Universal health care in Thailand: Concerns among the health care workforce

Objective. To investigate the impact of the universal health care policy from the perspective of Thai health care professionals. Methods. Semi-structured interviews with purposively selected health care professionals and key informants. Results. Health care professionals at public hospitals, particularly in rural areas, have experienced up to a doubling in the number of daily out-patients; many with superficial symptoms. While the improved access to health care provisions was welcomed, questions regarding the appropriateness of seeking medical advice were raised. Concern regarding equity: between the universal health care policy and two parallel public health cover schemes; rural and urban areas; and the public and private sector also emerged. There are potentials for health care professionals to congregate in the private sector and urban areas where workloads are perceived to be less demanding.Conclusions. The general perception of the health care professionals interviewed suggests that although increased access and health equity was welcomed, this policy has had undesired effects and exacerbated rural-urban and public-private tensions. Universal coverage increased access to health care. However, equity may be further enhanced by consolidating the three public health covers into a single scheme and develop a parallel private income protection insurance scheme

Inequitable distribution of human resources for health: perceptions among Thai healthcare professionals

Background: Effective delivery of health care is dependent on health manpower. In Thailand, an insufficiency of human resources relates to an inequitable distribution of healthcare professionals rather than to insufficiencies overall. Both internal and external factors influence healthcare professionals' choice of where to work, although perceptions rather than actual circumstances are more influential in their decision-making process. This inequitable distribution of healthcare professionals in Thailand affects rural areas and the provision of primary health care. Objectives: To understand the subjective perceptions, attitudes and dynamics among healthcare professionals regarding where they seek employment and the impact on the provision of primary care. Design: Questionnaire survey among Thai healthcare students and professionals and semi-structured interviews with healthcare professionals investigating attitudes and perceptions.Setting: Thai rural, urban and metropolitan areas. Results: An interesting mix of factors influences healthcare professionals with regard to where they seek employment, or continue their employment. Family and community commitments, social status and a sense of belonging were associated with healthcare professionals seeking employment in their province of origin. Tensions are also emerging between preventative and curative health. These tensions, together with financial remuneration and professional development opportunities and promotions, as perceived by healthcare professionals themselves, have implications for current and future healthcare policy. Conclusion: The scaling up of human resources for health in Thailand will not, based on past experiences and attitudes outlined in this research, ensure an equitable distribution of healthcare professionals. Further consideration of these professionals' expectations of being able to work in areas close to their families and of sufficient financial remuneration is required. It is likely that rural regions and the delivery of primary care will be negatively affected by continued inequities. It was also found that current healthcare policies are creating new tensions

Report on research findings: Improving access to social and economic services for people with disability in Lao PDR

This workshop will present the findings from the Australian Aid funded research “Improving Access to Social and Economic Services for People with Disability in Lao PDR (2013-16)”. The research has been conducted by a team from Curtin University School of Occupational Therapy and Social Work, with our Implementing Partner LDPA, through a Memorandum of Understanding with the Ministry of Labour and Social Welfare

Primary and Secondary Drowning Interventions: The American Red Cross Circle of Drowning Prevention and Chain of Drowning Survival

Creating awareness about primary and secondary interventions that can be used in situations involving drowning is an important prevention strategy. Consistent among reports from almost all countries is that drowning injury steals life from young children, followed by youth, and then young adults. As a result of the on-going need to reduce these types of statistics, the American Red Cross Scientific Advisory Council – Aquatic Sub Council established two intervention programs to address both sides of drowning events. Content of this manuscript is based on work by members of the Aquatic Sub Council. It focuses on describing and providing scientific rationale for two educational programs designed to approach the issue of drowning from both a primary and secondary intervention perspective. Presented are the Circle of Drowning Prevention and the Chain of Drowning Survival along with the thought processes and foundational research that brought them into existence. Both intervention programs are currently being used in educational materials and marketing efforts within American Red Cross water safety materials

Identifying the Needs of Refugee and Asylum-Seeking Children in Thailand: A Focus on the Perspectives of Children

This research reports on the under-researched needs of urban refugee and asylum-seeking children living in precarious circumstances in Bangkok, Thailand. Further, it takes an unconventional approach and utilizes child-centred research methods to privilege the perspectives of children. It then compares children’s perspectives with those of adults who are their parents/guardians and key informants who are service providers and policy advocates. Qualitative research methods, including participant observation, semi-structured interviews and drawing with children, were employed in late 2014. This article reports remarkable findings on the similarities and differences between the perspectives of children and adults. The similarities and differences are contextualized in light of the supports and services available to improve the children’s wellbeing

How social capital influences community support for alternative water sources

Ensuring future water security requires broad community support for changes in policy, practice, and technology, such as those involved in delivering alternative water schemes. Building community support for alternative water sources may involve a suite of engagement activities, ranging from information campaigns, through to grassroots and participatory approaches. There is increasing recognition that ‘social capital’—the degree of social connectedness, trust, and shared values within a community—is important for building support for pro-environmental policies. However, little research has examined how social capital might influence support for alternative water schemes. We surveyed a representative sample of Australian adults (n\ua0=\ua05194). Support for alternative water sources was examined using a series of questions focusing on stormwater harvesting, desalination, and recycled water. Involvement in community organisations (defined as participation or membership) was used as an indicator of social capital. Using a series of mediation analyses, we identified that community involvement is associated with support for alternative water sources, and that this effect is mediated by (i) stronger water-related social norms, (ii) greater water-related knowledge, and (iii) increased recall of water-related information. Our results also suggest that these indirect effects can be conditional upon location, employment status, life satisfaction, and language spoken within the home. These findings highlight the importance of social capital in building engagement in water-related issues, and specifically, building support for alternative water sources. In addition they highlight potential pathways for the association between social capital and support for alternative water sources for different social groups and communities

How do marine and coastal citizen science experiences foster environmental engagement?

Citizen science programs enable community involvement in scientific research. In addition to fostering greater science literacy, some citizen science programs aim to foster engagement in environmental issues. However, few data are available to indicate whether and how citizen science programs can achieve greater environmental engagement. We survey individuals choosing to attend one of seventeen reef citizen science events and examine the extent to which attendees reported three indicators of greater environmental engagement: (i) willingness to share information, (ii) increased support for marine conservation and citizen science, and (iii) intentions to adopt a new behavior. Most participants reported being willing to share information about reef conservation (91%) and described increased support for marine science and conservation (87%). Half of participants (51%) reported intentions to adopt a new conservation behavior. We found that key elements of the citizen science experience associated with these outcomes were learning about actions to protect reefs and coasts (procedural learning), experiencing surprise, and experiencing negative emotions about environmental problems. Excitement was also associated with positive outcomes, but only in participants who were less likely to see themselves as environmental, or were less frequent visitors to reefs and coasts. Importantly, the association between factual learning and environmental engagement outcomes was limited or negative. These findings suggest that the way citizen science experiences make people feel, may be more important for fostering future environmental engagement than factual-based learning. When designing citizen science programs for community members, these findings provide a reminder to not focus on provision of factual information alone, but to highlight environmental impacts while providing meaningful experiences and building environmental skills