The Development of basic occupational health services (BOHS) for workers in the informal sector through primary care units

Introduction
In Thailand, more than half of the working population are agricultural, informal, or self-employed workers. They are unable to get access to OH services. The Ministry of Public Health has conducted a project to develop BOHS for those underserved workers in term of feasibility and suitable OH services. The aim of the presentation is to describe how to develop and implement BOHS in Primary Care Units (PCUs) in the country.

Methods
The project was started by conducting a pilot study on BOHS model development during 2004-2007. The activities included setting the BOHS guidelines, development of training curriculum for health officers, and pilot provision of BOHS. After that, the model of BOHS in community hospitals (CUPs) and the linkage system between PCUs and CUPs was set up and developed. In addition, the BOHS supportive system was established by introducing policy movement starting from the central government to local authority. Currently, the implementation of the model throughout the country has been carried on.
Results: The project showed all PCUs were able to provide BOHS. The target groups were mainly farmers. The activities performed included OH education, first aid and emergency treatment, working environmental survey in farms, and health screening for pesticide exposure. The project can raise an awareness of the importance of OH in farmers and other workers in informal economy among health authorities and officers at provincial and local levels.

Discussions
The project showed that BOHS for underserved workers can be integrated effectively into a general health service system at the PCU level. However, policy support, resource allocation and continued capacity building to increase knowledge and skills for the health care staff are needed to improve the quality of the services.