Accessibility to Health Services and Health Seeking Behavior among Different Ethnic Groups of Migrants from Myanmar in Thailand

Migrants from Myanmar in Thailand are studied as homogenous group of population in research and policies. In reality, Myanmar is one of the ethnically diverse country in ASEAN with 135 ethnic groups as recognized by the government (DOP, 2014). There is a need to examine ethnic significance of the health service user and provider side as well as health system. This study examines the factors influencing on accessibility to health services and health seeking behavior of migrants from Myanmar in Thailand and the culture difference among ethnic groups in terms of accessibility to health services and health seeking behavior. This study also aims to investigate how Thailand’s health system, health service providers’ perception and challenges effect on the above mentioned points. This is a mixed-method study with secondary data using PHAMIT2 Project and followed by qualitative in-depth interview with 28 migrants from Myanmar (Bamar, Mon and Karen ethnic groups) and 19 health service providers in Samut Sakhon area.

 

Our findings indicate that the ethnicity and health seeking behavior are significantly correlated. The results indicate that the motives behind choosing public hospital includes migrants’ legal status, owning hospital registration cards or health insurance cards. A common practice among all three ethnic groups, Bamar, Mon and Karen, is the usage of traditional medicine for pain, fever, blood related disorder. Healing practices with religions, spirits and astrologers are found to be different among ethnic groups. Praying and healing with the spirits is practiced among Mon ethnic and Getting treatment by astrologers are found with Bamar ethnic groups. For Karen ethnic migrants, the spiritual worship when they get sick is also common. Among Mon and Karen ethnic groups used public services followed by private health services whereas Bamar ethnic groups used public health services followed by NGO, drug stores and traditional medicine health services. The perceived cost of treatment and affordability play role in selecting private hospital for health services. Migrants go nearby private clinics are chosen over the public hospitals if the migrants have minor ailment. Ethnicity is associated with both satisfaction and convenient towards private health services but not for the public health services. The affordability of migrants towards health services is influenced by the health insurance status. The most challenging in accessibility to health services for the migrants is translator availability as there is a limitation number of translators who can speak ethnic languages. 

 

This study recommends to strengthen the health service provision to migrant workers by both prevention and treatment and to promote the ethnic sensitivity and cultural variations with the migrants from Myanmar particularly providing different ethnic translators at the health services.