location: nan, 'Thailand 
year: 2001 source: HSRI 
title: Health insurance problems and needs of agricultural informal sector workers 
abstract:Those working in the agricultural informal sector were at disadvantage in getting access to the public service. They lacked assets and were at health risk owing to their occupations. This study was aimed at finding out their problems, needs, readiness and cooperation concerning the health insurance system in order to determine some ways to deal with their health insurance. The samples of the study were those who were engaged in farming, plantation, fruit-growing, animal-raising, and fishing. The studied areas were Chiangmai, Khonkaen, Suphanburi and Trang. The data were collected by interviewing household heads in individual occupations and holding focus group discussion with community leaders and government officers in the study area. It was found that working characteristics depended on their earning assets and land and the environment. Occupation inputs were investment funds, labor and agricultural materials. The uncontrollable external factors, such as prices of produces and fishery sources were main conditions. Those working in the agricultural informal were different from general agriculturists in that they had to follow the regulations set by others, i.e., public organizations and officers, employers or product purchasers and other influential people, such as capitalists, and local leaders. Because they had to rent land, encroached forest reserves, lacked public utilities, lived in remote areas, could not get access to current news and modern technology. They entered the occupations in either of the two ways : 1) succeeding their ancestors, and 2) seeking a new occupation because of the failure in the old occupation or in the old workplace. Moreover, it was found that most of the household members completed elementary school. They received news or information at a low level. There were not many working hours each day and the productivity was low. They lacked motivation as a result of drops in prices of goods, lack of funds, and inadequate agricultural land. Their yearly incomes ganged from 20,000 to 30,000 per household. More than half of the sample's expenses exceeded the income and they were in debt. Working problems were that they did not form a group, lack of continuing activities. It was difficult for them to solve their own problems and to do so required high expenses. They did not prevent themselves from health problems; on the contrary, they sought treatment after they were ill. They had risky behavior because they drank, stroked, and took pain killing or stain-releasing medicines. Some also encountered health problems resulting from their occupations such as fishery. Some used chemical substances to a great extent in cultivation and some suffered from pollution in the environment. To deal with these problems. It was necessary to organize a system, to identify of classify health insurance people into groups, to set criteria for evaluation, to define the scope, and to update the data every 6 months. Responsible agencies should be established and power should be decentralized to local government. Cooperation among agencies should be sought. The health system should be built, taking into consideration the area, function and participation (AFP). Emphasis should be put on providing health insurance with a charge of 300-500 baht yearly or seasonally. Also, health prevention measures should be of primary concern. Those responsible for collection the fees should be the municipality and the tambon administrative organization. The follow-up and evaluation of the health insurance project should be carried out continuously.