Cooperation Model on Trans-border Referral System between Thailand and Myanmar, Laos PDR, and Cambodia: Outcome of International Cooperation Measures

Abstract

The objective of this study was to explore a cross-border cooperation model for patient referral between Thailand and Myanmar, Laos PDR, and Cambodia. It was conducted in the years 2016-2017 at the following study sites: Thai - Myanmar border at Ranong and Tak provinces; Thai - Laos border at Ubon Ratchathani and Nong Khai provinces, and Thai - Cambodia border at Srakaew and Trad provinces. Target groups were stakeholders on border health at provincial, district, and sub-district levels. Data were collected by interview usimg questionnaire; and were analyzed by coding and content analysis. It was found that the referral system for TB/HIV diseases existed at all border sites. There were 3 models identified: (1) the referral system between government hospitals based on the clinical practice guidelines of the diseases; (2) the referral system following the MOU but was incomplete, and (3) the referral systen was at development stage without existing memorandum of understanding (MOU) between the responsible government hospitals. There were problems relating to the reduction of budgetary support from international organizations, the limitation of performance capacity for of disease control at the checkpoints, and the problematic data system and communication.