Health Policy and Planning
Volume 32, Issue 8, 2017, Pages 1212-1219

Migrant tuberculosis patient needs and health system response along the Thailand-Myanmar border (Article) (Open Access)

Tschirhart N.* , Nosten F. , Foster A.M.
  • a Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N6N5, Canada, Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, PO Box 46, Mae Sot, Tak, 63110, Thailand
  • b Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, PO Box 46, Mae Sot, Tak, 63110, Thailand, Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
  • c Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N6N5, Canada

Abstract

This article aims to identify how the health system in Tak province, Thailand has responded to migrants' barriers to tuberculosis (TB) treatment. Our qualitatively driven multi-methods project utilized focus group discussions, key informant interviews, and a survey of community health volunteers to collect data in 2014 from multiple perspectives. Migrants identified legal status and transportation difficulties as the primary barriers to seeking TB treatment. Lack of financial resources and difficulties locating appropriate and affordable health services in other Thai provinces or across the border in Myanmar further contributed to migrants' challenges. TB care providers responded to barriers to treatment by bringing care out into the community, enhancing patient mobility, providing supportive services, and reaching out to potential patients. Interventions to improve migrant access and adherence to TB treatment necessarily extend outside of the health system and require significant resources to expand equitable access to treatment. Although this research is specific to the Thailand-Myanmar border, we anticipate that the findings will contribute to broader conversations around the inputs that are necessary to address disparities and inequities. Our study suggests that migrants need to be provided with resources that help stabilize their financial situation and overcome difficulties associated with their legal status in order to access and continue TB treatment. © 2017 The Author.

Author Keywords

TB Migrants Health system Thailand Myanmar

Index Keywords

information processing refugee economics Thailand human Refugees middle aged statistics and numerical data health service volunteer Volunteers ethnology qualitative research Surveys and Questionnaires Humans male female tuberculosis questionnaire Myanmar health services legislation and jurisprudence adult migration Transients and Migrants Focus Groups Health Services Accessibility health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85030676444&doi=10.1093%2fheapol%2fczx074&partnerID=40&md5=f194d6cf2d559575e04c1ab0db98c96f

DOI: 10.1093/heapol/czx074
ISSN: 02681080
Cited by: 1
Original Language: English