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This study investigated what competencies are crucial for mental health practitioners’ culturally competent practice with LGBTIQ clients in Thailand. The study used two-round Delphi methodology to aggregate views of mental health practitioners with expertise on LGBTIQ issues (n = 14), and of LGBTIQ individuals who had used mental health services (n = 13). Participants proposed competencies in Round 1 through interviews or an online questionnaire, and rated these competencies’ importance in another online questionnaire in Round 2. Forty-one knowledge competencies, 35 awareness/attitude/belief competencies, 14 skill competencies and 35 action competencies were rated. Among key themes were understanding gender/sexual diversity as well as issues affecting LGBTIQ people and their families, and being able to assist on these issues; accepting gender/sexual diversity, respecting clients’ self-determination, and communicating this to clients; being aware of the impact of one’s beliefs, attitudes, identities and values; recognizing and rejecting stereotypes; being open, humble, and willing to learn more; knowing how to use feminist counseling techniques and other specific techniques; refraining from offending actions; social justice action; and obtaining information sensitively. Developing these competencies is likely to improve mental health services’ appropriateness for LGBTIQ clients and should be included in mental health practitioners’ training in Thailand.

Although the health care resources in Chin State are comparable to those in other regions, the indicators of maternal health status there are the poorest in Myanmar. While the Myanmar government has initiated health care system reforms, the increase in service capacity alone is a necessary but insufficient condition to improve access. Because the effectiveness of antenatal care is critical in terms of reducing maternal mortality and serious morbidity, this study determines how women's beliefs affect the utilization of antenatal services. The qualitative study analyzes in-depth interviews with 25 women who had given birth during the past year in both rural and urban areas of three townships in Chin State. The results show that women's beliefs strongly influence the utilization of antenatal services. The women did not recognize pregnancy risks or the benefits of antenatal services. They also did not trust the staff in the formal health care sector, and their trust in traditional birth attendants served as a barrier to utilization of antenatal service. To improve utilization, policymakers must understand the sociocultural context of women, as well as their beliefs and trust related to antenatal care, and should design policy to address the relevant influencing factors.

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