BackThe Constitution of the Kingdom of Thailand B.E.2560, Chapter 5, Duties of the State, Section 55 stipulates that the State must ensure that the people receive efficient public health services universally, ensure that the public has the basic knowledge in relation to health promotion and disease prevention, and shall promote and support the advancement of wisdom on Thai traditional medicine to maximize its benefits. The public health services under paragraph one shall cover health promotion, control and prevention of diseases, medical treatment, and rehabilitation. The State shall continuously improve the standard and quality of public health services.
The Ombudsman is aware of civil rights in public health and whether state agencies are able to efficiently provide public health services under their duties and mandates to citizens. In the meantime, there have been complaints filed with the Ombudsman concerning the need for pregnant women to take folic acid (vitamin B9) supplements to prevent birth defects in newborns in a daily dose of 0.4 milligrams before pregnancy, especially during the three months before getting pregnant and the first three months of pregnancy.
According to the World Health Organization (WHO), there are guidelines to reduce birth defects in all countries worldwide. Women of reproductive age or those preparing for pregnancy should take folic acid supplements of 400 micrograms daily before getting pregnant. However, the fact that Thailand had not yet produced folic acid tablets (vitamin B9) with a specific dosage in milligrams causes ineffective prevention of birth defects in newborns. The cost of folic acid tablets (vitamin B9) was also expensive, making the vitamin unaffordable for people with insufficient income. Therefore, the Government Pharmaceutical Organization (GPO) was requested to produce 0.4 milligram folic acid tablets for distribution to the public to prevent birth defects in newborns because the currently available folic acid (vitamin B9) supplements were 5 milligrams, which exceeds the body's daily requirement.
The Ombudsman conducted a fact-finding and held meetings with related agencies. The facts obtained from the investigations show that if women of reproductive age take a daily folic acid tablet (vitamin B9) of 0.4 milligrams, it can prevent 50 percent of birth defects in newborns, including the prevalence of neural tube defects, congenital heart disease, limb deformities, urinary tract dysfunction, anorectal malformation, cleft lip and cleft palate, as well as Down syndrome.
Hence, the Ombudsman recommended that the Government Pharmaceutical Organization (GPO) produce 0.4 milligrams of folic acid (vitamin B9) supplements for people to conveniently acquire in general within May 2020. The Ombudsman also suggested that the Ministry of Public Health, Ministry of Education, Ministry of Interior, Ministry of Social Development and Human Security, Ministry of Labour, National Health Security Office, Thai Health Promotion Foundation, and Bangkok Metropolitan Administration promote and raise awareness among citizens, youths, students, university students, and the working-age population, especially women of reproductive age, about the benefits of folic acid (vitamin B9) supplements.
This is to ensure that they understand the importance of taking folic acid (vitamin B 9) supplements to prevent birth defects in newborns and have access to these supplements.
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Source: The Office of the Ombudsman of Thailand
