Safety and Health at Work Vol. 13 Supplement 2022
Quality assurance approach for basic occupational health services provided by Primary Care Units (PCUs) in Thailand, an example for others?

Safety and Health at Work Vol. 13 Supplement 2022
Quality assurance approach for basic occupational health services provided by Primary Care Units (PCUs) in Thailand, an example for others?

Quality assurance approach, basic occupational health services provided, Primary Care Units (PCUs), Thailand

Introduction: Total of 9,815 PCUs in Thailand are as a key mechanism for providing health services for all because their locations are close to the community. Integration of basic occupational health services (BOHS) in this setting is very crucial because high risk community workers can access services easily. Thailand has launched BOHS program in PCUs since 2008. Ten years later, the quality control strategy using the OHS practices standards tool was established. Such standards are divided into 5 components and 25 items including 1) organizational set up, human resources, plans, evaluation and occupational health network collaboration, 2) OHS for health workers of PCUs, 3) pro-active OHS for community workers, 4) in-house OHS and 5) integration of environmental health services (EHS). This work was undertaken to explore the OHS quality control program among PCUs following such standards.
Material and Method: The staff of the Regional Office of Disease
Prevention and Control (RDDC), and the staff of the Provincial Public Health Office have been trained to audit PCUs. Additionally, the basic OH course has been developed and trained PCUs’ staff. The evaluation system using the web-based has been established since 2019 and the instruction manual for all users have been documented as well. The PCUs’ staff conducted self-assessment and RDDC staff approved their results through such platform. The assessment criteria of the standards have been classified into 4 levels including starting level, good level, very good level and excellent level depending on the performance of PCUs practices.
Results: During 2018-2021, 2,456 PCUs (25.7%) participated in the project and conducted self-assessment following OHS standards. Of them, 1,529/ (62.3%) PCUs could pass the criteria approved by the
external auditor. Their levels were starting, good, very good and
excellent amounting to 262 (17.1%), 585 (38.3%) , 321 (21.0%),and 361 (23.6%) respectively. E-learning basic OH curriculum has been developed after gathering training need information from PCUs’ staff. There were 12 study hours and 7 subjects packed in the course including OH policy, walkthrough-survey, risk assessment and control, common occupational diseases (OD), practical BOHS, OD record and related OH laws. This course will plan to begin next year (2022).
Conclusions: Participated PCUs could provide BOHS following such
criteria. However, they had some limitations, such as 1) the capacity
of PCUs’ staff for early diagnosis of OD and EHS provision were limited, 2) common hazards related to health problems have been identified, but control measure still need to be strengthened, Currently, the web-based audit platform was very helpful because of COVID-19 outbreak. Capacity building, training and supervision were the main activities for strengthening the quality assurance system.
Recommendations: The future development should be addressed in 4 issues as follow: 1) specification of OHS interventions in the benefit package of universal coverage scheme to support operational finance, 2) training PCUs’ staff to enhance competency, 3) OHS quality continuous development and 4) OHS legislation enforcement.

Collin Tukuitonga

Elsevier Korea LLC

January 2022

Sri Wahyuni

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Safety and Health at Work Vol. 13 Supplement 2022