This project “The integration of GIS into a health information system for migrant health monitoring: In the Eastern Economic Corridor” is about utilizing data for health service and health status of migrant workers management. Migrants’ health information is extracted from 43 files of database, Health Data Center (HDC) dashboard, Ministry of Public Health. This new developed system presents data in Dashboard and mapping. Accordingly, the users can access migrant workers’ health information through web browser: http://www.eecmigrants.com. The web application has 3 main categories: statistical database, spatial database, and data table, which divided into 5 subcategories: Patient identification, Diagnosis, treatment, Treatment results, and Medical rights. This database assists users to manage health data quickly and effectively. However, there are problems and limitations in this study described as below:
1. The database system of Ministry of Public Health did not support the programmer to access information automatically via Application Programming Interface (API). Therefore, the programmer had to access data through only channel that the ministry allows, which was difficult to pull selected data out. Apart from that, the data collection at the sub-department level still was lack of unity. It used different systems to gathering data, it also contained out-of-date information.
2. This database system allowed us to retrieve 1,000,000 record at one time. In practice, downloads were specified by date and time. The programmer would not exactly know the amount of data that pulled out. As a results, when having information overload, the programmer had to split the big data into small size. Then, making a data account to keep track on latest download location. This would help acquiring full information.
3. The database system did not support the OFFSET in SQL command which allow users to select the range of data. Nevertheless, the development team analyzed data and found that data had date written in each table. Thus, we selected information by date to do analyze.
4. The database did not connect with other databases which belong to private sector and other public healthcare organisations (e.g., office of the Municipality, pharmacy).
5. Some of migrant workers’ information were incomplete due to illegal immigration. Also, when access healthcare, they used other workers’ information for hiding their undocumented status, causing duplicate data at that. According to the interview with Burmese, Cambodian, Lao migrant workers, most of them had education lower than high school. Additionally, lots of migrant workers entered Thailand legally with health insurance. Some were undocumented immigrants. Their monthly income were about 10,000 baht and monthly average expenses were 6,000 baht. Mostly migrant workers accessed healthcare knowledge from television, mobile phone, friends and their employers. It is obvious that when they got sick, they would go to the nearest hospital. The finding revealed that they were satisfied with Thai healthcare service. Furthermore, migrant workers were interested to know about their right and benefit of health insurance and the access to healthcare service.
The problems that arise from providing service to migrant workers were 1) the burden of medical expenses that patients could not afford to pay 2) healthcare workers even worked harder 3) there were a chance that emerging and re-emerging infectious diseases would be spread and difficult to control 4) a risk of recurrence of vaccine-preventable disease from migrant workers’ children 5) migrant workers took part in rights and medical resource that preserve for citizens 6) delayed payment of insurance did serious impact on hospitals’ financial management, and 7) inefficient use of health care resources.
In spite of the fact that the recommendations from the study can help planning the more effective healthcare for migrants in the Eastern Economic Corridor, there are some points that need to be improved
1. Establishing the same standard for recognized migrant workers’ identification in order to reduce data redundancy.
2. Organizations should share relevant information, as well as, allow the others to access the data regarding the law.
3. Setting data standardization that can be connected to other database properly. Besides, create strong security for protecting the data.
The effective way to sending health information to migrant workers, is using media in their own languages. According to that, they can easily access via television, mobile phone and their employers. Turning to urgent health issues in migrant workers, communicable disease and emerging and re-emerging infectious diseases should be taken care of as top priority.