Demographic and socioeconomic obstacles to access to malaria services for Myanmar migrants in Thailand.

ABSTRACT

BACKGROUND: Typically mobile and vulnerable, migrants face significant barriers to access to routine malaria prevention, diagnostics and treatment, which leads to unchecked malaria transmission, particularly in border regions with a high population displacement. This study aimed to investigate the demographic and socioeconomic obstacles to access to malaria services among Myanmar migrants residing in the Thailand-Myanmar border areas. METHODS: A cross-sectional study was conducted in early 2024 across three districts near the Thailand-Myanmar border. Quantitative data were collected from Myanmar migrants using standardized questionnaires through structured surveys. Data analysis included descriptive statistics and simple and multiple logistic regression models. RESULTS: Out of 300 participants, approximately a quarter (27.3%) reported adequate access to comprehensive malaria services, including prevention, diagnostics, treatment and malaria-related health information. In multiple logistic regression models, factors associated with inadequate access included Myanmar migrants aged over 60 years (aOR 7.63, 95% CI 1.74-20.58), accompanied by one to three family members (aOR 3.33, 95% CI 1.06-8.45), earning monthly incomes below 3000 THB (aOR 5.13, 95% CI 1.38-19.09) and 3000 to 6000 THB (aOR 3.64, 95% CI 1.06-12.51), belonging to the Karen ethnicity (aOR 2.13, 95% CI 1.02-3.84), with poor perception toward malaria (aOR 2.03, 95% CI 1.03-4.01) and with poor preventive and health-seeking practices (aOR 5.83, 95% CI 2.71-9.55). CONCLUSIONS: A significant proportion of Myanmar migrants encounter demographic and socioeconomic barriers to access to routine malaria services in Thailand. Tailored interventions are required to expand such access, including the recruitment of worksite health volunteers, strengthening the role of ethnic health organizations across the border and collaboration with private sector stakeholders (e.g. farm/company owners) to distribute preventive tools and ensure timely referral of suspected malaria cases to health facilities.