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Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking
Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual fa...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400460/ https://www.ncbi.nlm.nih.gov/pubmed/32679855 http://dx.doi.org/10.3390/ijerph17145113 |
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author | Kunpeuk, Watinee Teekasap, Pard Kosiyaporn, Hathairat Julchoo, Sataporn Phaiyarom, Mathudara Sinam, Pigunkaew Pudpong, Nareerut Suphanchaimat, Rapeepong |
author_facet | Kunpeuk, Watinee Teekasap, Pard Kosiyaporn, Hathairat Julchoo, Sataporn Phaiyarom, Mathudara Sinam, Pigunkaew Pudpong, Nareerut Suphanchaimat, Rapeepong |
author_sort | Kunpeuk, Watinee |
collection | PubMed |
description | Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants (n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants’ access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities. |
format | Online Article Text |
id | pubmed-7400460 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74004602020-08-07 Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking Kunpeuk, Watinee Teekasap, Pard Kosiyaporn, Hathairat Julchoo, Sataporn Phaiyarom, Mathudara Sinam, Pigunkaew Pudpong, Nareerut Suphanchaimat, Rapeepong Int J Environ Res Public Health Article Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants (n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants’ access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities. MDPI 2020-07-15 2020-07 /pmc/articles/PMC7400460/ /pubmed/32679855 http://dx.doi.org/10.3390/ijerph17145113 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kunpeuk, Watinee Teekasap, Pard Kosiyaporn, Hathairat Julchoo, Sataporn Phaiyarom, Mathudara Sinam, Pigunkaew Pudpong, Nareerut Suphanchaimat, Rapeepong Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking |
title | Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking |
title_full | Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking |
title_fullStr | Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking |
title_full_unstemmed | Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking |
title_short | Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking |
title_sort | understanding the problem of access to public health insurance schemes among cross-border migrants in thailand through systems thinking |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400460/ https://www.ncbi.nlm.nih.gov/pubmed/32679855 http://dx.doi.org/10.3390/ijerph17145113 |
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