งานนำเสนอเรื่อง: "Migrant workers-trend, issue, policy and solution"— ใบสำเนางานนำเสนอ:
1 Migrant workers-trend, issue, policy and solution Dr. Chanvit TharathepDeputy Permanent Secretary, MoPH
2 Population Movement into Thailand 905,573+405,371106,970+61,625เชียงรายแม่ฮ่องสอนหนองคายเชียงใหม่อุบลราชธานีกาญจนบุรี235,521+112,275สุรินทร์ราชบุรีตราดระนองTotal Registration 20121,268, ,271
3 Top 5 Provinces Department of Employment 2004-2009 Where are the migrants?Provinces,20042009Bangkok163,637252,768Samutsakon77,527106,232Chiengmai48,50275,780Samutprakan31,49371,037Surajthanee33,19265,452Top 5 Provinces Department of Employment
4 Health Impacts Communicable Diseases Re-emerging diseases Maternal and Child HealthSanitation, EnvironmentHealth Expenditure and BurdenHealth Risks for Thai People
5 WITH THE Ill and poor migrants? Healthy Thailand?WITH THE Ill and poor migrants?
9 Immigration Bureau, National Security Council, Military Ministry of Interior, PoliceLawSecurityHealthHuman RightsEconomyInterestMinistry of Public HealthNGOMinistry of LaborLocal Government, Employer
10 Situation Analysis Carbinet Approved Regulation Year by Year Migrant: Fear, CommunicationEmployer: Rotated Migrant, Illegal MigrantHealth Service Unit: Limited resourcesParticipants: MoI, MoL, MoPH, MoD, Securities organization, NGOs (WHO, IOM, UNICEF, Global Fund, JICA, Care, Phamit, etc)Seperated Strategies, Missions among Organizations?
11 Policy and PlanningChange Illegal Migrants into Semilegal then Legal MigrantsImprove Coverage Health StrategySpecific Service for Specific Problem: HIVInformation System DevelopmentImprove Access to Health Service SystemImprove Participation, Migrant Health worker.
14 Strategy Map Health Service for Minority, Migrants Vision “ Healthy, High productive labor force with ensuring health security, prepared the health service systemUnder multisectoral Network and Community Partici[ationStrategy 1Strategy 2Strategy 3Strategy 4, 5Health Service SystemHealth Care SecuritySelf Care and Community ParticipationManagement and Information System1. Healthy Migrant, Minority8. Information SystemInnovation6. Prevention3. Health Care Security4. Adequate Input5 Promotion2. Health Service Delivery7. Management8. Holistic Care11. Benefit Package10. Catchment Area16. Co-ordinationGIS, Activities Mapping14. Self Care Skill15. Law, RegulationCustomer9. Intergration of care,Specific Service System: HIV, Violence12. Referal System13. Safety Net, High Cost, AE26. Electronic Record17. Health Service Network18.Environment, Sanitation19. Health Check, Screening21.Migrant Health Worker22.Risk Behavior23. Tools: Manual guidelinesFinance20. Unit CostActivity Based25. Human Resources24. GO, NGOs NetworkingLearngin andGrowth27. Knowledge Management28. Human Resource29. Structure
15 Self Care and Community Who are involves?Health Service SystemHealth Care SecuritySelf Care and CommunityParticipationManagement and MISOther Ministries:MoL, MoI, MoD, Police, Security√MoPHCentral LevelProvincial LevelNGO, international NGO, Global OrganizationMigrants
16 Physical Check up for Migrant ItemMaleFemale1. Chest X-Ray2. Syphilis, Filariasis *3. Urine Amphetamine4. Pregnancy Test-5. Leprosy6. Others as request by PhysicianAlbendazole 400 mg.*DiEthyl Carbamacine) 300 mg. before blood test
17 Health Care Security for Illegal Migrant 1,300 Bahts For 1 YearDisease Prevention*, Health PromotionOutpatient, Inpatient (30 Bahts Per Visit at the Contracted Hospital)**Work Related Disability (Employers, Work Related Fund)Accident and Emergency (Every Hospitals)*ARV to Prevent Mother to fetus infection**Not Include ARV for HIV+, Hemodialysis for CRF
18 Health Status of Migrants 2004-2008 YearCheckupTreatment and Follow upPregnancy2005713,6881.25%1.75%2006726,4781.04%1.43%2007534,4811.76%2008329,8510.80%20091,200,5690.56%1.95%2010825,2920.37%2.39%20111,124,5050.72%2.13%Health Service System Development Bureau, MoPH
19 Migrant Health Service Provision: impacts on Migrant health We can demonstrate the good outcome, the migrants who need treatment and follow up group reduced year by year.
26 Lessons learnt National Migrant Policy: Carbinet Approve Improve Participation: Migrant Health WorkersHolistic Concept: Social, EnvironmentIntersectoral coordination: Among Ministries, NGOPromote Improving Access to Health Service System,Equity: Same Benefit Package as Universal coverage Program.Appropriate Tactics in Different contexts
27 Immigration Bureau, National Security Council, Military Security, Economy, ….. Human Right, Health?Immigration Bureau, National Security Council, MilitaryMinistry of InteriorLawSecurityHealthHuman RightsEconomyInterestMinistry of Public HealthNGOMinistry of LaborLocal Government, Employer