Border health system management along Thai-Laos border; a case study at communities with temporary check point in Wiang Kaen District, Chiang Rai Province

Abstract

This action research aims to investigate border health system management along the Thai-Laos border in the communities with the temporary check point, Wiang Kaen district, Chiang Rai province. By using simple random sampling, 206 participants from 2 villages in Thailand and 305 participants from 3 villages from Laos were selected. The questionnaire was used and in-depth interview was applied in the stakeholders who work at the temporary check points. We used percentage, mean, standard deviation in statistical analysis followed by thematic analysis and triangulation of qualitative data. This study was conducted from May 2018 to September 2019. Result: for the participants from Thai, female accounted for 60.7%, being married 70.4%, educated in primary school level 68.9% and being agronomist 44.7%; from Laos, male 54.4%, being married 86.2%, educated in primary school level 30.5 %, being agronomists 28.2 %. Thai people accessed to health care services at subdistrict health promoting hospital 62.1% and community hospital 17.5%. Laos people accessed to health care services at Bokeo province hospital 44.3% and Huayxai district hospital 40.6% because they trusted in the physician qualification and it was easily to come across the border for treatment. For the self-care of people in communities, more than half bought medicine from community shop for treating themself if they had been ill, 56.5% in Thai and 89.5% from Laos. In case of getting illness, 79.2% went to subdistrict health promoting hospitals. Community participation to provide the community rules for Laos population who come across the border to reside in the community was conducted; Laos people must notify with a community leader and village health volunteer. Community leaders, community members, community mainstay, long-tailed boat drivers, and taxi drivers developed participatory some practical skills as well as the screening form on patient transfer to use at the temporary check points by volunteer defense corps, immigration police and local security agencies. After screening process, patients were transferred to subdistrict health promoting hospital and Wiang Kaen hospital. Primary screening and early detected on communicable diseases could be done to prevent the outbreak in the communities effectively. Conclusion: The communities have the surveillance system for screening the people who travel across the border checkpoints rapidly, responsively, and powerful. Established regulations to manage disease prevention and control for community well-being will further lead to the formulation of local and central policies as well as guidelines and practices for disease surveillance at the temporary check points.