Migrant workers-trend , issue, policy and solution
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Transcript of Migrant workers-trend , issue, policy and solution
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Migrant workers-trend, issue, policy
and solutionDr. Chanvit Tharathep
Deputy Permanent Secretary, MoPH
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Population Movement into Thailand
เชยงรายแมฮองสอนเชยงใหม
กาญจนบรราชบร
ระนอง
อบลราชธาน
สรนท
ร
ตราด
หนองคาย905,573+405,371
106,970+61,625
235,521+112,275
Total Registration 20121,268,044+579,271
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Where are the migrants?
Provinces, 2004 2009Bangkok 163,637 252,768
Samutsakon 77,527 106,232Chiengmai 48,502 75,780
Samutprakan 31,493 71,037Surajthanee 33,192 65,452
Top 5 Provinces Department of Employment 2004-2009
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Communicable Diseases Re-emerging diseases Maternal and Child Health Sanitation, Environment Health Expenditure and
Burden Health Risks for Thai People
Health Impacts
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WITH THE ILL AND POOR MIGRANTS?
Healthy Thailand?
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สาเหตทมแรงงานตางดาวในประเทศไทย**โครงสรางประชากรไทยกำาลงเสยสมดล**
กลมผสงอาย (65+) เพมขน ขาดแคลนแรงงาน ใชแรงงานตางดาว
ผสงอายเพม ลกหลาน
ตองดแล
วยเดกและ
ทำางานลดลง แต
ตองการเศรษฐกจ
เตบโต
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โครงสรางอายประชากรเสยสมดลเพราะอตรามบตรลดลงเหลอเพยง 1.5 คน/หญงไทย คาทสมดลคอ 2.1 คน/หญง
ไทย
จดสมดล 2.1คน/หญงไทย เหลอ 1.5
คน/หญงไทย
เกดปญหาแรงงาน
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อายแรงงานขามชาต
แรงงานขามชาตลงทะเบยนทวประเทศ ป 2553อายสงสด 21 ป (2552), 26 ป (21 ป 2547)อายไมกระจายตวแบบปกต
1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 55 58 61 64 67 70 73 76 790
10000
20000
30000
40000
50000
60000
70000
80000
จำานวนอาย
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LawSecurity
Economy Interest
Health Human Rights
Immigration Bureau, National Security Council, Military
Ministry of Interior, Police
Ministry of Labor Local Government,
Employer
Ministry of Public HealthNGO
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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?
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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.
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แรงงานตางดาว
เขาเมองผด
กฎหมาย
ผตดตามและบตร
ผดกฎหมายเขาเมอง
มทร. 38/1ตรวจสขภาพ
ประกนสขภาพ อนญาตทำางาน
แรงงานตางดาว
ถกกฎหมาย
พสจน
สญชาต
แรงงานตางดาว
ไดรบอนญาตชวคราวผตดตามและบตร
ไดรบอนญาตชวคราว
แรงงานตางดาวนำาเขาถกกฎหมาย
ตาม MOU
กลม 1ผลกระทบดาน
สาธารณสข
กลม 2เจบปวยนอย มการวางแผนครอบครวด
สงเสรมสขภาพ ปองกนโรคด
กลม 3
กลม 4
ทศทางนโยบาย เปลยนผดกฎหมายเปนกงถกกฎหมาย และถกกฎหมายในทสด
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ผลกระทบจากนโยบายความมนคงประเภท ธค. 2547 ธค. 2548 ธค. 2549 ธค. 2550 ธค. 2551 ธค. 2552 ธค. 2553 ธค.2554 มย.2555
รวมทงสน 826,399 806,764 790,664 1,544,902 1,300,281 1,950,650 975,984
รวมถกกฎหมาย 137,272 112,794 209,151 228,353 210,745 344,686 678,235 905,041
ตลอดชพ 14,423 14,423 14,423 14,423 14,423 14,423 983 983
ทวไป 99,999 75,630 84,278 98,294 68,399 70,449 73,841 75,661
พสจนสญชาต 14,150 17,059 77,914 210,044 505,238 683,565
นำาเขา 72,098 71,017 27,447 26,525 72,356 117,547
สงเสรมการลงทน
22850 22,741 24,202 27,590 22,562 23,245 25,817 27,285
รวมผดกฎหมาย 849,552 713,605 596,613 562,311 1,334,157 955,595 1,272,415 70,943
ชนกลมนอย 45,029 50,341 60,741 19,775 23,340 24,351 24,108
3 สญชาต 668,576 546,272 501,570 1,314,382 932,255 1,248,064 46,835ป 50-51 แรงงานตางดาวจดทะเบยนนอย (แรงงานตางดาวเถอนมาก) ป 50-51 เกดอหวาตกโรคระบาด 50
จงหวด สาเหตจากกลมนไมมประกนสขภาพป 2555 แรงงานตางดาว จดทะเบยนลดลง แตจำานวนยง
อยระหวางเกบรวบรวม
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Strategy Map Health Service for Minority, Migrants
Health Service System Health Care Security
Self Care and Community
ParticipationManagement and
Information System
9. Intergration of care,Specific Service
System: HIV, Violence
8. Holistic
Care
Strategy 1 Strategy 4, 5Strategy 2 Strategy 3
10. Catchment Area
20. Unit CostActivity Based
21.Migrant Health Worker
22.Risk
Behavior
23. Tools:
Manual guidelin
es
14. Self Care Skill
15. Law, Regulati
on
25. Human Resources
2. Health Service Delivery
17. Health Servic
e Netwo
rk
19. Health Check,
Screening
18.Environment,
Sanitation
1. Healthy Migrant, Minority
12. Referal System
3. Health Care Security
11. Benefit Package
5 Promotion6. 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 systemUnder multisectoral Network and Community Partici[ation
4. Adequate Input
27. Knowledge Management 28. Human Resource
13. Safety Net, High Cost, AE
Lear
ngin
and
G
row
thFi
nanc
eC
usto
mer
Inno
vati
on
7. Managemen
t
29. Structure
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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 √ √
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Item Male Female 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
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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
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Health Service System Development Bureau, MoPH
Health Status of Migrants 2004-2008
Year CheckupTreatment and Follow
upPregnancy
2005 713,688 1.25% 1.75% 2006 726,478 1.04% 1.43%2007 534,481 1.04% 1.76%2008 329,851 0.80% 1.76%2009 1,200,569 0.56% 1.95%2010 825,292 0.37% 2.39%2011 1,124,505 0.72% 2.13%
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Migrant Health Service Provision: impacts on Migrant
health
2004 2005 2006 2007 2008 2009 20100.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40 1.25
1.03 1.04 1.04
0.80
0.56
0.37
% Treatment/Follow up Group%
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2004 2005 2006 2007 2008 20090.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
54.47
65.30 64.44
69.76
63.81
45.84
33.76 32.62 32.34
26.2224.76
50.81
2.610.90 1.46 0.54 0.68 2.58
TBSyphilisElephantiasis
%
Treatment and Checkup Group
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Health Care SecurityPhysical Check up and Health
Insurance
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Self Care and Community ParticipationMigrant Health worker.
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Health Service ProvidingMother and Child Health
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Management and Information
System:Education for HIV, STD
Prevention
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Different Area, Different context
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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
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LawSecurity
Economy Interest
HealthHuman Rights
Immigration Bureau, National Security Council, Military
Ministry of Interior
Ministry of Labor Local Government,
Employer
Ministry of Public HealthNGO
Security, Economy, ….. Human Right, Health?
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New Initiative• 15th Jan 2013 Cabinet approved• MoPH Migrant health long term
Strategy• Not just migrant workers but
families and children• Documented and Undocumented
Children health insurance
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THE END
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