Perceived Barriers of Accessing Healthcare among Migrant Workers in Thailand during the Coronavirus Disease 2019 (COVID-19) Pandemic: A Qualitative Study

Abstract

The outbreak of Coronavirus Disease 2019 (COVID-19) has threatened health and well-being in all populations. This impact is also deepening structural inequalities for migrant workers in Thailand. Due to their vulnerability and limited opportunity to access health services, they have greater risks in many health aspects compared to other populations. This qualitative study sought to examine the key health concerns and barriers during the COVID-19 pandemic on healthcare access among migrant workers in Thailand through the lens of policymakers, healthcare professionals, experts on migrant health, and migrant workers. We conducted 17 semi-structured in-depth interviews of stakeholders from health and non-health sectors in Thailand from July to October 2021. The interviews were transcribed and analyzed using both deductive and inductive thematic approaches. Thematic coding was applied. The results showed that financial constraints were a major barrier for healthcare access among migrant workers. These included affordability of healthcare and difficulty accessing funds (migrant health insurance). Structural barriers included some health facilities opening for emergency cases only. Insufficient healthcare resources were profound during the peak of positive cases. Cognitive barriers included negative attitudes and diverse understanding of healthcare rights. Language and communication barriers, and a lack of information also played an important role. Conclusion, our study highlights healthcare access barriers to migrant workers in Thailand during the COVID-19 pandemic. Recommendations for future resolution of these barriers were also proposed.

Socio-Economic and Health Consequences of COVID-19 on Indian Migrants: A Landscape Analysis

“…The study reported that financial constraints were the major barrier to access to health care. 35 Further, there was disruption of livelihood due to loss of wages like inability to pay the rent, loan, borrowing from relatives, and fear of its consequences. The review also highlighted that although the government implemented various schemes to help the migrants, the majority were left out due to the non-availability of identity proof and ration cards.…”

Factors Influencing Thai Health Workers’ Attitudes toward Providing Health Services to Migrants

“…In addition, Thai health workers are likely to turn away from migrants since they do not have insurance. 8 Besides, some health facilities denied migrants care while Thai people were the priority. 8 Thus, migrants and their dependents might have more health problems than Thai citizens and experience inequality in health service access compared to Thais.…”

“…8 Besides, some health facilities denied migrants care while Thai people were the priority. 8 Thus, migrants and their dependents might have more health problems than Thai citizens and experience inequality in health service access compared to Thais. 9,10 In Europe, migrants may encounter healthcare inequality, which can cause poor health outcomes such as high morbidity and mortality rates for various chronic diseases.…”

“…11 Besides, there was unsatisfactory and poor communication between healthcare providers and migrants, and thus, the migrants did not realize the health information due to linguistic and cultural limitations. 8,12 Most studies on migrant workers utilized a qualitative approach to examine health workers' attitudes toward migrants. [13][14][15][16] Health professionals felt frustrated by the system's lack of resources and migrants are not able to access care.…”