Abstract
The outbreak of Coronavirus disease 2019 (COVID-19) has a massive impact on health and well-being in all populations especially the vulnerable populations. Due to their vulnerability and limited opportunity to access health services, vulnerable populations have a greater health risk compared with other populations. Despite existing universal health insurance for all populations in Thailand including Universal Health Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS), and Health Insurance Card Scheme (HICS) for migrant workers and their dependents, there remain some uninsured populations. Therefore, this study aimed to provide policy recommendations to improve the health systems for vulnerable populations in Thailand during the COVID-19 pandemic. Both quantitative and qualitative studies were performed. Firstly, the situation of access to health services among vulnerable populations in Thailand during COVID-19 was studied by using the hospital service records of the Ministry of Public Health (MOPH) (43 folders), a secondary data, from National Health Security Office (NHSO) from January 2020 to June 2021. Secondly, document review regarding access to health services for vulnerable population. s. Lastly, in-depth interviews and focus group discussions on relevant stakeholders were performed to develop recommendations for improving health services for vulnerable populations. In this regard, a total of 39 participants including policymakers, staff responsible for taking care of vulnerable populations, and vulnerable populations were selected by purposive sampling and snowball sampling. The findings demonstrated that vulnerable populations the COVID-19 screening test utilised by vulnerable populations accounted for approximately 1,154,355 records (included all insurance schemes) during January 2020 – June 2021. Focused only on the UCS, there were COVID-19 screening tests in total 939,444 times. The number of visits of vulnerable people receiving COVID-19 tests and treatment in both outpatient (OP) and inpatient (IP) care was about 9,288. The number of deaths of vulnerable populations due to COVID-19 was 216.
