งานนำเสนอเรื่อง: "Migrant workers-trend, issue, policy and solution Dr. Chanvit Tharathep Deputy Permanent Secretary, MoPH."— ใบสำเนางานนำเสนอ:
Migrant workers-trend, issue, policy and solution Dr. Chanvit Tharathep Deputy Permanent Secretary, MoPH
Population Movement into Thailand เชียงราย แม่ฮ่องสอน เชียงใหม่ กาญจนบุรี ราชบุรี ระนอง อุบลราชธานี สุรินทร์ ตราด หนองคาย 905,573+405,371 106,970+61,625 235,521+112,275 Total Registration 2012 1,268,044+579,271
Where are the migrants? Provinces,20042009 Bangkok163,637252,768 Samutsakon77,527106,232 Chiengmai48,50275,780 Samutprakan31,49371,037 Surajthanee33,19265,452 Top 5 Provinces Department of Employment 2004-2009
Communicable Diseases Re-emerging diseases Maternal and Child Health Sanitation, Environment Health Expenditure and Burden Health Risks for Thai People Health Impacts
WITH THE ILL AND POOR MIGRANTS? Healthy Thailand?
Law Security Economy Interest Health Human Rights Immigration Bureau, National Security Council, Military Ministry of Interior, Police Ministry of Labor Local Government, Employer Ministry of Public Health NGO
Situation Analysis Carbinet Approved Regulation Year by Year Migrant: Fear, Communication Employer: Rotated Migrant, Illegal Migrant Health Service Unit: Limited resources Participants: MoI, MoL, MoPH, MoD, Securities organization, NGOs (WHO, IOM, UNICEF, Global Fund, JICA, Care, Phamit, etc) Seperated Strategies, Missions among Organizations?
Policy and Planning Change Illegal Migrants into Semilegal then Legal Migrants Improve Coverage Health Strategy Specific Service for Specific Problem: HIV Information System Development Improve Access to Health Service System Improve Participation, Migrant Health worker.
Strategy Map Health Service for Minority, Migrants Health Service System Health Care Security Self Care and Community Participation Management and Information System 9. Intergration of care, Specific Service System: HIV, Violence 8. Holistic Care Strategy 1 Strategy 4, 5 Strategy 2 Strategy 3 10. Catchment Area 20. Unit Cost Activity Based 21.Migrant Health Worker 22.Risk Behavior 23. Tools: Manual guidelines 14. Self Care Skill 15. Law, Regulation 25. Human Resources 2. Health Service Delivery 17. Health Service Network 19. Health Check, Screening 18.Environment, Sanitation 1. Healthy Migrant, Minority 12. Referal System 3. Health Care Security 11. Benefit Package 5 Promotion 6. Prevention 24. GO, NGOs Networking 8. Information System 16. Co- ordination GIS, Activities Mapping 26. Electronic Record Vision “ Healthy, High productive labor force with ensuring health security, prepared the health service system Under multisectoral Network and Community Partici[ation 4. Adequate Input 27. Knowledge Management 28. Human Resource 13. Safety Net, High Cost, AE Learngin and Growth Finance Customer Innovation 7. Management 29. Structure
Who are involves? Health Service System Health Care Security Self Care and Community Participation Management and MIS Other Ministries :MoL, MoI, MoD, Police, Security √√√ MoPH Central Level Provincial Level √√√√ √√√√ √√√√ √√√√ NGO, international NGO, Global Organization √√√ Migrants√√
ItemMaleFemale 1. Chest X-Ray 2. Syphilis, Filariasis * 3. Urine Amphetamine 4. Pregnancy Test- 5. Leprosy 6. Others as request by Physician Albendazole 400 mg. *DiEthyl Carbamacine) 300 mg. before blood test Physical Check up for Migrant
Health Care Security for Illegal Migrant 1,300 Bahts For 1 Year Disease Prevention*, Health Promotion Outpatient, 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
Health Service System Development Bureau, MoPH Health Status of Migrants 2004-2008 YearCheckup Treatment and Follow up Pregnancy 2005713,6881.25%1.75% 2006726,4781.04%1.43% 2007534,4811.04%1.76% 2008329,8510.80%1.76% 20091,200,5690.56%1.95% 2010825,2920.37%2.39% 20111,124,5050.72%2.13%
Migrant Health Service Provision: impacts on Migrant health
Treatment and Checkup Group
Health Care Security Physical Check up and Health Insurance
Self Care and Community Participation Migrant Health worker.
Health Service Providing Mother and Child Health
Management and Information System: Education for HIV, STD Prevention
Different Area, Different context
Lessons learnt National Migrant Policy: Carbinet Approve Improve Participation: Migrant Health Workers Holistic Concept: Social, Environment Intersectoral coordination: Among Ministries, NGO Promote Improving Access to Health Service System, Equity: Same Benefit Package as Universal coverage Program. Appropriate Tactics in Different contexts
Law Security Economy Interest Health Human Rights Immigration Bureau, National Security Council, Military Ministry of Interior Ministry of Labor Local Government, Employer Ministry of Public Health NGO Security, Economy, ….. Human Right, Health?
New Initiative 15 th Jan 2013 Cabinet approved MoPH Migrant health long term Strategy Not just migrant workers but families and children Documented and Undocumented Children health insurance