Abstract
An attempt to expand health insurance to cover ‘everybody’ on the Thai soil has been
implemented for years, as evidenced in the Vision of the National Health Security Office (NHSO) and the Border Health Plan of the Ministry of Public Health (MOPH). One of the issues that have caught political attention is a continuing growth in the volume of migrant children born in Thailand. However, the number of migrant children, who have been enrolled in the public insurance is quite limited. Such a situation creates a concern as to whether these migrant children received adequate immunization. This point also links to a risk of emerging and reemerging diseases that cause public health threats. Therefore, the objectives of this study are (1) to draw lessons from international experiences in managing health promotion and disease prevention services for migrant children, (2) to explore the current situation in managing health promotion and disease prevention services for migrant children in Thailand in terms of pros, cons, and challenges from the perspectives of policy makers, local implementers, and service users, and (3) to estimate budget impact for supporting vaccination program for migrant children in Thailand. The researchers applied parallel mixed methods design. Objective 1 employed narrative literature review approach as the main data collection tool. The majority of literature was retrieved from grey literature databases in the European Union. Objective 2 used in-depth interviews with policy makers, local implementers, and service users. Objective 3 applied quantitative analysis on secondary data (43 standard folders of the MOPH). Fieldwork was conducted in 4 provinces where migrants are concentrated. This study still faces some limitations as follows. Firstly, a narrative literature review is more prone to bias than a systematic review. This is because the narrative literature review lacks rigorous quality screening process on the selected articles. Secondly, the interviews in Objective 2 involved a small number of participants, and other qualitative data-collection techniues, such as participant observation, were not extensively exercised. Moreover, it is difficult to blind the interviewees to the professional status and workplace of the researchers. These factors more or less affected the validity of the interviewed information. Thirdly, the study involved only 4 provinces. Thus generalization ability of the findings is quite limited. Lastly, the calculation in Objective 3 relies on many presumptions. Some postulations used fingures or numbers from previous studies that were conducted long ago, and the analysis was confined to material cost only. Hence, if the findings in this study are to be used for policy advocacy, there should be a process that allows all stakeholders to discuss and agree on the assumptions since the beginning, before delving into the calculation. Besides more updated figures should be used as references and the calculation should include other incurred costs (such as administrative cost and labour cost).
