Community participation of cross-border migrants for primary health care in Thailand

Abstract

This is the first report of the large-scale utilization of migrants as health volunteers in a migrant primary-healthcare program. The program recruited migrants who volunteered to serve their communities. This study explores the identities of these volunteers, their relationship with program management, and their attitudes. The study also investigates the impact of the volunteers, from the migrants' and healthcare workers' perspective. The study was conducted in two provinces, Tak (northern Thailand) and Samut Sakhon (central Thailand). Primary and secondary information was collected. Mixed methods, comprising in-depth interviews, observation and questionnaires, were used to gather primary data from three groups of participants-migrant volunteers, migrants and healthcare workers. Secondary data, and in-depth interviews with healthcare workers, showed that migrant volunteers made a significant contribution to the provision of both preventive and curative services. The quantitative study covered 260 migrant volunteers and 446 migrants. The results found that <5% of volunteers were selected by the community. Almost all attended a training course. Most were assigned to be health communicators; four stated they did nothing. Volunteers' attitudes were very positive. Most migrants reported that the volunteers' work was useful. It was concluded that the migrant health-volunteer program did help deal with migrant health problems. However, management of the program should be closely considered for more effective outcomes.

Migrant tuberculosis patient needs and health system response along the Thailand–Myanmar border

“…Participants were predominantly female (70%) with a majority aged 30–49 (62%). Another study from two Thai border provinces similarly found that most (56.9%) of the migrant volunteers were women ( Sirilak et al 2013 ). In our sample, most CHVs spoke Burmese, self-identified as documented migrants (60%), and had been working as a CHV for 2 or more years (54%).…”

“…The way that CHVs framed their rationale for volunteering may be related to the way they see themselves, as members of a minority group in a foreign country where they need to work together in solidarity. Our survey did not collect information on reasons for volunteering but a CHV survey with a similar migrant population found that 98.1% believed that volunteer work assisted members of their ethnic group ( Sirilak et al 2013 ). This model of care, where migrants are embedded in treatment programmes as medics and volunteers, is not limited to TB programmes but is commonly used by numerous organizations that provide healthcare to migrant populations along the border.…”

“Because if we talk about health issues first, it is easier to talk about human trafficking”; findings from a mixed methods study on health needs and service provision among migrant and trafficked fishermen in the Mekong

“…Our findings show that interpreters encouraged care-seeking and built goodwill with employers. The Migrant Health Volunteer model holds promise, although it has only been implemented in two coastal provinces [65]. In another large-scale NGO program, Migrant Field Officers provide similar support alongside negotiating disputes with police, employers and health workers [66].…”

Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand

“…Very few studies are conducted in LMICs. In Thailand, one study describes the benefits and challenges of implementing a Migrant Health Volunteer (MHV) program in two provinces [19]. In Malaysia, a recent survey with migrant workers found that those who preferred other languages for clinical communication (not English or Malay) were 2.7 times more likely to delay treatment when severely sick, compared to those who preferred to communicate in Malay [20].…”