Development of an Occupational Friendly Health Service Model for Migrant Workers Using Modified Delphi Techniques

Abstract

This study was aimed to develop a friendly-migrant occupational health services (OHS) model among health care units for migrant workers. The descriptive study was conducted during year 2019 - 2020 and it consisted of two stages including the situation analysis, formation and model development.  In stage I, the qualitative data were collected from executive staff and related officers at 2 hospitals in Samut Sakhon and Samut Prakan using in-depth interview and focus group methods.  The thematic analysis was used to analyze such data. In stage II, modified Delphi technique was used to develop the model.   Two rounds of questionnaires were sent out to the experts who worked in occupational health issue.  The quantitative data were analyzed using frequency, percentage, median and interquartile range (IQR). Results in stage I showed that Samut Sakhon hospital could provide both passive and pro-active OHS to migrant employees.  The interpreters have been employed to facilitate during services provision at the migrant clinic. Only in-house OHS have been provided for migrant workers in Samut Prakan hospital and Interpreters offered by non-governmental organization were available only in Tuberculosis clinic.  Results of the 2^nd round of questionnaire in stage 2 showed that the median and IQR were 5 or 6, and 0 – 1, respectively.  Such data indicated that 21 experts agreed to all proposed statements.  The OHS model displayed that some activities such as pre-placement health examination, periodic health examination, occupational diseases screening, diagnosis and record, return to work management and occupational health (OH) risk communication should cover migrant workers as well.  In addition, the health service units should train related staff, employ Interpreters, and provide 2-3 languages OH and safety media following the friendly services concept.  The limitations of this study revealed as follow; 1) based on time constraint, this model was not evaluated in the field and 2) such model was developed based on the context of formal migrant workers.  This study recommended that the model should be launched to health services units which are located in the abundant migrant provinces to increase the accessibility of OHS among migrant workers.