Developing primary care occupational health services for informal sector workers in Thailand

Abstract

This study demonstrates action research's emancipatory traditions in enabling community stakeholders in rural Thai settings to increase self-reliance and collaboration in improving primary care occupational health services. Most of the Thai workforce are informal sector workers outside Thai labor law protections, health and safety regulatory frameworks, and without specific occupational health services to provide for work-related health needs. This project brought together community leader teams, village health volunteers and informal workers themselves to collaboratively develop community services for this underserved group. Significant changes were effected at Downloaded from community team level, with improvements in networking and community nurses' health care for the workers and in their oversight and supervision of village health volunteers (VHVs) in the community. Most notably, VHVs' self-confidence improved at providing illness prevention and health promotion support in workers' homes and work settings congruent with their daily lifestyle and work schedules. Informal workers' health selfcare behaviors improved.

Using Action Research to prevent work‐related illness among rubber farmers in Northeastern Thailand

“…In this study, we found very limited preventive health education for the farmers to reduce work‐related health risks. This lack of support‐services and information on proper self‐care had led to many health problems, similar to previous findings (Chaimay & Boonrod, ; Nilvarangkul et al., ; Wongphon & Inmoung, ). Rubber farmers and other community stakeholders had close relationships.…”

“…Village health volunteers (VHVs) were key for supporting farmers to learn better self‐care work practices. Thailand lacks community nurses and primary health care personnel (Wongwichai, ) and has limited occupational health personnel at the community level to care for the farmers in the informal work sector (Nilvarangkul et al., ). The VHVs had time for contact with the farmers since they lived in the same communities, had similar lifestyles, and some were also rubber farmers themselves.…”

“…Although they make a significant contribution to the Thai economy, as informal sector workers they work outside Thai Labor Protection Act (1998) (Department of Labour Protection and Welfare, Ministry of Labour, ) and without occupational health services to provide for work‐related health needs. Thus, they lack opportunities for accessing information and services related to health promotion, and work‐related health and safety issues (Arphorn, Chaonasuan, Pruktharathikul, Singhakajen, & Chaikitiporn, ; Nilvarangkul et al., ).…”

Courses on Basic Occupational Safety and Health: A Train-the-Trainer Educational Program for Rural Areas of Latin America

“…In addition, occupational health lecturers at this university were not full-time professors and no extra hours were assigned by universities' management for the program. This highlights the importance of community involvement from the beginning as well as the importance of institutional support in programs like this [58].…”

How does informal employment affect health and health equity? Emerging gaps in research from a scoping review and modified e-Delphi survey

“…Because informal workers remain excluded from the health and safety regulatory system, diverse interventions were attempted to extend occupational health and safety to informal workers, including the development of a health and safety program by non-governmental organizations with urban street vendors in South Africa [ 68 ] and by community stakeholders in rural Thai settings [ 69 ] and awareness program on various occupational health hazards among the ragpickers in India [ 70 ]. Even though informal workers are given the right to refuse dangerous work as in the case of South African mine workers [ 71 ], significant gaps in implementation were identified due to the predominant practice of non-confrontational consultation with supervisors.…”