School-based Psychosocial Interventions’ Effectiveness in Strengthening Refugee and Migrant Adolescents’ Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study / [La eficacia de las intervenciones psicosociales centradas en la escuela para potenciar la salud mental, la resiliencia y las relaciones sociales de adolescentes refugiados y migrantes: un estudio de grupos aleatorizados en cuatro países]

School-based psychosocial interventions are increasingly put forward as a way to support young refugees’ and migrants’ well-being and mental health in resettlement. However, the evidence on these interventions’ effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth’s mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.(AU)

Cada vez se proponen más las intervenciones psicosociales centradas en la escuela como ayuda al bienestar de jóvenes refugiados y migrantes en su realojamiento. No obstante hay pocas pruebas sobre la eficacia de tales intervenciones y los expertos denuncian fallas en dichas pruebas hasta el momento debido a la falta de estudios controlados a gran escala que incluyan medidas de los resultados sociales. El presente estudio de grupos aleatorizados pretende potenciar la base de pruebas sobre intervenciones psicosociales centradas en la escuela con jóvenes refugiados y migrantes analizando el efecto de dos intervenciones, “El drama en el aula” y “Bienvenido al colegio”, en la salud mental, la resiliencia y las relaciones sociales de los jóvenes en Bélgica, Dinamarca, Noruega y el Reino Unido. Se efectuaron análisis multinivel por separado para las dos intervenciones (“El drama en el aula”, n = 307, edad entre 11 y 19 años; “Bienvenido al colegio”, n = 251, edad entre 11 y 23 años) con grupos de control sin tratamiento separados. Los análisis mostraron un efecto positivo principal significativo de “El drama en el aula” en el apoyo familiar percibido y un efecto en el apoyo percibido de los amigos moderado por el país: en el Reino Unido el grupo de intervención presentó un aumento del apoyo percibido de los amigos, mientras que en el grupo control disminuyó. Además la resiliencia básica moderaba el efecto de la intervención de “El drama en el aula” en las dificultades conductuales y en el bienestar. No se apreció efecto de “Bienvenido al colegio” en ninguna de las variables resultado. En términos generales el estudio supone un inédito y detallado aval de las intervenciones psicosociales centradas en la escuela en el caso de adolescentes refugiados y migrantes.(AU)

Migração, trabalho e violência: interfaces com a saúde / Migration, labor and violence: interface with health

A cartilha é um material educativo fruto da pesquisa "Migração, saúde e violências: experiências de trabalhadoras(es) migrantes e refugiadas(os) no Rio de Janeiro"*, durante a qual foram escutadas(os) migrantes e refugiadas(os) residentes no Brasil, especificamente no estado do Rio de Janeiro. (AU)

Undocumented: An examination of legal identity and education provision for children in Malaysia.

Education is a fundamental human right. Yet there remain gaps in our understanding of undocumented children in Malaysia and their vulnerabilities in education access. This study aims to describe and contextualise undocumented children in Malaysia and their access to education. We conducted a desk review and in-depth interviews with 33 key stakeholders from June 2020 to March 2021. Framework analysis was conducted. Salient themes were geographical location and legal identity in terms of citizenship and migration status. We found that the lack of legal identity and non-recognition by the State was the root cause of vulnerability, experienced uniformly by undocumented populations in Malaysia. Only undocumented children with Malaysian parents or guardians can enter public schools under the Malaysian government's 'Zero Reject Policy'. Most undocumented and non-citizen children must rely on informal education provided by alternative or community learning centres that typically lack standardised curricula, resources, and accreditation for education progression beyond primary levels. Nevertheless, as non-citizen groups are diverse, certain groups experience more privilege, while others are more disadvantaged in terms of the quality of informal education and the highest level of education accessible. In Peninsular Malaysia, a very small proportion of refugees and asylum-seekers may additionally access tertiary education on scholarships. In Sabah, children of Indonesian migrant workers have access to learning centres with academic accreditation supported by employers in plantations and the Indonesian Consulate, whereas Filipino migrants who were initially recognised as refugees are now receiving little government or embassy support. Stateless Rohingya refugees in Peninsular Malaysia and Bajau Laut children at Sabah are arguably the most marginalised and have the poorest educational opportunities at basic literacy and numeracy levels, despite the latter receiving minimal governmental education support. Implementing a rights-based approach towards education would mean allowing all children equal opportunity to access and thrive in high-quality schools.

Educational Intervention of Healthy Life Promotion for Children with a Migrant Background or at Socioeconomic Disadvantage in the North of Italy: Efficacy of Telematic Tools in Improving Nutritional and Physical Activity Knowledge.

The aim of the "Smuovi La Salute" ("Shake Your Health") project was to implement an integrated and comprehensive model to prevent and treat overweight and obesity in low socioeconomic status (SES) and minority groups living in three different districts in the north of Italy. An app and a cookbook promoting transcultural nutrition and a healthy lifestyle were developed, and no-cost physical activities were organized. Healthy lifestyle teaching was implemented in 30 primary school classrooms. Learning was assessed through pre- and post-intervention questionnaires. At the Obesity Pediatric Clinic, overweight and obese children of migrant background or low SES were trained on transcultural nutrition and invited to participate in the project. Primary school students increased their knowledge about healthy nutrition and the importance of physical activity (p-value < 0.001). At the Obesity Pediatric Clinic, after 6 months, pre-post-intervention variation in their consumption of vegetables and fruit was +14% (p < 0.0001) and no variation in physical activity habits occurred (p = 0.34). In this group, the BMI z-score was not significantly decreased (-0.17 ± 0.63, p= 0.15). This study demonstrates the feasibility and efficacy of telematic tools and targeted community approaches in improving students' knowledge with regard to healthy lifestyle, particularly in schools in suburbs with a high density of migrants and SES families. Comprehensive and integrated approaches provided to the obese patients remain mostly ineffective.

Travel health seeking behaviours, masks, vaccines and outbreak awareness of Australian Chinese travellers visiting friends and relatives - Implications for control of COVID-19.

BACKGROUND: The COVID-19 pandemic has highlighted the role of international travel in spreading infections. Travellers visiting friends and relatives (VFR) are at higher risk of acquiring infections than other travellers, therefore improving the travel health behaviour of these travellers is important. Ethnic Chinese are one of the largest migrant groups in many countries, yet there have been no published studies regarding this population as VFR travellers. We present findings of a study of Australian Chinese VFR travellers relevant to the pandemic response. METHODS: In 2013, five focus groups were conducted with Australian Chinese VFR travellers, exploring topics such as vaccines, face masks, outbreaks and travel health seeking behaviour. Participants were aged 18 years or older and had travelled to China for VFR purposes in the preceding 18 months. Sessions were recorded and transcribed, and thematic analysis was undertaken. RESULTS: Participants viewed VFR travel as low risk, and underestimated the risks associated with travelling during an outbreak. However, they were generally willing to receive pre-travel vaccination specifically for an outbreak, but not otherwise. Attitudes towards face masks and other infection control measures were mixed. Multiple factors influenced their travel health behaviour, including low risk awareness, misconceptions, and cultural barriers to seeking health care. CONCLUSION: Our research found that Chinese VFR travellers undertake suboptimal precautions related to VFR travel, associated with an underestimation of risks. While they share many characteristics with other VFR travellers, unique cultural health beliefs should be taken into account when developing risk communication and educational interventions as part of a pandemic response.

Challenges to pre-migration interventions to prevent human trafficking: Results from a before-and-after learning assessment of training for prospective female migrants in Odisha, India.

BACKGROUND: Awareness-raising and pre-migration training are popular strategies to prevent human trafficking. Programmatic theories assume that when prospective migrants are equipped with information about risks, they will make more-informed choices, ultimately resulting in safe migration. In 2016, India was estimated to have 8 million people in modern slavery, including those who migrate internally for work. Work in Freedom (WiF) was a community-based trafficking prevention intervention. This study evaluated WiF's pre-migration knowledge-building activities for female migrants in Odisha to prevent future labour-related exploitation. METHODS: Pre- and post- training questionnaires were administered to women (N = 347) who participated in a two-day pre-migration training session. Descriptive analysis and unadjusted analyses (paired t-tests, McNemar's tests, Wilcoxon signed ranks tests) examined differences in women's knowledge scores before and after training. Adjusted analyses used mixed effects models to explore whether receiving information on workers' rights or working away from home prior to the training was associated with changes in scores. Additionally, we used data from a household survey (N = 4,671) and survey of female migrants (N = 112) from a population sample in the same district to evaluate the intervention's rationale and implementation strategy. RESULTS: Female participants were on average 37.3 years-old (SD 11) and most (67.9%) had no formal education. Only 11 participants (3.2%) had previous migration experience. Most participants (90.5%) had previously received information or advice on workers' rights or working away from home. Compared to female migrants in the population, training participants were different in age, caste and religion. Awareness about migration risks, rights and collective bargaining was very low initially and remained low post-training, e.g. of 13 possible migration risks, before the training, participants named an average of 1.2 risks, which increased only slightly to 2.1 risks after the training (T(346) = -11.64, p<0.001). Changes were modest for attitudes about safe and risky migration practices, earnings and savings. Before the training, only 34 women (10.4%) considered migrating, which reduced to 25 women (7.7%) post-training (X2 = 1.88, p = 0.169)-consistent with the low prevalence (7% of households) of female migration locally. Women's attitudes remained relatively fixed about the shame associated with paid domestic work. Survey data indicated focusing on domestic work did not correspond to regional migration trends, where women migrate primarily for construction or agriculture work. CONCLUSION: The apparent low effectiveness of the WiF short-duration migration training may be linked to the assumption that individual changes in knowledge will lead to shifts in social norms. The narrow focus on such individual-level interventions may overestimate an individual's agency. Findings indicate the importance of intervention development research to ensure activities are conducted in the right locations, target the right populations, and have relevant content. Absent intervention development research, this intervention suffered from operating in a site that had very few migrant women and a very small proportion migrating for domestic work-the focus of the training. To promote better development investments, interventions should be informed by local evidence and subjected to rigorous theory-based evaluation to ensure interventions achieve the most robust design to foster safe labour migration for women.

Sólo Se Vive Una Vez: The Implementation and Reach of an HIV Screening Campaign for Latinx Immigrants.

Latinxs in the United States are disproportionately affected by HIV and present with more advanced disease than their non-Latinx peers, due to numerous barriers to care including HIV stigma. We describe the adaptation, implementation, and reach of Sólo Se Vive Una Vez (You Only Live Once), Baltimore's first social marketing campaign promoting HIV screening among Spanish-speaking Latinxs. The 6-month campaign promoted free HIV testing by addressing HIV stigma. The campaign included a website, a social marketing campaign, community outreach events, and advertisements via radio, billboards, local partners, and buses. During the campaign, there were 9,784 unique website users, and ads were served to over 84,592 people on social media platforms. Among Latinx HIV testers at the Baltimore City Health Department, 31.6% reported having seen or heard of Sólo Se Vive Una Vez and 25.3% of Latinx HIV testers reported that the campaign influenced them to get tested.

Cultural diversity, migration and education.

Migration is not a new phenomenon. However, recent data indicate that unprecedented numbers of people have experienced forced migration around the world with 51% under the age of 18 years. How can educational policies and practices respond sensitively to increasing cultural and migration-based diversity? The purpose of this special section that includes eight studies is to consider these issues more deeply. As a frame for the special section, we address the main question: What are promotive or protective factors for positive development of children and youth attending culturally diverse school contexts? In the collection of papers, these promotive and protective factors range from peers and families, to teachers, to organisational context and climate. With continued disruptions in children's lives due to a pandemic, climate change, war, conflict and poverty, migration will remain a pressing concern and will continue to transform the student populations in our classrooms and schools for the foreseeable future. The need to address how we can best provide students from diverse backgrounds equitable and supportive education, continues.

[The "Creation of History" workshop: a clinical device for migrant children in Brazil]. / L'atelier "création d'histoire" : un dispositif clinique auprès des enfants migrants au Brésil.

A clinical research device, the "Creation of History" workshop was set up in schools in São Paulo, Brazil, with migrant children aged 6 to 10. This workshop allows these children to retrace their migratory history with the help of a family album, based on the construction of the space-time dimension present in their interpretation of their drawings.

Systematic development of a training program for healthcare professionals to improve communication about breast cancer genetic counseling with low health literate patients.

There is a disproportionate underuse of genetic testing in breast cancer patients from lower education or migrant background. Within these groups, communication about referral to genetic counseling appears challenging due to limited health literacy and cultural barriers. Our aim was to develop and evaluate a training program for healthcare professionals (breast surgeons and specialized nurses), to increase effective communication. We systematically developed a blended training program based on patients' and healthcare professionals' needs and preferences. Prior to the training, we assessed awareness, knowledge and self-efficacy of healthcare professionals. Acceptability and usefulness of the training program were assessed directly after the training. Healthcare professionals (n = 65) from 17 hospitals showed moderate to high awareness and knowledge about the prevalence and impact of limited health literacy. They were aware of cultural factors that influence communication. However, they did not feel confident in recognizing limited health literacy and their self-efficacy to communicate effectively with these patients was low. The training program was rated as acceptable and useful. Healthcare professionals lack confidence to effectively communicate with patients with limited health literacy or migrant background. The training program offers opportunities to improve communication about referral to breast cancer genetic counseling.

Effect of Health Education on Healthcare-Seeking Behavior of Migrant Workers in China.

Health education is considered to be an effective way to improve the healthcare-seeking behavior of migrant workers. This study examined the impact of health education on healthcare-seeking behavior of migrant workers in China and explored the differences in different health education methods. This paper used the 2017 China Migrants Dynamic Survey (CMDS) to analyze the relationship between health education and healthcare-seeking behavior. Our results indicated that health education could significantly improve the healthcare-seeking behavior of migrant workers, but there was still ample space for improvement. From the perspective of different health education methods, lectures, public consultation, and online education were positively correlated to healthcare-seeking behavior, while publicity materials and bulletin boards were not. Although the effects of publicity materials and bulletins were limited, these two health education methods were still the most widely used. Our results emphasized the necessity of increasing investment in lectures, public consultation, online education, and other similar health education methods. This change in health education methods can play an effective role in the spread of health education to improve the healthcare-seeking behavior of migrant workers.

Safety training for migrant workers in the construction industry: A systematic review and future research agenda.

In the construction sector, there is a high risk for accidents, injuries, and fatalities, particularly for migrant workers who comprise a large proportion of the workforce. This article presents a systematic literature review of current safety training provision for migrant construction workers. In the interests of rigor, we draw on the learning, training transfer, and training effectiveness literatures, exploring not only the extent to which training brings about the intended outcomes, in terms of enhanced safety behaviors, and reduced accidents and injuries, but also the factors that influence learning and transfer of training back to the working environment. The literature search revealed only 18 peer-reviewed articles have been published since 2000, which is particularly surprising, given the disproportionate accident and fatality rates for migrant workers. Consequently, we propose a research agenda to enhance safety training for low skilled, migrant and native construction workers, drawing on cognitive and social constructivist instructional design models, which view training as a dynamic process involving active participation of trainees. We advocate the importance of attending to the situational context in which workers are embedded, including labor market conditions, social relations, and cultural differences. Finally, we propose the need for further longitudinal, multidimensional research to evaluate the impact of safety training on learning, transfer of training, and individual- and organizational-level outcomes, such as behavior change, and accident and fatality rates. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Agricultural Safety Comic Book for Latinx Migrant Families: Development and Evaluation.

INTRODUCTION: Comic books and graphic novels have been used in health education. The youth of migrant and seasonal agricultural workers are highly vulnerable to the health hazards associated with agricultural work and the migrant workers' itinerant home environment. METHOD: The purpose of the study was to create a bilingual, culturally specific educational comic book to inform families of safety issues in youth hand-harvesting agricultural work and provide anticipatory guidance safety tips for agricultural work camp residence. In a mixed-methods design, a multistate and multidisciplinary team used focus groups to obtain the voice of potential users regarding the strengths and weaknesses of the comic book prototype and scales on satisfaction, helpfulness, and usability. RESULTS: Focus group participants contributed constructive criticism to modify the prototype. Quantitative surveys found the comic book to be satisfactory, helpful, and highly usable. DISCUSSION: This report describes the steps in the creation of the comic book that can be used for health promotion education.

The role of refugee and migrant migration status on medication adherence: Mediation through illness perceptions.

BACKGROUND: Illness perceptions may vary between different populations. This raises the question as to whether refugees and migrants of the same ethnic background have different perceptions. Understanding differences may have a significant impact on enhancing medication adherence in these groups. OBJECTIVE: The study examined the associations and differences between illness perceptions, and medication adherence in hypertensive Middle Eastern migrants and refugees. METHODS: Middle Eastern refugees and migrants (≥30 years old), with hypertension were recruited from Arabic community groups in Australia and asked to complete a cross-sectional survey. The survey consisted of basic socio-demographic and clinical profile, self-reported illness perceptions, and self-reported medication adherence. The outcome measure was the Medication Adherence Questionnaire. Simple mediation modelling was applied to examine the role of illness perceptions as a mediator between different migration statuses, and medication adherence. RESULTS: A total of 320 participants were recruited; 168 refugees, and 152 migrants. Educational level was found to be positively significantly associated with medication adherence in refugees, p = 0.003, while employed migrants were more likely to report higher adherence to hypertensive medication, p = 0.005. In both groups, there was a significant association between illness perceptions and medication adherence p = 0.0001. Significant differences were found between both groups regarding adherence and illness perceptions variables. Refugees had more negative illness perceptions and were less adherent than migrants. Illness perception was a mediator in the relationship between migration status and medication adherence; the unstandardized indirect effect was 0.24, and the 95% confidence interval ranged from (0.21-0.36). CONCLUSIONS: To achieve better adherence to medications in vulnerable populations such as refugees, illness perceptions need to be understood, and differentiated from other populations, such as migrants from similar backgrounds. Patients' education about illnesses and medications should be specific and targeted to each population. Interventional studies are recommended to modify refugees' and migrants' illness perceptions, to enhance medication adherence and wellbeing.

Impact of safety training and interventions on training-transfer: targeting migrant construction workers.

Despite substantial efforts to improve construction safety training, the accident rate of migrant workers is still high. One of the primary factors contributing to the inefficacy of training includes information delivery gaps during training sessions (knowledge-transfer). In addition, there is insufficient evidence that these training programmes alone are effective enough to enable migrant workers to transfer their skills to the jobsite (training-transfer). This research attempts to identify and evaluate additional interventions to improve the transfer of acquired knowledge to the workplace. For this purpose, this study presents the first known experimental effort to assess the effect of interventions on migrant work groups in a multinational construction project in Qatar. Data analysis reveals that the adoption of training programmes with the inclusion of interventions significantly improves training-transfer. Construction safety experts can leverage the findings of this study to enhance training-transfer by increasing workers' safety performance and hazard identification ability.

Place of Residence, Working Conditions and the Burden of Back Pain among Hired Farmworkers in the United States.

Objectives: Back pain is the leading occupational health problem among agricultural workers. Current study aimed to assess the burden of farm work-related back pain and to investigate its associations with living residence location and work conditions among farmworkers. Methods: We used the National Agricultural Workers Survey (NAWS) data from 1999 to 2004, 2008-2010, and 2014. Work-related back pain was defined as a back pain that was developed when performing farm work in the 12 months prior to the interview, and it caused pain or discomfort for at least five consecutive days. To assess the associations of place of residence and working conditions (i.e. work equipment and access to toilet and water for washing hands at work) with back pain, we analyzed the data using mixed-effects logistic regression models while adjusting for age, gender, race, birthplace (US vs. foreign country), education, marital status, work authorization (yes vs. no), below poverty income, whether the worker was hired by a farm labor contractor or not, and weekly working hours. Results: The standardized annual back pain prevalence during the study period ranged from 2.6% to 11.3%. In the adjusted model, farmworkers who lived in a residence located on the farm, who did not have access to toilet at work, and who paid for work equipment had higher odds of back pain than their counterparts. Conclusion: Back pain is particularly common among farmworkers with poor working and living conditions. Interventions should target the identified high-risk groups to mitigate their burden of back pain.

Conveying Safety Messages on Agricultural Machinery: The Comprehension of Safety Pictorials in a Group of Migrant Farmworkers in Italy.

The comprehension of safety signs affixed to agricultural machinery is fundamental to warning users about the residual risks which cannot be eliminated with machinery design and the adoption of protections. This is particularly relevant for the migrant workforce, which may encounter some language barriers with written safety communication. The present study aimed to investigate the comprehension of safety signs affixed to agricultural machinery in a group of migrants from both European and non-European countries employed in Italian agriculture. Thirty-seven migrant farmworkers (12 Indians, 17 Pakistanis, and eight Romanians) were individually interviewed to test the comprehension of four safety signs referring to the main causes of fatal and non-fatal injuries caused by interactions with farm machinery. Romanians obtained the highest comprehension performance (68.8% of correct answers), followed by Indians (35.4%), with Pakistanis being last (32.4%). The nationality and the previous experience as a farmworker significantly affected the comprehension of safety signs. The results pointed out the importance of adequately training migrants on the meaning of safety signs. Beside this, the study suggests a redesign of the signs, considering some signs' features to enhance pictorials' cross-cultural comprehension.

A pilot project to increase health literacy among youth from seasonal farmworker families in rural eastern North Carolina: a qualitative exploration of implementation and impact.

OBJECTIVE: There are substantial health inequalities for seasonal agricultural workers and their families in the United States. One identified inequality is in health literacy. The authors explored the implementation and impact of connecting youth from seasonal farmworker families who participated in a leadership and college pipeline program with Internet access by providing a tablet with a paid cellular data plan and university library-based health literacy training. METHODS: With the support of a National Network of Libraries of Medicine Health Information Outreach Award, we conducted a qualitative, utilization-focused evaluation by conducting semi-structured interviews from December 2017 through February 2018 with middle and high school age participants in the program (n=10). After parental consent and youth assent, we recorded interviews with participants at program activity locations or in their homes. We then utilized inductive thematic analysis with 2 primary coders. RESULTS: We identified four themes: (1) having access to the Internet can be transformative, (2) access resulted in increased knowledge of and interest in one's own and others' health, (3) "Google" is the norm, and (4) participant training increased self-efficacy to determine credible sources and resources. CONCLUSION: Providing Internet access and iPads was possible to implement and resulted in increased utilization of health information. The combination of Internet access with training on information literacy was a key factor in achieving these positive outcomes. The findings suggest the importance of ensuring equitable access to the Internet in efforts to improve educational and health outcomes for seasonal farmworkers and their families.

Education Policy for Migrant Children in Thailand and How It Really Happens; A Case Study of Ranong Province, Thailand.

Health and education are interrelated, and it is for this reason that we studied the education of migrant children. The Thai Government has ratified 'rights' to education for all children in Thailand since 2005. However, there are gaps in knowledge concerning the implementation of education policy for migrants, such as whether and to what extent migrant children receive education services according to policy intentions. The objective of this study is to explore the implementation of education policy for migrants and the factors that determine education choices among them. A cross-sectional qualitative design was applied. The main data collection technique was in-depth interviews with 34 key informants. Thematic analysis with an intersectionality approach was used. Ranong province was selected as the main study site. Results found that Migrant Learning Centers (MLCs) were the preferable choice for most migrant children instead of Thai Public Schools (TPSs), even though MLCs were not recognized as formal education sites. The main reason for choosing MLCs was because MLCs provided a more culturally sensitive service. Teaching in MLCs was done in Myanmar's language and the MLCs offer a better chance to pursue higher education in Myanmar if migrants migrate back to their homeland. However, MLCs still face budget and human resources inadequacies. School health promotion was underserviced in MLCs compared to TPSs. Dental service was underserviced in most MLCs and TPSs. Implicit discrimination against migrant children was noted. The Thai Government should view MLCs as allies in expanding education coverage to all children in the Thai territory. A participatory public policy process that engages all stakeholders, including education officials, health care providers, Non-Governmental Organizations (NGOs), MLCs' representatives, and migrants themselves is needed to improve the education standards of MLCs, keeping their culturally-sensitive strengths.