location: nan, 'Thailand 
year: 2001 source: HSRI 
title: Health management service for informal sector : hawkers and residual collectors 
abstract:Health  Management  Service  for  Informal  Sector :  Hawkers  and  Garbage  Collectors This  research  is  aimed  to 1)  know  their  working  conditions , major  health  risks,  health  problems  and  care,  2)  know  their  awareness,  understanding  and  access,  of  health  service  system  for  them,  their  selection  of  health  service,  rights  and  benefits,  their  satisfaction  and  problems  of  health  service  system  use,  their  expectation  of  health  service  system  and  their  ability  to  make  additional  payment  into  the  health  fund,  and 3)  propose  guidelines  on  provision of health service system for informal sector : hawkers and  garbage  collectors.	This  is  qualitative  research  and  data  were  collected  in 3 ways  including  1) in-depth  interview  with 165 hawkers and  garbage  collectors  in  Bangkok  and  peripheral  zones,  2) interview  with 5 officials  directing  health  service,  and  3) 2 focus  groups  of  the  health  service  receivers  and  providers. 	The  research  can  be  concluded  that   most  of  165 samples  are women  being  31-40 years  of  age  and  having  primary  education,  single  families  and  about 4 family  members.  Most  samples  migrated  seasonally  or  permanently  form  the  northeastern  region,  reside  in  rented  houses  with  about ฿ 800/month.  Most  samples  have  worked  for  over  10 years  with  daily  income  of  ฿300-400 being  equal  to  their  expenditure.  Some  have  short-term  debts  with  monthly  interest  rate  of  7-20%  being  incurred  to  be  their  revolving  fund  for  trade  or  to  be  their  expenses  for  medical  treatment.	They  work  at  kerbs  or  in  public  and  crowded  places  for 8-10 hours  a  day  without  taking  any  holiday  for  relieving  their  stress  or  exhaustion  from  hard  or  repetitious  work.  They  also  encounter  polluted  air,  dust,  strong  sunlight  and  noise  of  heavy  traffic.  So,  this  is  rather  risky  work  without  certain  income. 	As  for  their  belief  in  health  care,  they  believe  that  their  families  and  themselves  are  strong  at  this  middle  age,  so  they  are  not  aware  of  health  protection  or  improvement.   In  case  of  illness,  Most  of  them  buy  drugs  instead  of  seeing  a  doctor  for  saving  on  time  and  money  and  for  quicker  recovery.	Most  of  the samples and their  families  were  not  seriously  ill  during  the  past  year  but  they  suffered  only  from  headaches,  armaches,  legaches,  backaches, shoulderaches,  colds,  exhaustion  and  stress.   Yearly  expenses  for  health  care  are  ฿ 200-300 per  family.  More  than  half  of  them  have  health  insurance  but  the  48% remainder  have  not  because  they  know  nothing  about  health  insurance  schemes  or  think  that  such  schemes  are  not  worthwhile  because  they  have  never  been  ill  or  that  better  service  results  from  cash  payment,  not  from  the  use  of  health  insurance  cards.	As  for  their  problems  of  health  service  system  use,  those  having  no  health  insurance  must  bear  medical  expenses  or  borrow  money  if  they  are  seriously  ill.  Public  hospitals  are  open  only  during  official  hours  and  the  health  insurance  schemes  are  usually  publicized  in  announcements  or  leaflets  which  are  hardly  or  cannot  be  read  by  them.  Those  having  health  insurance  usually  face  problems  with  hospitals  being  provided  for  them  according  to  administrative  zones,  so  most  of  them  suggest  that  suitable  hospitals  should  be  chosen  in  not  only  the  social  insurance  schemes  but  also  these  health  insurance  schemes.  Moreover  they  can  willingly  make  additional  payment  into  the  health  fund  for  about ฿ 500 –600 a year.	The  guidelines  on  provision  of  health  service  system  for  hawkers,  garbage  collector  are  as  follows :	1.  Public  awareness  of  health  improvement  and  protection  must  be  more  stimulated  than  medical  treatment  which  finally  requires  high  expenses.	2.  Suitable  health  insurance  should  be  basic  health  service  system  being  provided  for  informal  sector  having  no  health  insurance.  It  should  be  the  same  rights  and  benefits  as  those  offered  by  the  schemes  of  the  poor  and  needy  relief.   The  expenses  of  this  basic  health  insurance  must  be  borne  by  the  government.  If  anybody  wants   more  rights  and  benefits,  e.g.  selection  of  hospitals,  treatment  for  chronic  diseases,  use  of  extra  drugs,  etc.,  should  be  offered  and  additionally  paid  for.  The  insurer  taking  good  care  of  himself/herself  without  using  health  service  of  medical  treatment  should  be  given  a  discount  for  continuous  insurance.  Besides,  the  health  insurance  schemes  must  be  fully  publicized  by  local health  volunteers  or  radio  and  television  programmes  for  creating  correct  understanding  of  health  insurance.