Skip to main content

Table 5 Factors affecting policy implementation of MHV and MHW programmes in Thailand

From: Strengthening the migrant-friendliness of Thai health services through interpretation and cultural mediation: a system analysis

Factors that influence effective implementation of policies

MHW and MHV programmes

No insurmountable external constraints

Both public sector organisations and NGOs follow legislation regulating LC employment; however, the training guidelines are voluntary implemented.

Adequate time and sufficient resources

There is an insufficient budget in some areas and a low number of MHWs and MHVs due to high turnover rate and lack of competitiveness with private sectors.

Requires combinations of resources

The budget allocated to MHW and MHV programmes in public health facilities depends on local agreements and the number of registered migrant workers.

Valid theory

The training courses are not specific to the core competences of interpreters and cultural mediators.

Causal connections are reasonable, clear and direct

It is a good start that MOPH and NGOs allocate resources for MHW and MHV programmes, but it is not well-developed in terms of resource sharing because the programmes started to provide services before resources were properly organised.

Dependency relationships are minimal

It is still unclear which agency has the authority to manage MHW and MHV national programmes.

Understood and agreed objectives

All organisations recognise the importance of MHWs and MHVs, but there are different perspectives on the tasks involved, e.g. some expect MHWs to have only interpretation tasks while some expect them to expand their role beyond this.

Correct sequence of tasks

There is a lack of working processes in the overall system.

Communication and coordination

There is unclear communication about the purposes of the allocated budget, e.g. no specific budget for MHW employment.

Compliance

There is no resistance from health sectors, but some resistance from citizenship privileges and other ministries e.g. employing MHWs in similar fashion as Thai employees and allowing MHWs to receive same benefits as Thai employees are still matters of debate.