Background Depression is globally recognized as a major mental health problem in all age categories, particularly among those living in poor economic conditions and with low levels of education, including the hill tribe people in northern Thailand. Methods This cross-sectional study aimed to estimate the prevalence of depression and determine the factors associated with depression in the hill tribe population aged 40 and over in northern Thailand. Hill tribe people who lived in the selected villages and met the inclusion criteria were invited to participate in the study. A validated questionnaire and the Patient Health Questionnaire-9 (PHQ-9) were used for data collection. An interview was conducted in a private and confidential room in the selected villages between January and April 2019. Logistic regression was used to determine the factors associated with depression at a significance level of α = 0.05. Results A total of 601 participants were recruited into the study. More than half (64.23%) were women, 46.76% were Akha, 61.90% were aged 40–59 years, and 76.37% were married. Half of the participants were Christian (57.07%) and had no monthly income (51.25%), and 85% were illiterate. The overall prevalence of depression was 39.10%: 75.74% had mild depression, 17.88% had moderate depression, and 6.38% had severe depression. In the multivariate model, three variables were found to be associated with depression: being female, having a history of substance abuse, and experiencing stress six months prior. Compared to men, women were 2.09 times (95% CI 1.30–3.35) more likely to have depression. Those who had a history of substance abuse were more likely to have depression than those who did not have a history of substance abuse (AOR = 1.97; 95% CI 1.25–3.10). Those who had a history of stress in the prior 6 months were more likely to have depression than those who did not (AOR = 6.43; 95% CI 4.20–9.85). Conclusion Public health screening programs to identify depression in the hill tribe population are urgently needed, particularly for women, those who have abused psychoactive substances, and those who have experienced stress.

Background Hill tribe children, an ethnic minority group in Thailand, experience wide-ranging social and health inequalities. Previous reports indicate that hill tribe children, especially age under 5 years, face social health disadvantages but little is known about the underlying causes. Exploring healthcare utilization among hill tribe children is therefore essential and it may well provide some insight. Methods A qualitative study was conducted using purposive sampling techniques to recruit participants based on our criteria. In-depth interviews and focus-group discussions were employed to explore the experiences of parents (n = 20), community leaders (n = 20), and healthcare providers (n = 20) when caring for children aged under 5 years. Interview transcripts were coded, and thematic analysis was then performed. Results The participants shared their experiences with accessing healthcare services in underserved areas. Barriers to access was the central theme identified. Sub-themes included: (1) distance matters, (2) education and socioeconomic deprivation, (3) lack of cultural sensitivity, (4) communication problems, (5) tradition, beliefs, and differences in cultural practice, (6) lack of child health professionals, and (7) bureaucratic hurdles. Conclusions Healthcare services and environments must be transformed to provide healthcare services, education, and information appropriate to the cultures and beliefs prevalent in the hill tribe population.

The widespread availability and use of vaccines have tremendously reduced morbidity and deaths related to infectious diseases globally. However, in hill-tribe communities in Northern Thailand, vaccination rates remain low, and there is limited literature on parental perceptions, attitudes, and beliefs about vaccination for children under five years of age. We conducted a qualitative study employing semi-structured interviews to understand parents’ perceptions, attitudes, and beliefs about vaccinations. A purposive sample was used to recruit participants. Data were analyzed using thematic analysis. 74 hill-tribe parents (14 Akha, 11 Hmong, 12 Lahu, 13 Lisu, 12 Karen, and 12 Yao) were interviewed. Four themes emerged from the interviews: 1) traditional beliefs, and practices 2) traumatic experiences, 3) lack of information and effective communication, and 4) trust and support from the community. Findings highlight that it is crucial to build trust by providing knowledge, appropriate information, and advice about vaccinations in order to improve vaccine coverage in children under five years of age in the hill-tribe context.