Guidelines for the Development of Access to Health Services in Primary Health Care of Myanmar Migrants in Mae Sot District, Tak Province by World Vision Foundation of Thailand

Abstract

The research objectives were to studies 1) access to health services in primary health care, 2) support factors and interruption factors of access to health services in primary health care and 3) guidelines for the development of access to health services in primary health care of Myanmar migrants in Mae Sot district, Tak province by World Vision Foundation of Thailand, Mae Sot special project coordination center, Tak province. The study was a qualitative research using 3 methods. The 1^st method is the focus group discussion method in 2 groups of samples: (1) 13 people of World Vision Foundation of Thailand staff and relevant government officials, and (2) 50 people of migrant health volunteers and migrant health staffs. The 2^nd method is the interview method in 3 groups of samples: (1) 60 Myanmar migrants have access to Health Post, (2) 3 staffs of World Vision Foundation of Thailand project, and (3) 10 relevant government officials. And the 3^rd method is workshop seminar method with 3 staffs of World Vision Foundation of Thailand project and 10 relevant government officials. The results of the study on access to health services in primary health care of Myanmar migrants in Mae Sot district, Tak province, migrants have access to a small number of public health services. The problems in accessing health services include: 1) most of the migrants are out of the system, do not understand the health service system and do not care to use the health services of the Thai authorities, 2) the migrants have a poverty problem, thus preventing access to the Migrant Health Card, 3) limitations of Thai health insurance and social security system, 4) the migrants are unaware of information about access to health services of government agencies in Thailand, 5) communication between health service authorities and migrants, and 6) the public health services of government agencies are the low number. There are three factors that support access to health services in primary health care for migrants: 1) Health Post (HP), 2) Migrant Health Volunteer (MHV), and 3) implementation as a network partner for health services in primary health care. There are four factors to the interruption: 1) the problem comes from the migrants, 2) migration policy in Thailand, 3) differences in language and culture among Thais and migrants, and 4) discontinuity of health services in primary health care support for migrants. The development of access to health services primary health care for Myanmar migrants in Mae Sot district, Tak province, there are six approaches: 1) to build understanding and support for Community Based Organization (CBO) in the migrant communities, 2) to expand primary health care services, 3) human resources development (MHV and government officials) in public health,  4) Regulate clear and adoption of policies and laws for the migrants, 5) Establish and operate as a network partner, and 6) a mechanism to manage the health service in primary health care.