location: , 'Thailand year: 2022 source: HSRI

title: A Pilot Study: Safety and Immunological Response Following Intradermal COVID-19 Vaccination to Get The Most Out of Vaccine Management

abstract: Background: The SARS-CoV-2 (COVID-19) pandemic has widely spread with numerous waves of different variants of concern, which resulted in shortage of COVID-19 vaccine. Fractional intradermal (ID) dosing regimens for COVID-19 vaccination could be considered as an alternative to minimize possible adverse effects and ease up vaccine supply. Methods: This randomized, open-label study was conducted at a single center, Siriraj Hospital, Bangkok, Thailand. This study was conducted in two sub-studies. The first study was to determine the safety and immunological response of fractional ID as a booster dose. The following study focused on the accelerated fractional ID as primary series. The first study was conducted among 150 volunteers who completed 2-dose IM primary series between 12 and 24 weeks earlier. Those participants who received the primary series of ChAdOx1 (IM) were allocated to vaccinated 0.05 mL BNT162b2 (ID) as booster, while participants previously vaccinated with primary series of BBIBP-CorV (IM) or CoronaVac (IM) were randomized to receive fraction doses of 0.1 mL ChAdOx1 (ID) or 0.05 mL BNT162b2 (ID). The second study was carried out among 90 volunteers who were naïve to SARS-CoV-2 infection. The two vaccinations, 2 injections for each vaccination on a separate arm at the deltoid area, given in an accelerated schedule of 7 days apart. In the initial part of this study, 50 participants were randomly assigned to 5 groups equally consisting of homologous primed ChAdOx1 and BNT162b2, and homologous primed between CoronaVac – ChAdOx1, CoronaVac – BNT162b2 and ChAdOx1 – BNT162b2. Additional participants were recruited in the two groups (20 per group) with the highest proportion of adverse events. The participants were observed for at least 30 min following the vaccination for any immediate adverse events, and self-reported adverse events were collected for 7 using an electronic diary in Google Form. The immunogenicity was determined by the level of anti-receptor binding domain (anti-RBD IgG) of the SARS-CoV-2 and neutralizing antibody (NT) against various variants. T-cell responses were measured by ELISpot using S-peptide and NMO-peptide stimulation. Results: In the first study among volunteers who completed the primary series, 105 eligible participants were randomly assigned to 3 study groups equally (n=35, 33.33% per group). The overall median age was 38 years, around half of participants were male, and the BMI was normal. There were no significantly different in baseline demographic characters. At 2 weeks following booster dose, participants who received 2-dose primary series of BBIBP-CorV (IM) or CoronaVac (IM) followed by BNT162b2 (ID) as booster induced the highest antibody IgG (GMC=1,723.00 BAU/mL). ID administration induced lower IgG than the reference IM of the same vaccine. Likewise, NT levels following ID route were generally lower than that following reference IM, except for the group that received ChAdOx1 (ID) boost which induce NT against Omicron in the similar level to that of the reference IM. Adverse events (AEs) were mostly mild to moderate levels of severity in all study groups. 28.57% of the injection site reaction and 64.74% of systemic AEs were reported. For the second study, 57 eligible participants were randomly assigned to receive 5 study groups of fractional accelerated ID as primary series. The overall median age was 35 years (IQR=28-45 years). At 2 weeks following the primary series, participants who received 2-dose (ID) of ChAdOx1 - BNT162b2 have induced the significantly highest antibody IgG (GMC=597.29 BAU/mL), followed by BNT162b2 - BNT162b2 (GMC=414.84 BAU/mL). Overall, ID have shown a significantly lower antibody IgG than reference IM of the same vaccine regimens (p<0.001). The regimen ChAdOx1 - BNT162b2 also induced the highest NT levels against Wuhan (GM=254.20) and Omicron BA.1 (GM49.34). All groups had similarly low NT against Omicron to the references IM (p=0.304). Likewise, the ELISpot-S response was highest in the group ChAdOx1-BNT162b2 (GM=441.34 SFU/106 cells). There was no significant difference in the proportion of AEs between the study group in this study. Conclusions: The fractional ID as a booster dose has generated antibody responses against SARSCoV-2 infection but in a lower level than IM references; however, well tolerated. It should not be the primary route of vaccination but may be considered in cases of vaccine shortage. Likewise, accelerated fractional ID dosing regimens as primary series is immunogenic for both humoral and cellular but with lower antibody levels than IM references. The accelerated ChAdOx1-BNT162b2 induced the highest immunogenicity and may be considered in the next pandemic that require rapid priming particularly when the vaccine supply is insufficient.


location: , 'Thailand year: 2015 source: HSRI

title: Health Providers’ Perception and Opinion towards an Increase of Budget to Facilitate Appendectomy, Hernia Repair Surgery and Tubal Resection in Community Hospitals of Seven Provinces in North-Eastern Region, Thailand

abstract: The National Health Security Office, region 8, Udon Thani had surveyed the perception and opinions
of health providers towards an increase of funding to facilitate appendectomy, hernia repair surgery
and tubal resection in community hospitals around the North-Eastern region; Loei, Nong Bua Lam Phu,
Udon Thani, Nong Khai, Bueng Kan, Sakon Nakhon, and Nakhon Phanom during the fiscal year of 2013.
The informants consisted of 280 people. The results demonstrated that 66.1% has never known about this
policy before, 72.9% agreed with this policy, and 40% has acknowledged that their hospitals have had the
policy to increase the operations. 76.4% has wished that this kind of policy would not be terminated. The
study revealed that the relationship between the health provider’s perception and the hospital’s policy to
increase surgeries was significant (p<0.05). Three factors influencing hospital to increase the operation
are: 1) the readiness of the operation team, 2) the availability of surgeons, and 3) the convenience of the
patients. However, the first three factors that make “No more” surgical are: 1) the capability of the team is
not enough, 2 ) no surgeon, and 3 ) the risk of being sued.


location: , 'Thailand year: 2003 source: HSRI

title: Sexuality education via computer-aided instruction for early secondary school students

abstract: Background Unprotected sex increases adolescent risk of early and unwanted pregnancy and childbirth, unsafe abortion and sexually transmitted diseases such as infection with the human immunodeficiency virus (HIV). Sexuality education serves as one means of helping young people prevent these problems and improve their future reproductive health. Development and utilization of a computer-aided instruction (CAI) on sexuality education may facilitate learning and provide additional education channel to this group of people.Methods	Contents of the CAI were organized into six key concepts including human development, relationships, personal skills, sexual behavior, sexual health and society and culture. Information and illustrations were employed and tailored to fit for Thai society and culture. Tutorial methodology was used and arranged into the following categories: introduction of the tutorial, questions and responses, judgment of responses, feedback about responses, remediation, organization and sequence of program segments and learner control in tutorials. Three phases of planning, design, and development were assigned and followed, The CAI was created in collaboration with a NECTEC staff and had been tried out in an early secondary school classroom within Roi-Et municipality. Macromedia Authorware 5.2 was used as authoring tool and the final material was written into a compact disc.	Results	A six-chapter interactive multimedia tutorial was developed, It occupied about 192 megabytes on a compact disc. While trying out in the classroom, there was some initial perplexity in using the CAI by the students, which made the beginning of the study cumbersome, In the second half of the study, however, the students could easily use the CAI. Each chapter of the tutorial took about 50 minutes to complete. A total of 8 sessions were needed to finish the CAI. In a focus group discussion at the end of the study, the students exhibited their preference to the CAI.Conclusions 	CAI seems to be one of potential methods for comprehensive sexuality education through facilitate learning and provide additional education channel. Problem underlay CAI usage is preparedness of student.


location: , 'Thailand year: 2012 source: HSRI

title: Responsiveness under different health insurance schemes and hospital types

abstract: The Statue on National Health System B.E 2552 section 7, the health system must promote human
value and dignity and attach importance to fairness and equity in society. This concept leads to an attempt
to capture interaction between providers and users in order to improve and develop the health service
system. Every person should be treated equally even though he/she accesses to care under different health
insurance schemes and hospital types. The purpose of this research was to assess the responsiveness of
Thai health care service system according to different types of national health insurance schemes and
health care facilities in 9 provinces. An exit survey of 6,507 out-patients covered by 3 health care schemes:
Civil Servants Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS) and Universal Coverage
Scheme (UCS), was conducted. The health care settings included 4 hospital types: regional/general hospital,
community hospital, university hospital and private hospital. The field survey period was from April
to June 2011.
The study revealed that there were significant difference between median scores, both overall and
hospital-type based, of responsiveness to users among three schemes in some domains and responsiveness
scores under the CSMBS was higher than those from the SSS and UCS. Nevertheless, results from
logistic regression show that, when 75 percentile of score of each component was adopted as cut point for
high responsiveness, health insurance scheme was not significantly associated with all responsiveness
components, except choice: the scores of the CSMBS was significantly higher than those of the UCS. On
the other hand, type of hospital was significantly associated with responsiveness in all components. Overall,
the score of private hospital was significantly higher than those of the others, whereas that of the
university hospital was significantly lower than the scores of the other hospitals, except choice, which was
significantly higher than in the university hospital than in the regional/general hospital.


location: , 'Thailand year: 2023 source: HSRI

title: Seamless and Integrated Emergency Medical Services System for Mental Health Crisis Patients in Thailand

abstract: Currently, there has been an increasing number of psychiatric patients. From 1 in 5 people in the country to have mental health problems, Thailand has 14.3% or 7 million psychiatric patients at risk of mental health crisis with a chance of inflicting self-harm or violent behaviors towards people and surrounding property. The present research aimed to implement a seamless locally integrated emergency medical service system for emergency mental health crisis patients, monitor, evaluate, and provide policy recommendations. The mixed methods research comprised quantitative and qualitative analysis. The sample group is a multidisciplinary stakeholder in the field of “Emergency Medical Service Systems for Locally Integrated Emergency Mental Health Patients”. The research is conducted in 12 provinces distributed across Health Region 1-12 using a purposive sampling. The tool consisted of a knowledge set, risk evaluation survey, warning sign knowledge assessment form, and questions for the group discussion. The data were analyzed with descriptive statistics and content analysis. The results showed that 1,858 risk groups in 12 pilot sub-districts were mostly male (76.7%), aged 21-50 years (71.4%), with a history of intermittent treatment for psychiatric disorders (43.8%). From these 2,099 relatives/caregivers, most had good understanding on “warning symptoms and requests for help for emergency mental health patients”. As for the self-management community system, most pilot areas had working guidelines before, during, and post treatment, especially on organizing a response team to assess and mitigate before external teams enter the scene. This is connected to the local police unit in conjunction with the initial emergency operations to bring the health service system to the appropriate destination hospital. As an outcome, patients with mental health crises have faster and more access to emergency medical services. In addition, there were no reports of injuries to patients, officer or surrounding people as well as being able to extend the results through the service plan of the Mental Health and Substance Abuse. The impact for the expected effects, those at risk of mental health crisis can access the health system quickly and appropriately, reducing complications and preventable dangers. In addition, it is expected that the community become more self-reliant, increase in health literacy in promoting, preventing, and providing basic assistance for mental health crisis situation, as well as having established integrated guidelines for the health service system including prevention, pre-hospital care, in-hospital care and inter-facility transfer seamlessly.


location: , 'Thailand year: 2022 source: HSRI

title: Process of Situation Reviewing and Health Policy and System Research Providing: The Case of Transferring Sub-District Health Promoting Hospitals to Provincial Administrative Organizations

abstract: The objectives of this project are to develop patterns or mechanisms to support evidence-based policy decision-making, especially for issues that are complex, involve many stakeholders, and/or have a limited time frame. This project focuses on the transfer of the duties of Chaloem Phra Kiat 60 Years Nawamin Maharachini Health Center and Tambon Health Promoting Hospital (THPH) to the Provincial Administrative Organization (PAO), which occurred in the fiscal year 2023. There are four main processes: (1) building up two main teams, a small working group as a core team called “Working Ant Team” to monitor the situation of the transfer, and a larger working group called “Thailand Team” for stakeholder participation including policymakers, specialists, and academics; (2) monitoring the situation of the transfer of the duties of the health centers and THPHs to PAOs via several methods, such as literature review, attending training or meeting related to the transferring; 3) interviewing stakeholders; and 4) surveying the progress of policy implementation and opinions of PAOs and Provincial Public Health Offices (PPHO). Data were analyzed and consulted within the Working Ant Team for perspective sharing between researchers and policymakers. The concept of the six building blocks of the health system from the World Health Organization (WHO) was used as a framework for analysis. The concept of primary healthcare measurement framework and indicators from the WHO was used as a framework for monitoring the progress of related research and conducting a research mapping. The results revealed that, in the fiscal year 2023, three thousand two hundred and sixtythree health centers and THPHs transferred from the Ministry of Public Health to PAO in 49 provinces. The manual for transferring the duties of the Chaloem Phra Kiat 60 Years Nawamin Maharachini Health Center and THPH to the PAO in 2021 mentioned roles and responsibilities specified to responsible institutions. Analyzed the manual with the six building blocks of the health system, the issues of the drug and medical devices and health information systems were less detailed than other systems. Before the transfer, important activities were communicating the guideline in various methods such as official documents, orders for rehearsal of understanding, training workshops, or meetings, and introducing regulations for clarification procedures. One of the main problems to implement the manual was the lack of clarity in transferring health workforce issues, such as the issue of hiring, incentive, career path, and job description. The Ministry of Public Health’s employees faced the most impact of transferring because this type of hiring is specific to the regulation of the Ministry of Public Health while there has not been a regulation for hiring like this in the Ministry of Interior. The survey of readiness of PAO and PPHO for transferring the health centers and THPHs from August to September 2022 revealed that the three most ready activities of PAO are establishing “the Committee for Health in Area Level” (CHA), meeting of CHA, and documenting a plan for health in area level. Opinions those PAO and PPHO agree with are about the roles of PPHO. PPHO should 1) regulate and control the standard of care of the transferred health centers and THPHs 2) technical support and supervise the PAO, and 3) participate in the development of the health information system of PAO. Mapping of research related to transferring the health centers and THPHs revealed 18 research projects. Four projects finished are about the allocation of budget from the National Health Security Office, the standard of care, health workforce, and prototype of primary health care system. This study documented the situation before the transfer of the health centers and THPHs and after transferring on 2nd October 2022 to November 2023. There are 4 main issues to further follow up: (1) allocating of health workforces of both PAO and PPHO, (2) monitoring and regulating of transferred health stations and THPHs, (3) policy implementation of PAO such as management of health resource, development of health information system, and management of drug and medical devices system, (4) roles of the Ministry of Public Health according to the manual of transferring. For patterns or mechanisms to support evidence-based policy decision-making, the Working Ant Team and the Thailand Team should keep monitoring the situation continuously. The objectives for the further phase should be (1) to support evidence-based policy decision making for ensuring primary health care in Thailand keep progress with the least impacts from transferring and develop for better before transferring, (2) to monitor the situation after the transfer in the fiscal year 2023, as an overview of the country, connecting with stakeholders, and contextualizing with information in area level (3) to monitor the progress of research projects related to the transfer and update the research mapping (4) to expand stakeholder participating for both policymakers and implementers including the public health side, the local government side, and the academic side.


location: , 'Thailand year: 2008 source: HSRI

title: Health financing in Thailand : technical report

abstract: Health financing in Thailand : Technical reportFor the past, Thailand’s health care system has increasingly emphasised more advanced medical technologies and the Thai have been more reliant upon health care providers than self-care. Both public and private expenditures for health services consequently increased in real terms. 75% of health expenditures (the largest portion, 66% from the Ministry of Public Health (MOPH)) was incurred in the public sector compared with 25% in the private. During 1986 to 1996, the MOPH budget increased by 258% in real terms and then dropped since 1997 because of budget constraint caused by economic crisis. From 1995 to 1999, the budget grew about 6% in real terms. In consideration of the MOPH budget in 1998, 42%, 31% and 27% were gone for salaries, recurrent inputs and capital expenditures respectively. The budgeting was based on historical requirement leading to inequity of financing among provinces. Household expenditure became a portion of revenue to public health facilities. Whether the government budget for each public health facility was sufficient remained dubious due to poor cost accounting of public health facilities. Therefore, determining either capitation rates weighted by age, sex or DRGs was inconclusive.Thailand had 5 major health insurance schemes, Civil Servants’ Medical Benefits Scheme (SCMBS), Social Security Scheme (SSS), Voluntary Health Card Scheme (VCS), Low-income Card Scheme (LICS) and Private Indemnity Insurance. Around 76% of the Thai were covered by one of these. The CSMBS covered all government employees, pensioners and their dependents. The program was financed by government tax and managed by the Ministry of Finance. Since the economic crisis, the program did cost control by abolishing reimbursement for private care and imposing co-payment for some services e.g. for non-essential drugs. The SSS was premium-based by collecting 1.5% from the employee, the employer and the Ministry of Social Welfare. Payment to contracted hospitals was on capitation from 700-1000 Baht per head per year.The VHCS was community revolving funds targeting the near poor. The premium was 500 Baht supplementary to 1000 Baht, 500 Baht from the MOPH and 500 Baht from the ADB. The most problem of the program was ineffective targeting measure. The wealthy got the cards while a large number of the near poor were not covered. The LICS basically intended to cover the poor but its objective was enlarged to cover the elderly, children under 12, veterans, religious and community leaders and the handicapped. The program also had a problem of targeting the deserved. On the demand side, the insured often bypassed to their registered hospitals preferable to registered primary care centres or health centres. The paper recommends development of universal health coverage for all.


location: , 'Thailand year: 2022 source: HSRI

title: Impacts and Resilience in Covid-19 Pandemic: Case study of Prison and Communities in Bangkok

abstract: This qualitative descriptive study aimed to 1) assess impacts and resilience mechanism of prison, communities and related organizations in Bangkok during Covid-19 pandemic, 2) synthesize lesson learned for community resilience towards problem solving in the Covid-19 pandemic, and 3) synthesize policy recommendation for prison and community resilience through stakeholder participation. Methods included documentary review, brain storming (n=100), focus group interviews (n=55), observation, and in-depth interviews (n=60). Through purposive sampling with inclusion criteria, participants were selected from three opened communities including Klong Toei, Thawi Watthana, Yothi Medical Innovation District, and three closed communities including Workers’ camp, Klong Prem Central Prison, and Homeless Protection Centers. Data were collected via online or onsite and were analyzed using content analysis. Subsequently, 100 stakeholders provided suggestions on the draft report presentation. Results revealed that communities were positively and negatively affected by Covid-19 including impacts on health, surveillance, referrals and quarantine, access to healthcare, communication and social stigma, travels, food security, occupation, education, economic and social support. Mechanisms of community resilience included Acceptance of the situation, the infected patients returning to communities, and the diversity; Agility and Flexibility in thinking and responding to the impacts; Belief in capacity through volunteer; Competence; Desire to learn and change; Efforts to develop skill; Further forward, and Get and give support through social networks. To promote community resilience, there were components related to healthteam and organization “SCIENCE”: Sharing resources and experiences; Communication and Connectedness for referrals; Integration, Innovation, Information Technology; Empathy; Networking; Care; and Engagement. Lesson learned included 1) Infrastructure facilitating resilience: Primary care systems for prevention and control of Covid-19 along with care provision and rehabilitation that harmoniously linked with health service systems and Information Technology, particularly Community Isolation; 2) Social responsibility and mechanisms of community volunteer that accelerate access both in healthcare and health literacy necessary for community, health team, and related parties; 3) Equity in education, socioeconomic and rights; 4) Leadership and management with agility and flexibility, teamwork with networks aiming to develop innovation that solves problems in the Covid-19 situation through community based approach. Results suggest following policy implications: Bangkok Metropolitan and local organizations collaborate with Ministry of Public Health to consider arranging primary health care systems specifically for primary prevention of Covid-19 that takes less time and resources than treatment and rehabilitation as well as consider Covid-19 vaccine management. In addition, reducing density of community housing is suggested along with strengthening community. Bangkok Metropolitan collaborates with 1) Ministry of Education to systematically consider basic education including informal education, 2) Ministry of Digital Economy and Society consider to control reliability of information with a link of information technology system, 3) Ministry of Labor continuously to monitor labor standards and Ministry of Industry to control construction sites, 4) Ministry of Transport to control standards for Minibus, 5) Ministry of Social Development and Human Security and networks to improve quality of life of communities, 6) Ministry of Agriculture and Cooperatives to support long-term cultivation of basic edible gardens, and 7) Ministry of Commerce to distribute products with fair price thoroughly to the public. Ministry of Justice considers modifying infrastructure of prison to reduce population density and promoting Covid-19 literacy. Ministry of Higher Education, Science, Research and Innovation creates a knowledge development model. While communities collaborate with local organizations and networks to modify environment, promptly prepare community volunteers for surveillance based on epidemiolgical principle, and promote literacy for caring in community, aiming at preparedness and response to Covid-19 or new emerging diseases.


location: , 'Thailand year: 2015 source: HSRI

title: Medical Rehabilitation Services for People Living with Disabilities in Thailand: Current Situations in Public Hospitals

abstract: Medical rehabilitation aims to strengthen or sustain functions of persons with disabilities. The objective
of this research was to explore the current situations of medical rehabilitation services for persons
with disabilities available in public hospitals, including community, general and regional hospitals in
Thailand. The questionnaires were mailed to 215 hospitals in 20 provinces between January and March
2014. The data were derived from 155 hospitals (72 percent response). Descriptive statistics were used for
data analysis.The results showed that, at community level, physiatrists and rehabilitation nurses were employed
in only 4% of hospitals; 88% of hospitals hired physiotherapists and there was no audiologist, speech
pathologist and orthotic technician. There were physiotherapists working in all general and regional hospitals
whereas physiatrists and rehabilitation nurses were found in only 40% and 25% of general and
regional hospitals.
The assessment of disability and prescribing assistive devices were mainly for persons with physical
and mobility disability. The most common services were physiotherapy (100% in regional and general
hospitals, 91% in community hospitals) while speech and hearing rehabilitation services were provided at
the smallest proportion (2% in regional and general hospitals and no service in community hospitals). The
services of training programs for using assistive devices, user follow-up and device repair were still missing
in some hospitals. Visual and hearing aids were unavailable in community hospitals. Medical device
services for all type of disabilities were provided in regional and general hospitals but some items of
devices still were unavailable in some hospitals.


location: , 'Thailand year: 2004 source: HSRI

title: Enlargement of safety promotion system development in the school buses at rural areas of Chiang Rai province

abstract: This study aims to enlargement of safety promotion system development in the school buses at rural areas of Chiang Rai province in the 4 districts. Study population are 408 school bus drivers. Implemented activities and data collection was concurrently done in two periods of time. Questionnaires, focus group discussion and behavioral surveillance are used at the first period. Activities including physical check-up, meeting, school bus check-up for developing the school bus safety system were conducted at the second period. Results Most of school bus drivers were male (86.4%). Mean age was 41.6 years.59.8% of them were primary school education level background and 27.9% were juniors high school. 9.9% of them were smokers, 1.6% were drinkers About half of them (56.8%) had annually physical check-up and 12.4% had health problem. Fifty-five percents of school buses were pickup truck and 34.8% were van. Most of drivers have their own school buses and had 4.9 years (median) driving experience. Thirty percents of school bus (roof, seats) were modified and each school bus was used for transferred students in one school. Most of passengers were junior high school students (85.75%). The capacity building that related to traffic law, ethical and primary health care was developed and found that the school bus accidents were decreased when compared to the previous period. Conclusion The promotion of school bus safety and the collaboration of governments organization, school bus driver association and school bus network led to declination of traffic accidents.


location: , 'Thailand year: 2011 source: HSRI

title: Cost - effectiveness analysis of “80 cases weight control program for King Rama IX” in Angthong Province

abstract: The objective of this study was to compare the awareness, attitude and behavior on weight control of
the population before and after their attendance of the Camp for Eradicating Obesity and Belly Program
and the Weight Control Program. The study also took into consideration the efficiency of attending the
programs as one of the determining factor. The study design was the quasi-experimental research, which
studied obesity and health problem of the attendees before and after they had attended both programs.
The selected samples included 40 people who attended the Camp for Eradicating Obesity and Belly Program,
operated by Viseschaichan Hospital, and other 40 people who attended the Weight Control Program
of the Department of Health, operated by Pamok Hospital. The methodologies used in this research
were descriptive analysis, statistics pair t-test and the Pearson Product moment Correlation Coefficient. The study results for both programs shown an increase in awareness, positive attitude and weight
control efficiency. Meanwhile, blood pressure, body weight and waist circumference were decrease and
were significantly different prior to their attendance of both programs at p < 0.05. The samples who attended
the Camp for Eradicating Obesity and Belly Program could reduced weight 87.5 and 77.5 % by 8
and 16 weeks, while those who attended the Weight Control Program of the Department of Health could
reduced weight 65.0 and 67.5 % by 8 and 16 weeks accordingly. By week 16th, the studies found that the
unit cost of attending the Camp for Eradicating Obesity and Belly Program was 4,489 baht, while the
Weight Control Program was 3,518 baht. However, in order for the attendance to lose weight effectively,
the cost-effectiveness for the Camp for Eradicating Obesity and Belly Program and Weight Control Program
were 5,793 and 5,212 baht per person, respectively. The result of this study suggested that the Camp
for Eradicating Obesity and Belly Program was more effective but not appropriate to used in weight
control of large group population because of its high cost. The Weight Control Program of the Department
of Health had lower unit cost and consequently, was more practical due to its cost-effectiveness.


location: , 'Thailand year: 2019 source: HSRI

title: Professional Fee in the Private Hospital Disbursement of the Universal Coveragefor Emergency Patients (UCEP)

abstract: Professional fee is one of the emergency medical service disbursement lists that private hospitals can submit for compensation. The recent data showed that the professional fee was the highest item disbursed accounted for approximately THB 88 million. The objective of this study, therefore, was to examine the detailed lists, the amount and disbursement of professional fees made by private hospitals under the Universal Coverage for Emergency Patients (UCEP). The disbursement data from private hospitals providing emergency medical services between 1 April and 27 December 2017 were analyzed by descriptive statistics. The findings illustrated that from the list of UCEP professional fees, there were 512 items made by medical doctors (508 items matched with 4,389 items of the Thai Medical Council’s doctors’ fees handbook, and 4 items outside of the handbook). The items of UCEP disbursement procedures in Chapter 10 Obstetrical procedures covered 34.4% of the TMC doctors’ fees list. The proportion of doctors’ fees disbursement accounted for over a half of 512 items (51.4%), disbursing 30,944 times or 36.2% of total transactions, with approximately THB 47 million or 53.7% of total professional fees. The Item on the next treatment for inpatient (code 59009) incurred the highest transactions at 5,465 (17.7%), while the initial inpatient evaluation and management (code 83786) incurred the highest disbursement of over THB 3.8 million (8% of total fee). Chapter 1 Procedures of the head and maxillo-facial area disbursed over THB 12.3 million or a quarter of the total fee. The top three doctors’ fees were the initial inpatient evaluation and management (13.8%), followed by the coronary artery procedure (11.2%) and the medical examination (10%). Doctors’ fees disbursement of emergency medical services from private hospitals covered just approximately a half of total items. Disbursement agencies should, therefore, explicitly define meaning of individual items related to current services in hospitals. In case of hospitals, they should promote training of personnel to correctly entry disbursement information. Moreover, a specific agency within the National Institute for Emergency Medicine should actively update the list of procedures to cover unavailable items.


location: , 'Thailand year: 2020 source: HSRI

title: Policy recommendations on health workforce planning for the future aged society

abstract: The increase of older persons accompanying with increasing chronic diseases resulted in high demand for long term care services. To meet the needs of dependent elderly, integration between social care and health cares are needed and that health workforce should be adequate in term of number, distribution, skill, and motivation. This study thus aimed to forecast health workforce requirements and supply as well as develop policy recommendations to address health workforce challenges for long term care services. Secondary data and primary data from surveys and in-depth interview were used. Sample size for self-administered questionnaires comprised 51 representatives and 331 health workforce from long term care facilities, 130 care managers, and 271 care givers. In additional, 42 concerned stakeholders were interviewed. The results showed that, in term of number, the requirements of health professional and care givers are likely to meet the supply in 2026, except those of nurses, social workers and care managers. Other health workforce challenges concerned with distribution, skill and motivation. Health workforce were poorly distributed to long term care and primary care services, skills to look after long term care were inadequate especially those of care givers, and turnover rate of care givers were high particularly at institutional care. To address health workforce challenges for the long- term care services, Thailand should increase the production of health workforce professional and care givers in relation to number and skills. In additional, increase motivation in order to retain them in the system is in need.


location: , 'Thailand year: 2017 source: HSRI

title: Reimbursement system and budget impact for subsidising the treatment expense for emergency and critical illnesses for uninsured migrants/aliens

abstract: Thailand has put much effort in registering undocumented/illegal migrants/aliens and protecting health of non-Thai populations for years. One of the most distinct policies in protecting health of the non-Thais is the establishment of public insurance schemes, for instance, 'Health Insurance for People with Citizenship Problems' (HI-PCP) and 'Health Insurance Card Scheme for cross-border migrants' (HICS). However, in practice, there are always people failing to be enrolled in the insurance schemes due to various reasons, such as poor law enforcement and fear of being exposedby state officials amongst undocumented migrants/aliens. These uninsured migrants/aliens often visited state-run health facilities when they experienced severe illnesses. Some cannot afford the treatment cost. Accordingly, the visited facilities inevitably shoulder this unpaid debt instead. This research therefore sought to explore the reimbursement system for subsidising treatment cost for uninsured migrants/aliens with critical illnesses in Thailand. Mixed-methods design was employed. The study comprised three objectives. The first objective aimed to review literature regarding international experience in managing care for undocumented migrants/aliens. The second objective used qualitative approach (in-depth interviews and focus group discussion) to investigate perspectives of healthcare staff in establishing the reimbursement system of recouping cost of treating uninsured migrants/aliens. The third objective employed quantitative method to estimate budget impact for the whole country in case that the Thai government implements such a system.  The review in the first objective found that level of care for undocumented migrants/aliens from international experience could be classified into four levels: level 1—insurance for fully legalised migrants, level 2—insurance for illegal or undocumented migrants who passed the registration process arranged by the state, level 3—reimbursementscheme of specific diseases, and level 4—contingency/special fund. Compared to the Thai context, the Social Security Scheme might be regarded as level 1, the HICS as level 2, disease control programmes by the Department of Disease Control as level 3, and the contingency fund by the National Health Security Office as level 4. However, level-3 and level-4 care programmes were normally managed on ad hoc basis and have not been incorporated into the main insurance schemes. In terms of providers' views, most interviewees opined that the proposed reimbursement system is useful to health facilities. Some interviewees suggested that the system should cover not only the cost of treatment, but also health promotion and disease prevention activities. The proposed system should be set up in parallel with the improvement of the HICS administrative performance. Nonetheless, there were some concerns raised by the interviewees. Firstly, if this policy is clearly announced as though it is rights for undocumented/illegal migrants, this might indirectly encourage existing migrants to avoid the purchase of health insurance card. Secondly, this policy did not tackle the deep rooted problems regarding undocumented/illegal migrants. The bottom line was that migrant policies in Thailand at the status quo could not effectively prevent illegal border crossings. Lastly, the source of funding has not been explored. Should the reimbursement system reply on additional earmarked central budget, one might argue that such a proposal is taking advantage of Thai tax-payers. If this budget is drawn from the HICS, there might be less political constraint. Another option that is worth considering is using non-health budget, such as extracting part of the visa fee for tourists. Concerning quantitative analysis, the estimated budget is approximately 149 to 891 million Baht, depending on the scope of services and nationalities of the users (whether the reimbursement system should cover Cambodian, Laotian, and Burmese migrants only, or cover all ethnic groups). This study experienced some limitations. Firstly, it is difficult to ensure correctness of utilization data as they are routine hospital-based records. Secondly,  many figures used in the analysis might be out of date and based on several assumptions. Thirdly, service users (patients) were not included in the in-depth interviews. Lastly, this research has not explored sources of funding in detail. Key policy recommendation is the Thai government should set aside some budget for recouping cost of the treatment for uninsured migrants/aliens at public health facilities for around 149 to 891 million Baht. The size of budget depends on the openness of policy for migrants. The government might start from migrants from Cambodia, Lao PDR, and Myanmar first, then gradually expand to other non-Thai populations. The reimbursement system should be introduced in tandem with the improvement of the HICS administrative performance.


location: , 'Thailand year: 2021 source: HSRI

title: Identification of the involved factors and the underlying molecular mechanism rendering Mycobacterium tuberculosis Beijing strain ST10 Kanchanaburi which is the clonal outbreak MDR-TB strain to have special ability in causing high transmission rate and active MDR-TB in Thailand (2nd year)

abstract: Tuberculosis is still a major public health problem in Thailand due to the increased incidence in drug-resistant and multidrug-resistant infections. From the study on multidrug-resistant tuberculosis in Thailand by using whole genome sequence analysis technique, Associate Professor Dr. Angkana Chaisprasert has discovered that there is a clonal outbreak strain in the Kanchanaburi Province (which is now referred to as the "MKR superspreader"). The MKR superspreader belongs to the Beijing family sequence type (ST) 10 genotype and is appeared to have a special ability to spread the infection when compared to that of other strains in Thailand. In this research, our team therefore aimed to identify the mycobacterial and host factors that contribute to the special ability of the MKR superspreader to transmit the infection better than other strains in Thailand. Since one of the main factors affecting the ability of Mtb to spread well from one patient to another depends on its ability to grow at a high rate in the host macrophages such that the host cells will die by necrosis, at which the bacteria will be released outside the cells. When the patient coughs or sneezes, the infectious aerosols will then transmit the Mtb to the other person. The higher the number of bacteria in the infectious aerosols, therefore, will increase the chance of infection to others. In this study, we hypothesized that the MKR superspreader has the special ability to transmit better than other strains because it has the ability to inhibit the defense mechanism of host cells resulting in high growth rate and causes the host cells to undergo necrosis. In year 1, we already confirmed that the MKR superspreader grew at a high rate in host macrophages and caused host cells to undergo necrosis when compared to the other strain. By conducting RNA-sequencing analysis, we also identifed host and mycobacterial genes that may contribute to the higher ability of the MKR superspreader to grow inside host macrophages and cause host cells to undergo necrosis. In year 2, we validated the expression of these genes by qRT-PCR as well as studied their function using the Crispr-dCas9 interference system (specifically developed for mycobacteria) and siRNA knockdown (for host cells) coupled with the phenotypic analysis. The results obtained led to the identification of new drug targets that can be further developed to be used to inhibit the infection by this strain in the future.


location: , 'Thailand year: 2022 source: HSRI

title: Synthetic analytical research studies of judgments problems related to medical error cases to the appropriate methods of resolving medical disputes in Thailand

abstract: This research aimed to study the problem of appropriate medical dispute resolution in Thailand. The issue between the social sciences and the medical sciences is a different science that must come together to find a solution when a dispute arises, i.e., a medical conflict. Each party has reasons to claim how fair they should be received in the probation process. Or is there any way to solve the problem? It is, therefore, interesting that What is the proper procedure for resolving medical conflicts in Thailand? Which method is best depends on different situations. What are the ways in Thailand? Further steps should be developed or taken to resolve Thailand's most impacting medical disputes. Therefore, the study of civil liability guidelines Guidelines for criminal and judicial proceedings of various physicians Dispute Resolution Methods Examples of medical treatment cases in Thailand led to the study of dispute resolution methods through group meetings in 5 areas: the North, the Northeastern region of Chiang Mai; Khon Kaen Province central area Phitsanulok Province Southern area, Songkhla province and Bangkok 2 times per area and in-depth interviews with experts in the field of medicine and public health such as doctors, nurses, etc., and people who have practiced the medical profession. Legal professionals such as judges or former judges. A civil servant or an officer of the Court of Justice, a prosecutor or former public prosecutor, Government officials or employees of the Office of the Attorney General or former police government officials or employees of Police professors of law schools of various universities and lawyers, etc., who are affected or may be affected by medical errors. Until guidelines and opinions are presented to guide the resolution of appropriate medical disputes in Thailand. So far, the process of criticizing medical arguments remains a mediation process that must continuously develop according to Dispute mediation act, B.E. 2562 (2019). There should be legal measures to establish a committee. A pre-litigation committee and court to help prove the nature of a medical case that is more acceptable to all parties.


location: , 'Thailand year: 2013 source: HSRI

title: Health promotion and disease prevention policies for children age 0-5 years in Taiwan

abstract: Strategies for health promotion in Taiwan were developed based on the Ottawa Charter for Health
Promotion. The main health projects are broadly implemented in hospitals and health stations in communities
as well as in cities, schools, and workplaces. Health projects that are related to infants and young
children include the newborn screening program for 11 genetic metabolic disorders, child health check-up
preventive services, vaccination services, early detection and reporting of children with retarded development,
and management of rare diseases. At birth, every newborn is screened for 11 common genetic metabolic
disorders. An infant who has any of these metabolic disorders would be sent for further diagnosis,
treatment and monitoring. Expenses related to medication and nutrition supplements are supported by
the National Health Insurance system as specified under the conditions of the Rare Disease and Orphan
Drug Act. Moreover, the early intervention service (EIS) for children with developmental delay is an integrated and inter-discipline service. The implementation of screening and prevention of developmental
delay is started from antenatal period and continued to the age of seven years old. Suspected cases of
children with developmental delay will be referred to special health centers for further investigation and
treatment. The immunization coverage rate is as high as 95 percent due to an efficient national immunization
information system. Taiwan is also the first nation that uses a “stool color card” in a well child visit
book. The screening helps with the early detection and treatment of infants with biliary atresia.
In conclusion, health promotion policies in Taiwan aim at increasing birth rates, providing early
screening, and maximizing the child’s potential development. However, most references in this review
were from the government, a situation which may reflect only favorable aspects of public health policies.


location: , 'Thailand year: 2007 source: HSRI

title: Factors Affecting Patients’ Behavior  in Controlling Blood Glucose Levels in Non-insulin Dependent Diabetes Mellitus

abstract: This research study was conducted on 204 non-insulin dependent diabetes patients
to assess their behavior and the relationship between supporting factors, by making
practical use of the theory of the PRECEDE Model of Lawrence Green, which involves
studying cross-sectional data collected by survey, using structural interviews.  The study population (n = 204) was obtained by simple random sampling from the non-insulin
dependent diabetes patients attending the diabetes clinic in the period June 1-30, 2006.
Descriptive data were submitted for Pearson’s coefficient and multiple regression analyses.  The results were that the behavior in controlling the blood glucose level among
non-insulin dependent diabetes patients was at a moderate level.  Knowledge of diabetes
(p<0.01), perceived susceptibility to diabetes (p<0.01), perceived severity of diabetes
(p<0.01), benefits and cost of following the advice and suggestions of health officers
(p<0.01), the skill of a diabetic (p<0.01), and promotion by spouse, parents, relatives, siblings, neighbors, co-workers, doctors, nurses and public health officers (p<0.01) are positively and statistically significant related to the behavior of blood glucose level control.
The results of the stepwise multiple regression analysis revealed that the factors affecting
the behavior of blood glucose level control in non-insulin dependent diabetes patients
can be promoted by their spouses, parents, relatives, siblings, neighbors, co-workers,
doctors, nurses and public health officers (p<0.001) and the benefits and cost of following
the advice and suggestions of public health officers (p<0.01).  The two variances were in
line with the prediction at 12.90% (R
2
=0.129).  Information obtained from the present
study suggests that the use of certain health strategies, such as meetings, trainings, movies, slides, videos, and showing actual data, would enable the patients to gain more knowledge about the complication of diabetes which might occur in them.   Such strategies
could also give knowledge to their family members (spouses, siblings, as well as public
heath volunteers of the village, and community leaders), and lead to the establishment of
a diabetes club in their village.  Such steps would encourage the patients to take control of
their blood glucose levels so that thay become normal or near normal.


location: , 'Thailand year: 2008 source: HSRI

title: Satisfaction of public health personnel with the services provided by the contracting unit of the Primary Care board, Bankhai hospital, Rayong province

abstract: The purpose of this descriptive research study was to examine the level of satisfaction
of health personnel with the services provided by the Contracting Unit of Primary
Care (CUP) Board, Bankhai Hospital. Those services consist of planning, organizing,
leading and controlling. The study samples were 118 public health personnel working in
the CUP Board. The research instruments were demographic questionnaire and satisfaction
questionnaire with a five rating-scale. Data were analyzed by using percentage, mean,
standard deviation, and F-test.
The results of this study revealed that the public health personnelûs satisfaction was
at the middle level. Their differences in sex, age, work experience, education level, and
place of work were statistically different at the 0.05 level with regard to satisfaction with
the CUP Board’s services.


location: , 'Thailand year: 2022 source: HSRI

title: Policy Synthesis for the Tertiary Health Service Systems in the Situation of Corona 2019 (COVID-19) Pandemic in Bangkok Metropolitan Region

abstract: The coronavirus disease 2019 (COVID-19) pandemic have an impact on healthcare systems. A Mixed method study was used to explore 1) situation analysis of COVID-19 pandemic in Bangkok and metropolitan region 2) health system management COVID-19, problems and obstacles 3) lessons learned from the management of COVID-19 pandemic and 4) policy synthesis for the tertiary health service systems in COVID-19 pandemic in Bangkok and metropolitan region. Data were collected during from week 14 to week 54 in 2021. Quantitative data were collected from Co-lab and Co-ward. Qualitative data were collected by in-depth interview and focus group discussion. 126 purposive participants were conducted from hospital administrators or hospital representative, assessors, and multidisciplinary team in health care services. Descriptive statistics were used for quantitative data and content analysis were used for qualitative data. The results show that: 1. The situation analysis of COVID-19 pandemic in Bangkok and metropolitan region, the highest infected rate in Bangkok were found in week 32 (14,373 person/week or average number 2,053 person/day). Similarly, in metropolitan region, 183,558 infected persons reported on week 32. The highest infected persons reported on Nonthaburi, Samut Prakan and Samut Sakhon (54,998, 34,499 and 30,373 respectively). The registered hospital bed in Thailand were 154,942 beds, the bed capacity in Bangkok were reported 14.28 % and total bed capacity in Bangkok and metropolitan region addressed 23.01% of registered hospital bed. 2. The health system management COVID-19, problems and obstacles in Bangkok and metropolitan region, 2.1 service delivery: The hospitals adapted healthcare services under the concept of Incident Command System (ICS) in response to public health emergencies. Moreover, they modified some places to support many infected patients, postponed non-covid and non-emergency cases, developed clinical practice guideline, and making change in working methods follow the dynamic of situation. The participants reported service delivery barriers such as no service coverage during high infected rate, limited expertise due to emerging disease, people more afraid of catching COVID-19, non-collaboration between organizations across different sectors, lack of unity, and limited quality services. 2.2 health workforce: The hospitals reduced workload for responding to COVID-19, pooled the workforce, and managing appropriate role. In addition, developed competencies of healthcare providers, ensuring health care professionals safety, and providing reward. The informants reported health workforce barriers for example work overload and lack of health workforce during high infected rate, and fear during the first outbreak of COVID-19 pandemic 2.3 Information: The COVID-19 pandemic required health information systems (HIS) to report healthcare service, and disbursement record from National Health Security Office system. Furthermore, they needed to communicate with people and Covid patients. The participants reported information barriers such as the difficult to use and collapsed central health information system record from Ministry of Public Health, no linkage between health information system, incorrect data, unclear message, Wi-Fi problem. 2.4 Medical products, vaccines & technologies: The hospital adapted medical products, vaccines and technologies system by distribute medical products, accelerating access to vaccines, applied essential medical device, and developing innovations and technologies in health care services. The participants reported barriers to shortage and high price of medical products, medicine, and vaccines due to COVID-19 outbreak, coverage of distribution, and poor-quality. 2.5 Financing: The hospitals used budget of the hospital, special budget, disbursement from NHSO, and donation to fight against Covid-19. The financing barriers addressed unclear disbursement system, and limitation of disbursement. 2.6 leadership and governance: The leaders of team make a good, fast decisions, doing role model of hard work, co-operating, controlling and consulting management team, daring to switch new job, changed mindset, and good governance. However, the participants mentioned about without unity of command as the barriers in Bangkok hospitals. 3. The lessons learned from the management of COVID-19 pandemic in the tertiary health service systems, the key success factors to fight against COVID-19 lies in how to deal with COVID-19, learning and working together, taking advantage of working hard, Thai helping each other, crisis is an opportunity, and academic advising resources in response to COVID-19. 4. Policy synthesis for the tertiary health service systems in COVID-19 pandemic in Bangkok and metropolitan region, given that we now know the importance of revised Incident Command System for Disaster Preparedness with unity of command, developed data information system, and revised stock and allocation system of medical product, should be expected to provide resources to help support health service systems in COVID-19.


location: , 'Thailand year: 2018 source: HSRI

title: Evaluation of probiotic product for prevention of dental caries in young children

abstract: Background: In our previous clinical study showed that probiotic Lactobacillus paracasei SD1 was safe, and the strain could reduce salivary cariogenic mutans streptococci resulting in reduce caries progression in volunteers by receiving everyday milk powder containing probiotic L. paracasei SD1. Aims: This continued study aimed to examine the efficacy of caries prevention by receiving probiotic milk powder every day, 3 days/week compared to normal milk (without probiotic). Methods: The study designed as randomized double blind controlled trial taking 1 year of monitoring. After consented, all participants have been randomized into 3 groups including: probiotic group who received probiotic milk every day, mixed group who received probiotic milk 3 days a week and control group who received milk without probiotic every day, 3 grams for 6 months. All participants were monitor at baseline (T0), 6 (T6) and 12 (T12) months for caries status, salivary immune, human neutrophil peptides (HNP) 1-3 by ELISA kit, and bacterial levels (total lactobacilli, L. paracasei/L. casei and S. mutans) by real time PCR. Results: It showed that probiotic L. paracasei SD1 could prevent caries progression and promote regression among children who received probiotic milk either every day or 3 days/week compared to control group. This is the results from the findings of reducing of cariogenic S. mutans and stimulating of salivary immune HNP 1-3 among children who received probiotic milk either every day or 3 days/week compared to control group. In conclusions: Results of study indicated that the consumption of probiotic milk either every day or 3 days/week could prevent dental caries. However, it noticed that salivary immune HNP 1-3 level was significant higher in children who received probiotic milk every day than in children who received probiotic milk 3 days/week, which may effect on caries prevention in long term. This study provides information that may be useful for administration of giving probiotic L. paracasei SD1 to prevent caries in young children.


location: , 'Thailand year: 2008 source: HSRI

title: Diabetes Care in a Primary Care Unit

abstract: Primary care providers have the pivotal role in the care of people with diabetes; therefore, improving
care in this setting is an imperative. This review illustrated issues concerning diabetes management in
primary care including the following: aim and provision of diabetes care; organization of care; and education,
training and skill of the health-care team. The situation of diabetes management in primary care,
both in Thailand and other countries, predictors of high-quality care, and barriers to control of diabetes
were described. Suggested indicators for auditing the quality of diabetes care and the strategies utilized
for improving diabetes management in primary care were also described.


location: , 'Thailand year: 2020 source: HSRI

title: Improving primary care quality and district health system management by using information tools

abstract: Information tools are the tools for transforming collected data into meaningful and useful information which is important for district health system management and health service quality improvement. Objective of this study is development or adoption of appropriate information tools for analyzing or displaying information for district health system management and health service quality improvement. Three types of information tools were developed or adopted including Business Intelligence, Geographical Information System (GIS) and Data mining by applying in 3 districts. The results revealed that Business Intelligence tool for visualizing mortality data, disease surveillance data, health status and health service data was appropriate because of easiness and adequacy for use. It can compare data across sub-districts and across health facilities within each particular district. Trend over time is also provided together with map across sub-districts. Business Intelligence tool should be, therefore, the main tool for further expansion and improvement for covering all districts as it uses mainly national databases. For GIS tool, which is open source software, it can be the additional tool for interested districts as well as Data mining tool which can produce various models from service data such as Decision Tree, Neural Network, Logistic Regression and Clustering. Data mining can be used for knowledge generation by interested organizations and requires specific training for applying software and learning related fundamental knowledge.


location: , 'Thailand year: 1999 source: HSRI

title: Management of expensive medical-technology equipment: the literature review at the policy lever

abstract: This research is primarily a literature review, aiming for reviewing information and academic literature related to health economics and management of medical technology in Thailand, gathering recommendations from health economic studies and policy research on expensive medical-technology equipment, statistics, opinions, as well as policy options published as academic articles.   In addition, the review includes related body of knowledge on management of the technology at the public policy level and at the system policy level that has been studied and published in international academic journals, including technology assessment, acquisition, purchasing, diffusion, costs and utilization of the medical technology.	The finding indicates that Thailand has a limited number of researches on management of expensive medical-technology equipment.   Most of the studies are specific to certain technologies.   There are some technology assessment works but they are not common.    The investment of the public and private sectors on medical equipment before the country economic crisis tended to go up all the time.   Despite imperfect data on the technology diffusion, there are evidence that access to technology is not equitable.   There is no organization or mechanism to manage comprehensively and effectively.   Responsibility on monitoring distribution is scattered among several governmental units.	The international literature provides information on technology-assessment guidelines and measures, acquisition and import of technology, management of technology diffusion and use of expensive medical-technology equipment differently.   Nevertheless, some conclusions can be drawn that management measures for management of medical technology can be classified into three phases.  First, the pre-market phase comprises steps to be taken before import and diffuse the technology for use in the country, need assessment, assessment of infrastructures to support the technology and technology assessment.  Second, the purchasing and diffusion phase includes measures after medical technology is proved to be safe and appropriate for use in the country.  This is to ensure the proper diffusion of medical technology to maximize efficiency, effectiveness and equity in the system.   Third, the use phase consists of measures affecting provider decision to utilize the technology in diagnosing or treating patients in order to warrant appropriate use.


location: , 'Thailand year: 2013 source: HSRI

title: Population-based screening for nephrosis, nephritis and renal stone in Thailand

abstract: Nephrosis, nephritis and renal stone, commonly found diseases in Thailand, can cause severe chronic
complications. This article thus aims to study the value of a population-based screening for nephrosis,
nephritis and renal stone in Thailand through a systematic literature review and stakeholder discussion.
Urinalysis and blood for renal function tests are widely used in health check-up programs without evidence
of effectiveness and cost-effectiveness. Analysis of the clinical practice guidelines and experts’ opinions
found support for screening in high-risk groups, but not in the general population. Cost-effectiveness
ratio was $282,818 per quality-adjusted life year (QALY), but $53,372 and $18,621 per QALY, in the elderly
and hypertensive patients, respectively. One case would be diagnosed per 800 screened. Incremental costeffectiveness
ratio was $2779. Therefore, renal function tests or urinalysis are recommended for high-risk
groups, whereas the general population should be educated on the disease and risk reduction. Further
studies of the effective and appropriate screening tests for high-risk groups are also needed.


location: , 'Thailand year: 2019 source: HSRI

title: Tuberculosis Vaccines: Importance and Guidelines of Vaccine Study for Tuberculosis Prevention in Thailand

abstract: Thailand has high burdens of tuberculosis, tuberculosis with AIDS and multiple drug resistance tuberculosis. This may be due to the lack of efficient and effective tuberculosis prevention and control at all levels. Vaccination against tuberculosis is a primary prevention measure. In Thailand, the Ministry of Public Health has designated BCG as a basic vaccine against tuberculosis that all newborns should receive. But BCG has numerous limitations, it can only prevent against severe tuberculosis in children, but not in others. Nowadays, researchers worldwide are trying to accelerate the development of effective vaccines against tuberculosis for all populations and all age groups for using in parallel with health promotion and disease control measures appropriate to each societal context. This should be an effective and important way to control, prevent and reduce transmission of tuberculosis. The objective of this article aimed to present importance of tuberculosis vaccines and guidelines for studying the vaccines in Thailand. It is expected that this article would benefit interested readers, especially researchers and relevant persons to apply this knowledge along with prevention programs for controlling tuberculosis in the future.


location: , 'Thailand year: 2021 source: HSRI

title: The Village Health Volunteers and community involvement on prevention and surveillance the COVID 19 infection in the community by using the Geographic Information System

abstract: This research aims to develop the village health volunteers (VHVs) and community participation for prevention and surveillance of Covid19 infection by using the geographic information system (GIS) to the policy option for promoting the VHV’s role in strengthening community on Covid19 screening. The participatory action research was introduced to study in 2 districts in Nakhon sawan province and divided into 2 phases: 1) A model development for promoting the VHVs and community involvement on prevention and surveillance of the Covid19 by using the GIS and 2) Evaluation the model effectiveness and synthesis the policy options. Samples were community dwellers, VHVs, health personnel in subdistrict health promotion hospital (SDHPC) or primary care unit (PCU), subdistrict health boards (SDHB), provincial health administrators, and academic officers. Tools were questionnaires, interview guidelines, focus group guidelines, and GIS. Data analysis employed content analysis for qualitative data and percent, mean, and standard deviation for quantitative data. The results show that: 1) the model of VHV and community involvement for prevention and surveillance of the Covid19 infection was composed of the method of promoting the VHV and community involvement and the activities of prevention and surveillance the Covid19. 2) The GIS as a tool for prevention and surveillance of the Covid19 infection called “EpiScanCovid19”. It worked on the internet and composed of 2 application: Mini application on a smartphone (for VHV collect data, analyze the individual risk, health education, and situation report) and Web application on the computer (for health personnel or health board review the risk situation and monitor the VHV’s work). 3) the effectiveness showed VHVs perceived the risks, educated their community member, timely report events to SDHPC or PCU, and health personnel frequently monitor the VHV activity. They were satisfied with the application at a good level and over about 85%. The outcomes were early detection of the contact cases and rapid control of the spread. 4) the policy options were promoting the VHV and community involvement for active surveillance by using EpiScanCovid19 application, training for building the data management capacity of health personnel, providing the specific area or local quarantine, and supporting the expenditure of community-based surveillance and disease prevention by using this application especially the internet charge. Community-based surveillance and prevention by using the EpiScanCovid19 application were necessary interventions on waning the Covid19 infection spread. It was a health services and their network challenge for promoting the continuing and suggesting for applications in all areas or especially pandemic area. It is a good opportunity for people if this model is applied for non-communicable diseases or other infectious diseases.


location: , 'Thailand year: 2012 source: HSRI

title: Drug pricing measures for the reimbursement

abstract: Background: There are many effective drug pricing systems which Thai Government should employ
to solve drug pricing problems especially at the reimbursement level. This research focuses on a
comparison of budget saved by the payer after the application of different drug pricing measures at the
reimbursement level.
Methods: This was a quantitative research. The budget impact analysis modeling to estimate the
budget saved from the pricing policy implementation was employed.
Drugs belonged to the group HMG-CoA reductase inhibitor (statins) were purposive sampling to be
the sample for the budget impact analysis. They were divided into 3 groups and the sample of each group
was shown in the bracket: 1) Innovative drug with therapeutic improvement (Rosuvastatin), 2) Innovative
drug with technical improvement (Amlodipine+Atorvastatin), and 3) Innovative drug with Generic
drug (Atorvastatin).
Drug pricing measures assigned for each drug groups were 1) Price Volume Agreement, 2) Value
Based Pricing, 3) Maximum Allowable cost, and 4) Reference pricing.
Results: In terms of budget saving for: 1) Innovative drug with therapeutic improvement group:
Reference Pricing measure saved more budget than Price Volume Agreement. 2) ) Innovative drug with
technical improvement group: Value Based Pricing measure saved more budget than Price Volume Agreement.
3) Innovative drug with Generic drug group: Reference Pricing measure saved more budget than
Maximum Allowable Cost.
Discussion: The magnitude of saving in each measure depends on the factors such as percentage of
drug rational use, numbers and prices of drugs available in the market, and availability of local made
drugs.
Conclusion: There are many effective drug pricing measures which can be used to reduce the reimbursement
budget. The government should place the right measure to each drug to gain its most benefit.


location: , 'Thailand year: 2019 source: HSRI

title: Guidelines for Knowledge Development and Increased Efficiency of Community Waste Management by Participation of   elderly in urban of Central park of Thailand

abstract: This study aimed to develop learning of the elderly’s community waste management, enhance efficiency of community waste management, recommend the guideline to develop learning and increase efficiency of community waste management through the participation of the elderly in the rural central plains of Thailand and create cooperation mechanism of relevant agencies to drive waste management towards accommodation of appropriate learning and increased efficiency of community waste management. It was a mixed research including quantitative and qualitative research, as well as Participatory Action Research (PAR). The data was collected from 291 sample of 19 local administrative organizations in the rural central plains by systematic sampling. The random system was used to acquire policies, activities, projects, potential of community waste management, and participation of the elderly. Afterwards, selection was conducted for the community with potential to develop participation in waste management in parallel with care for the elderly in six provinces in six communities to organize focus group discussions; foster understanding of waste management; tend to various needs to create occupation of waste management with the elderly, with no fewer than 30 people per community; community leaders and relevant personnel of local administrative organizations. Creative activities of community waste management and products made from community waste were set up in addition, enhanc learning network with other communities through participatory action research, lessons learned, and performance assessment of the development of learning and increased efficiency in community waste management; promote occupation by making products out of community waste; prepare the handbook on the elderly’s community waste processing towards value-added creation for dissemination to other communities and network were undertaken. Test information prepared from two rural communities in two provinces, were conducted by doing activities of community waste management and making products from community waste, and by referring to the knowledge from the prepared handbook. Then 90 days later, the research team followed up on the sustainable assessment of community waste management and production of products from community waste to create cooperation mechanism of relevant agencies to drive waste management towards accommodation of appropriate learning and increased efficiency of community waste management. The study findings revealed that for the work on community waste management and care for the elderly of the sample of the local administrative organizations, there were enough personnel at the operating level; personnel had knowledge and ability to perform their work; sufficient equipment, tool, and locations; sufficient budget for operation; for the development of learning and promotion of the elderly’s participation in waste management, the annual operating plan and the plan on the development of learning and promotion of the elderly’s participation in waste community management were formulated where the elderly participated in the planning of community waste management. According to the workshops organized during the field trips, when the elderly learned about waste management from the trainings, they acquired knowledge and understanding of waste separation and recognized waste problems affecting the current environment. The elderly could implement the knowledge and disseminate knowledge and experience of waste separation to their children, grandchildren, and neighbors. The elderly were also interested in the occupation through production and sale of products from waste. They could apply the knowledge of waste recycling system to design and develop products or transform waste into new products to deal with community waste. Consequently, they had hobbies, income, pride in themselves, and attractive communities.


location: , 'Thailand year: 2021 source: HSRI

title: Outcomes of Pharmaceutical care in Hypertensive Patients by Pharmacists in Primary Care Cluster: Region Sixth Health Provider Case Study

abstract: The sequential embedded mixed-method research consisted of two phases. 1) The qualitative phase is aimed to explore the situation, experience, problems, and barriers of the family pharmacists in primary care cluster. Focus group discussion was conducted in 24 pharmacists working in the primary care unit (PCU) distributed in 7 provinces of the health region, in January 2020 and April 2021. Average period of working experience was 5.6±5.0 years, and eight of them were full-time pharmacists working in the PCU. Findings of content analysis comprised three main themes: pharmacist roles; related factors from policies, colleagues, and the pharmacist; and the resolution of common drug-related problems (DRPs). Four roles of pharmacists were health services at the PCU, home health care, pharmaceutical management, and consumer protection. The patients’ care barriers were a limitation of the health information connection and information access from the PCU. Part-time working in the PCU limited the pharmacist’s roles; however, updated medication knowledge promoted the pharmacists for effective home health care with the team. In addition, local organizations also supported in home health care and the consumer protection. Communication skills, solving DRPs skill and working experience led the pharmacists to providing effective resolutions of DRPs. 2) The prospective, longitudinal quasi-experimental study was performed as quantitative phase. Data collection in 1,471 hypertensive patients for continuously three visits at the PCU in 2020. This aims to examine DRPs, blood pressure, and physician acceptance of pharmacists’ resolution change over the study including factors affecting DRPs resolutions. 379 DRPs were identified and the highest DRP was 164 non-adherence problems. Following the pharmaceutical care, all DRPs and non-adherence were significantly decreased by 3 2 .4% (X2(2)=46.78, p<0.001), and 61.0% (X2(2)=98.60, p<0.001), respectively. Blood pressure was unchanged. Physician acceptance of pharmacists’ resolution were 77.8%, 70.3% and 68.4%, at visit 0, 1 and 2 respectively. Factor affecting non-adherence resolution was physician acceptance of pharmacists’ intervention (rs=0.18, p=0.020). The family pharmacists can reduce DRPs in patients with hypertension. The relevant factor of DRPs resolution was teamwork due to working experience and skills of pharmacists. There should then be increasing experience and related skills through short course training for pharmacists.


location: , 'Thailand year: 2020 source: HSRI

title: Self-Assessment of Primary Care Units in Providing Integrated People-Centered Care to Patients with Diabetes and Hypertension

abstract: Background and Rationale: An implementation research on integrated people-centered primary care has developed protocols and piloted new care processes to patients with diabetes and hypertension in 20 primary care clusters (PCCs) in Thailand. This study was conducted after 4 months of implementation aiming to assess care process provided by the piloted PCCs compared with other types of health facilities within the same district. Methodology: A survey of providers’ opinion on care process provided by themselves was conducted. Samples were all health workers providing care to patients with diabetes and hypertension in 4 types of health facilities in 20 districts, these included 301 piloted PCCs, 240 PCCs outside the project, 172 hospital non-communicable disease clinics, and 351 non-PCC health centers. A self-assessment form developed by the researchers was employed. The form covered 5 care process components: patient-provider relationships, shared care plan, health information system, self-management support, continuity of care and coordination including organizational supports. Data analysis was done using ANOVA test and the least significant difference test. Results: People working in piloted PCCs reported high mean scores on patient-provider relationships, shared care plan, health information system, self-management support, and continuity of care and coordination as 6.3, 6.1, 6.7, 5.9 and 6.3 respectively. Mean scores of all dimensions of the piloted PCCs were significantly higher than those of other types of health facilities (p-value < 0.05). Conclusion and discussion: The piloted PCCs reported highest integrated people-centered care to patients with diabetes and hypertension compared with all other types of health facilities. However, the self-management support got the lowest score that needed further strengthening. Further research on implementation outcomes was proposed including capacity building of staff on essential skills in providing integrated people-centered care.


location: , 'Thailand year: 2022 source: HSRI

title: The First Online World Health Assembly in History

abstract: Due to the global pandemic of coronavirus disease (COVID-19), the World Health Organization (WHO) decided to hold the 73rd World Health Assembly the first online meeting. The objectives of this study were (1) to review the online assembly and Thailand delegation’s online participation, (2) to analyze the advantages and challenges of online meeting and (3) to analyze the factors contributing to the success of the Thai delegates. The methods of this qualitative study included reviews of relevant documents, participant observations of the Thai delegates throughout the assembly meetings and opinions collection from the Thai delegates. The results showed that the 73rd World Health Assembly consisted of 3 sessions: (1) virtual de minimis – the concise virtual meeting, (2) intersessional session and (3) resumed 73rd World Health Assembly; all these sessions were participated by the Thai delegates. The online meeting was convenient as the delegates were able to connect to the meeting from anywhere with a good quality internet network. However, there was a challenge in terms of time zone difference that Thai delegates needed to attend the meeting at night and to continue their normal office hours. The factors contributing to the success of the Thai delegation were teamwork, systematic working process and adaptabilityof Thai delegates.


location: , 'Thailand year: 2018 source: HSRI

title: Situation of Alcohol Outlets

abstract: Commercial availability and density of alcohol outlets are the factors influencing availability of alcohol and alcohol consumption. The objective of this study is to explore alcohol outlets situation and compliance with the Alcohol Control Laws in Thailand. Methods: There were 325 alcohol outlets from five provinces across Thailand joining in this study by multi-stage cluster sampling. A questionnaire survey was administered to gather demographic characteristics and type of alcohol outlets and alcohol license. This study found that there were high alcohol outlets densities in five provinces of Thailand. There were alcohol beverages in milk and coffee shops. Grocery store, kiosk selling herbal drink and mix shop had ever gotten alcohol license as alcohol outlet but their licenses were expired. Alcohol outlets business hours violations during morning, afternoon and evening prohibition periods were prevalent. Therefore, government or related agencies should seriously enforce the legislations and develop regulations related to control alcohol outlet density and set criteria of alcohol license for alcohol outlets owners in order to prevent and protect the health of children, youth and people in Thai society.


location: , 'Thailand year: 1998 source: HSRI

title: Ayudthaya Metropolitan peoples' health utilization behaviour, experiences, health care expenditures, and their attitudes towards service delivery of medical center

abstract: Ayudthaya Metropolitan Peoples’ Health Utilization Behavior, Experiences, Health Care Expenditures, and their Attitudes towards ServiceDelivery of Medical Center.	People who lived in Ayudthaya Metropolitan were studied to understand their health care utilization behavior and their patterns of health expenditure so as to make comparison with the behaviors of those who lived outside the medical centers’ catchment area. Population factors for sampling in this study were various concentration, socio-economic status, distance to health facilities and whether the people were actually registered at the medical centers. 704 households or 1,794 people were chosen. According to the findings, 61.7% of the sampled population aging 14 or above were insured by any scheme of health insurance. In lower socio-economic area, the public health assistance scheme was mostly possessed. 85.6% of the selected population was insured by single health insurance scheme whereas the remaining was insured by two or more schemes. 	Self-drug use behavior was common for slight illness while convenient transportation was given for the most reason of those seeking care at the medical center. Private hospitals were largely selected as the first choice due to their specialization. Health care expenditures were various in ranges dependent upon where and what types of services were chosen; however, two-third of total expenditures were spent on private services. Chronic cases were reported highest in number at the medical centers. Most medical center users were satisfied with the providers’ communication and patient-provider relationship. 	When getting ill, 26.2%, 24.5%, and 19.7% of the population wanted to go to private clinics, the provincial hospital and the medical centers respectively. What the population firstly needed from the services was quick and convenient care. Good communication, price and well-skilled doctors came second, third and fourth respectively. The study suggested that the medical centers more closely work with both public and private facilities to provide increasingly comprehensive care and the multi-center study be taken in order to know overall health care utilization behaviors of the population irrespective of either micro or macro-scale level.


location: , 'Thailand year: 2007 source: HSRI

title: Evaluation of the Impact of Local Wisdom on Safety, Occupational Health, and Working Environment among Metal Handicraft Workers in Bangkok Metropolis

abstract: A study was carried out to evaluate the impact of local wisdom on safety, occupational health, and
the working environment among metal handicraft workers in Bangkok Metropolis. The objectives were
to survey the variety of the population and their problems; to analyze the data and construct a model; and
to evaluate the safety, occupational health and working circumstances. The sample group for this study
comprised 48 people in five communities. The data-collection instruments were questionnaires and interview
questions. The study methodology compared the risk assessment of a production process without
using the model, and the risk assessment (TISI.18001) of the process, using the constructed model.
The data were analyzed by job safety analysis (JSA).
The findings were as follows:
Baan Bu Community making brown bowls. The process of melting and hammering metal posed a high
occupational risk (82.7 percent); this was reduced to 50.6 percent by using the model and the level of
danger was acceptable.
Baan Bart Community producing food bowls for monks (batr phra). The blowing process to make bowls
showed a high occupational risk of 93.59 percent; this was reduced to 48.14 percent by using the model
and the level of danger was moderate.
Baan Nern Community producing “khong wong” (a musical instrument). The process of polishing and
cutting metal in making a khong wong poses a high danger risk (85.18 percent); this was reduced to 46.9
percent by using the model and this level of danger was low.
Baan Tee Tong Community producing gold leaf. The process of melting and hammering gold leaf poses
a high danger risk (86.42 percent); this was reduced to 64.19 percent by using the model and the level of
danger was acceptable.
Baan Chang Tong Community producing gold ornaments The process of melting gold for making ornaments
poses a high danger risk (67.9 percent); this was reduced to 37.03 percent by using the model and
the level of danger was acceptable.


location: , 'Thailand year: 2016 source: HSRI

title: Multi-Host Specific Immunochromatographic Test for Diagnosis of Human and Animal Pythiosis

abstract: Pythiosis is a life-threatening infectious disease of both humans and animals living in Asia, Americas, Africa, and parts of Australia and New Zealand. The etiologic pathogen is the fungus-like organism Pythium insidiosum. The disease has high mortality and morbidity rates. Use of antifungal drugs are ineffective against P. insidiosum, leaving radical surgery the main treatment option. Prompt treatment leads to better prognosis of affected individuals, and could be achieved by early and accurate diagnosis. Since pythiosis has been increasingly reported worldwide, there is a need for a rapid, userfriendly, and efficient test that facilitates the diagnosis of the disease. This study aims to develop an immunochromatographic test (ICT), using the bacterial protein A/G, to detect anti-P. insidiosum IgGs in humans and animals, and compare its diagnostic performance with the established ELISA. Eighty-five serum samples from 28 patients, 24 dogs, 12 horses, 12 rabbits, and 9 cattle with pythiosis, and 143 serum samples from 80 human and 63 animal subjects in a healthy condition, with thalassemia, or with other fungal infections, were recruited for assay evaluation. Detection specificities of ELISA and ICT were 100.0%. While the detection sensitivity of ELISA was 98.8%, that of ICT was 90.6%. Most pythiosis sera, that were falsely read negative by ICT, were weakly positive by ELISA. In conclusion, a protein A/G-based ICT is a rapid, user-friendly, and efficient assay for serodiagnosis of pythiosis in humans and animals. Compared to ELISA, ICT has an equivalent detection specificity and a slightly lower detection sensitivity.


location: , 'Thailand year: 2018 source: HSRI

title: Quality of Medicines in Thailand: 15 Years of Data from the Quality Assurance of Medicines Program, Department of Medical Sciences, Ministry of Public Health

abstract: Substandard medicines have a great impact on health systems. For example, they can engender drug resistance, adverse effects, drug toxicity, increase mortality and morbidity, etc. As a result, a larger budget is needed for longer healthcare treatment, while health personnel lose confidence in drug qual-ity monitoring and generic drugs. This study employs a descriptive retrospective design. It aims to analyze the database of test results from the Quality Assurance of Medicines Program, which was operated by the Department of Medical Sciences between the fiscal years of 2002 to 2016. The international pharma-copoeia, for example, the United States Pharmacopeia (USP) or British Pharmacopoeia (BP), were used as reference standards. The findings revealed that 428 government hospitals voluntarily sent medicine samples to the Quality Assurance of Medicines Program. The total number of modern medicine samples was 572 items or 16,212 samples. The number of substandard samples decreased from 19.0% in 2002 to 0.8% in 2016. Based on the latest 3-year data, 2.9% of domestic generic drugs failed the standard specifications, whilst 0.9% of imported drugs failed. Dissolution and content of active ingredients were the most common issues found. The corresponding organizations in pharmacovigilance and pharmaceutical manufacturing, for ex¬ample, the Thai Food and Drug Administration (Thai FDA), the Department of Medical Sciences (DMSc), the Government Pharmaceutical Organization (GPO), and the Thai Pharmaceutical Manufacturers Associ¬ation (TPMA) should cooperate to monitor and improve the quality of domestic generic drugs in order to achieve greater confidence in using domestic generic drugs while also making budget savings. This could also strengthen the domestic pharmaceutical industry and enhance national drug security.


location: , 'Thailand year: 2005 source: HSRI

title: Perception and media exposure to health care in Chiang Rai

abstract: The purpose of this research is to explore the people’s perception and exposure to health care regarding health news and medias in ChiangRai province. especially in the district of Muang, Mae Chan, Mae Sai, ChiangSaen, WiangChai, Thoeng, Pa-Daet, and Phan.  The target groups of study were divided into 5 groups: (1) government officers, (2) private employees and general laborers, (3) agriculturalists, (4) private-business owners, and (5) school and college students. The study found that the most popular medias can be classified by media type as follow: 	Newspaper:  National newspapers namely Thai Rath, Daily News and Kom Chad Luk are most popular. Local newspapers are Chaing Rath, Chiang Rai News, and Sue Chaing Rai. Those newspapers are the sources for people to acquire health news namely, Health education column and Medical consultative feather in the newspaper at the national ones 	Health mechanize: the most popular ones are Klai Maw, Cheewachita and Maw Chaow Bann.	Television:  the most popular TV channel is channel 7, Channel 3 and channel 9 respectively. The most popular TV programs are Phu Ying Phu Ying, from Channel 3, Ban Number 5 from channel 5, Kroob Krueng Reung Phu Ying from channel 7, Maw Surapol from channel 9, Health Window from channel 11 and Health Station from ITV.	In term of which media people can be able to obtain health information and news most, the study found that they are television, newspaper, radio, personnel, journal, village broadcasting service brochure leaflet and Poster. People agreed that most effective media has to have accurate and adequate amount of health news and information in order to maintain and health self care taking. The target group of this study has their trust on health personnel most when getting sick or having health problems.  In term of the health person people consult with; the first group are medical doctor, nurse and public - health care personnel   and the second group is comprised of friend or relative document consultation, and newspaper.		In all, despite of having an influence on the health perception of public,  medias are still having limitations. Health awareness is the most effective mean to alter public behaviors in the way that changing attitude, perception, believe, value, environmental factors, experiences, and individual readiness.


location: , 'Thailand year: 2017 source: HSRI

title: Scoping Review for Understanding Tuberculosis Situation in Migrant Labors in Thailand

abstract: The scoping review found no published research in the past decade that was focused on tuberculosis
surveillance in migrant labors in Thailand. The review data comparing the number of tuberculosis
patients in Thailand from three sources: the World Health Organization and two of the Ministry of
Public Health - the Permanent Secretary Office’s Information and Communication Technology Center
and the Department of Disease Control’s Bureau of Tuberculosis; indicated large disparities in terms
of both the number of migrant labors and the number of migrant labor tuberculosis cases in Thailand.
The chest X-ray screening for tuberculosis in migrant labors used by the Department of Employment of Thailand was in accordance with the tuberculosis screening guidelines of most Western and Asian
countries such as Singapore and Taiwan. The difference of tuberculosis screening processes was that
Western nations usually required pre-arrival screening from the country of origin of immigrants. Meanwhile,
migrant labors entered Thailand’s territory before any tuberculosis screening had been done.
The screening was then done after labor registration which might hinder the tuberculosis screening
process in the country. Singapore and Taiwan implemented time limits as to when the tuberculosis
screening would have to take place for migrant workers after arrival. The other countries also
screened to identify latent tuberculosis in vulnerable and high-risk groups. Major barriers of tuberculosis
monitoring in migrant labors in Thailand were the frequent relocating of labors and changes of
employment that made it difficult for the authorities to screen, monitor and treat tuberculosis in this
population as well as impeded the tuberculosis control efforts of public health agencies. The search
and review of information identified opportunities for improving tuberculosis management by enhancing
the efficiency of the tuberculosis surveillance in migrant labors in terms of coverage and quality
of health data.