study area. Four of the villages where populated by
Hmong hill tribes. Data were collected in two types of questionnaires: the first
questionnaire was comprehensive and looked at all socio-economic aspects of
the households; the second was related to health insurance. Data were collected
for the first questionnaire by interviewing two groups of farm households: the
hill-tribe Hmong and a local people known as Khon Muang. The random sample
consists of 200 households: 142 local northern and 58 Hmong households.
Primary data from the second questionnaire on health insurance was collected in
the Mae Rim district. The survey covered 200 households, 146 of which are
Thai and 54 Hmong.
The research started with the analysis of poverty and outlined the
assessment of the empirical poverty index, using Principal Component Analysis
(PCA). After the significant factors affecting poverty were identified, the next
procedure applied participatory rural appraisal (PRA) approaches in order to
know how households sustain their livelihoods. Then, individual farm
households were examined to analyse how they manage risks. If they managed
crises well, they were not exposed to severe consumption and income shocks.
Health risks were at the center of interest. Apparently, health insurance can
mitigate their risks so that demand and supply of health insurance was analyzed.
Thereafter, a classification of the factors responsible for dynamic poverty and
vulnerable households was done. This is important for policy makers to
propose appropriate health insurance and poverty reduction policies. The
analysis proceeded in six steps:
Firstly, the result of the PCA was utilized to determine the important
factors affecting household poverty. Furthermore, a poverty index was
developed. The PCA retained 16 out of 65 possible poverty determining
variables. The explicit factors relevant for assessing poverty are the dwelling
conditions, assets, human resources, and food security, respectively. The factor
which can lead the poor to become even poorer is the human resource factor,
where e.g. the number of dependents is comprised. The poverty compari