Access to Healthcare and Social Protection among Migrant Workers in Thailand before and during COVID-19 Era: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Conceptual Framework
2.2. Samples and Data Collection
2.3. Data Analysis
2.4. Ethics Consideration
3. Results
3.1. Sustainability of the HICS
“I think there should be an independent body to manage the HICS funding which is not the MOPH. We should separate a provider from the funding manager (to prevent COI). The MOPH can be a provider to manage health care services and the health systems overall.”—Public Health Officer PA-5
“As the HICS funding is not that big, we can include more beneficiaries of high-skilled workers to maintain the sustainability of this funding pool. We can also inform them about advantages of HICS packages that cover health promotion and non-communicable diseases in order to compete with private health insurance.”—NGO PA-2
“To set up on a single health insurance system like the UK can be a way to improve health and social equity. For the operational cost, I think this approach could save more money too as the management of different health insurance schemes will become less complex. However, it can be difficult in practice because the UHC law includes only beneficiaries with Thai nationality only.”—Public Health Officer PA-5
3.2. People Dropping out of the SSS
“Some migrant workers stay in Thailand for a short period of time, and some of them often change their employers. So migrants’ employers would not be satisfied once their migrant workers move away and they do not want to pay for the SSS fund because somehow it is not cost effective (even it is legally binding).”—Public Health Officer PA-5
“There is inequity of access to the SSS information between migrant workers and the Thais. Some migrants they do not know once their payment will be sent to the SSS or not. And it is too late that they can use this SSS when they get sick and want to do medical reimbursement. So I would like to see the proper SSS information system to help them track their payment and know their right.”—NGO PA-7
3.3. Quality of Health Screening in MOU Migrants
“The prevalence of HIV and syphilis is more intense in cross-border migrants. It will be more problematic if they get infected from their countries. Also, it means that its transmissibility will be greater in Thailand. Additionally, surveillance system for these infectious diseases is critical and it should be more proactive.”—Health Professional PA-5
“We have already had the health checks from migrant workers’ countries of origin but practically the implementation is not good enough although this is a condition under the MOU. Sometimes our MOL does not care about the health check results. They try to urge them to have work permits at first and then the health check.”—Health Professional PA-17
3.4. Health Screening Problems and State Quarantine Management in Response to COVID-19
“There is a gap in the financial policy to identify who should be the key player responsible for the cost of COVID-19 screening. Currently, the Department of Disease Control is bearing this cost but some told us that the DHEHSF has a direct mission to take care of migrant people. However, the HICS reimbursement does not cover COVID-19. I am so worried about this situation as now the Department of Disease Control and some health facilities have to use their own finances for the screening during this crisis.”—Health Professional PA-17
“It is unclear about the appropriate settings for the state quarantine. Some people suggested that migrants can be quarantined at the factories but we cannot ensure the quality of that. Now there is a negotiation to reduce the cost of state quarantine with a shorter period.”—Health Professional PA-5
3.5. Managing Migration Quota and Dependency on Migrant Workers
“The NESDC should speak out about how many low-skilled migrants should be imported from neighbouring countries within 5 years. This number needs to be identified, along with how many of them can boost the national economy.”—Health Professional PA-1
“In fact we should accept that there are many undocumented migrants in Thailand. We need to know who they are, where they live, and how we can deal with them. The government needs to have a plan and policy to address this issue and report the accurate number of undocumented migrants. Big data system is absent in Thailand which is a way to report and track some personal information systematically such as their ID.”—International Organisation Officer PA-10
3.6. Influx of Migrants in the Backdrop of COVID-19
“COVID-19 is an opportunity to revise the regulation on undocumented migrants. Though this crisis remains in the country, we still need migrant workers. A long-term plan for addressing undocumented migrants should be developed, and it should be not only a 5-year plan but rather 10 years.”—International Organisation Officer PA-10
“Opponents of the military regime will definitely come to Thailand. I am not sure how the local health authorities could deal with it. Actually, there should be temporary camps to help people fleeing from Myanmar but I am not sure whether now it is in place.”—Government Officer PA-15
3.7. Poor Living Condition of Migrants and the Impact of COVID-19
“Our concern is about their poor living conditions. Actually, food and housing are even worse than for Thais. The Ministry of Interior needs to take action to improve their quality of life. Employers have to take care of them. However, many employers, I have heard, also seek decent rooms for their migrant workers. Many of them are living in a small room, and the water quality is also poor.”—Health Professional PA-5
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ASEAN | Southeast Asia Nations |
CLM | Cambodia, Lao PDR, and Myanmar |
OSS | One Stop Service |
MOPH | Ministry of Public Health of Thailand |
MOI | Ministry of Interior |
MOL | Ministry of Labor |
MOU | Memorandum of Understanding |
NV | Nationality Verification |
UHC | Universal Health Coverage |
UCS | Universal Coverage Scheme |
CSMBS | Civil Servant Benefit Scheme |
SSS | Social Security Scheme |
HICS | Health Insurance Card Scheme |
DHEHS | Division of Health Economics and Health Security |
COI | Conflict of Interest |
NESDC | National Economic and Social Development Council |
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Code | Gender | Experience (Years) | Career Level | Organization |
---|---|---|---|---|
PA-1 | Male | >10 | Senior | Health sector (beyond the government) |
PA-2 | Male | >10 | Middle | NGOs 1 (migrant working group) |
PA-3 | Female | 5–10 | Middle | MOPH 2 |
PA-4 | Male | >10 | Senior | MOPH 2 |
PA-5 | Male | >10 | Senior | MOPH 2 |
PA-6 | Male | >10 | Senior | Government |
PA-7 | Male | >10 | Middle | NGOs 1 (migrant working group) |
PA-8 | Female | >10 | Senior | NGOs 1 (Thai social foundation) |
PA-9 | Male | >10 | Senior | Government |
PA-10 | Female | >10 | Middle | NGOs 1 (international) |
PA-11 | Female | >10 | Middle | NGOs 1 (international) |
PA-12 | Female | >10 | Senior | NGOs 1 (international) |
PA-13 | Female | 5–10 | Middle | NGOs 1 (migrant working group) |
PA-14 | Female | <5 | Middle | MOPH 2 |
PA-15 | Female | >10 | Senior | Health sector (beyond the government) |
PA-16 | Female | >10 | Middle | Academic |
PA-17 | Male | 5–10 | Senior | MOPH 2 |
PA-18 | Male | >10 | Senior | Academic |
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Share and Cite
Kunpeuk, W.; Julchoo, S.; Phaiyarom, M.; Sinam, P.; Pudpong, N.; Loganathan, T.; Yi, H.; Suphanchaimat, R. Access to Healthcare and Social Protection among Migrant Workers in Thailand before and during COVID-19 Era: A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 3083. https://doi.org/10.3390/ijerph19053083
Kunpeuk W, Julchoo S, Phaiyarom M, Sinam P, Pudpong N, Loganathan T, Yi H, Suphanchaimat R. Access to Healthcare and Social Protection among Migrant Workers in Thailand before and during COVID-19 Era: A Qualitative Study. International Journal of Environmental Research and Public Health. 2022; 19(5):3083. https://doi.org/10.3390/ijerph19053083
Chicago/Turabian StyleKunpeuk, Watinee, Sataporn Julchoo, Mathudara Phaiyarom, Pigunkaew Sinam, Nareerut Pudpong, Tharani Loganathan, Huso Yi, and Rapeepong Suphanchaimat. 2022. "Access to Healthcare and Social Protection among Migrant Workers in Thailand before and during COVID-19 Era: A Qualitative Study" International Journal of Environmental Research and Public Health 19, no. 5: 3083. https://doi.org/10.3390/ijerph19053083