Accessibility to Public Health Service among Migrant Workers in Pak Phanang District, Nakhon Si Thammarat Province

Abstract

Migrant workers may lead to problems in public health such as various communicable diseases. The problem of migration due to work and other businesses will continue to increase. This is mainly caused by economic conditions, exploitation and unemployment. Access to health services is one of the factors affecting health of migrant workers. The objective of this survey research was to examine migrant workers’ access to health services and to study the relationship between personal, social and environmental factors and access to health services among in Pak Phanang District, Nakhon Si Thammarat Province. The sample size was 140 people using simple random sampling. The questionnaire was used to collect data with a reliability of 0.90. Data were analyzed using descriptive and inferential statistics, including Chi-square and Fisher's Exact test. The results showed that most migrant workers were males with an average age of 27.5 years, married, and are Laotian nationality. Most completed primary school and work in agricultural sector with the average income at a high level. Most of them are healthy. The period of stay in Thailand is approximately 1-5 years. In terms of employment status, most had work permits and work 5-6 days a week, 5-8 hours a day. In terms of work risk, work has never been a cause for their illnesses. Injuries or accidents are often due to sharp cuts or falls. In terms of support from social networks, there were no village leaders or volunteers. When sick, they were taken to hospitals by the employers through self-contact. They had health insurance cards and were aware of health benefits. When sickness befalls them, they would go to be treated at the chosen hospital. Access to health services was at a moderate level which can be divided into 5 areas: sufficiency of available services, convenient access to services, facilities for receiving services, and ability to pay for the services and acceptance gained from the services; and Individual factors including age, nationality, education, occupation, income and length of stay in Thailand were statistically and significantly related to access to health services (p<.05). Socio-environmental factors including length of service, weekly work, leaders or volunteers, health care or health screening, health insurance card benefits were also statistically and significantly related to access to health services (p<.05). It was suggested that the health insurance must cover the rights to get services at local Sub-district health promoting hospitals too, not only at any particular hospitals agreed upon. Sub-district health promoting hospitals usually offers activities to promote, prevent, treat and rehabilitate patients, and volunteers are available to provide health advice for free. This will enable migrant workers to have greater access to health services.