Distance matters: barriers to antenatal care and safe childbirth in a migrant population on the Thailand-Myanmar border from 2007-2015, a pregnancy cohort study

Steinbrook, Eric; Min, Myo; Kajeechiwa, Ladda; Wiladphaingern, Jacher; Paw, Moo Kho; Pimanpanarak, Mupawjay; Hiranloetthanyakit, Woranit; Min, Aung Myat; Tun, Nay Win; Gilder, Mary Ellen; Nosten, François; McGready, Rose; Parker, Daniel M.

doi:10.1101/2020.11.13.20231464

2020

DOI: 10.1101/2020.11.13.20231464

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Distance matters: barriers to antenatal care and safe childbirth in a migrant population on the Thailand-Myanmar border from 2007-2015, a pregnancy cohort study

Eric Steinbrook

Myo Min

Ladda Kajeechiwa

et al.

Abstract: I.BackgroundAntenatal care and delivery with skilled attendants substantially improve maternal health outcomes across the pregnancy spectrum, from conception to delivery. The Sustainable Development Goals recognize the need to expand these services to all pregnant women but there is limited data on access for migrants and in post-conflict regions.II.MethodsUsing geographic information systems established for malaria elimination efforts in Kayin state, Myanmar and Tak Province, Thailand, retrospective estimates… Show more

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Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic

Gilder

Pateekhum

Hashmi

et al. 2022

Int J Equity Health

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Background Hepatitis B causes significant disease and death globally, despite the availability of effective vaccination. Migration likewise affects hundreds of millions of people annually, many of whom are women and children, and increases risks for poor vaccine completion and mother to child transmission of hepatitis B. In the neighbouring countries of Thailand and Myanmar, vaccine campaigns have made progress but little is known about the reach of these programs into migrant worker communities from Myanmar living in Thailand. Methods A cohort of 253 postpartum women (53 urban migrants in Chiang Mai and 200 rural migrants in Tak Province) were surveyed about their Hepatitis B knowledge and willingness to vaccinate their children between September 10, 2019 and March 30, 2019. They were subsequently followed to determine vaccine completion. When records of vaccination were unavailable at the birth facility, or visits were late, families were contacted and interviewed about vaccination elsewhere, and reasons for late or missed vaccines. Results Though women in Tak province displayed better knowledge of Hepatitis B and equal intention to vaccinate, they were 14 times less likely to complete Hepatitis B vaccination for their children compared to migrants in Chiang Mai. Tak women were largely undocumented, had private (non-profit) insurance and had more transient residence. In Chiang Mai migrant women were mostly documented and had full access to the Thai national health services. Though minor individual and facility-level differences may have contributed, the major driver of the disparity seems to be the place of migrants within local socio-political-economic systems. The COVID-19 pandemic further disproportionately affected Tak province migrants who faced severe travel restrictions hampering vaccination. Sixty percent of families who were lost to vaccine follow-up in Tak province could not be contacted by phone or home visit. Chiang Mai migrants, with 86.8% vaccine completion, nearly reached the target of 90%. Conclusions Achievement of high levels of hepatitis B vaccination in migrant communities is important and feasible, and requires inclusive policies that integrate migrants into national health and social services. This is more urgent than ever during the COVID-19 era.

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Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic

Gilder

Pateekhum

Hashmi

et al. 2022

Int J Equity Health

Self Cite

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show abstract

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Distance matters: barriers to antenatal care and safe childbirth in a migrant population on the Thailand-Myanmar border from 2007-2015, a pregnancy cohort study

Cited by 1 publication

References 27 publications

Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic

Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic

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