Barriers to healthcare access and coping mechanisms among Sub-Saharan African migrants living in Bangkok, Thailand

Abstract

Access to health care services among migrant populations is a major public health concern. Migrants' health profiles, values and beliefs may differ from those of the host population and present a potential to increased vulnerability to ill health and barriers in accessing health services. In addition, migrants may travel with or may acquire diseases or conditions while travelling or while staying in the host country, that present need for regular healthcare services.Migrants often do not consider or prepare for potential health challenges in host countries. According to the UN's International Migration Report, Asia received 4.4 million migrants from Africa in 2013 alone, most of which were from Sub-Saharan Africa (SSA) with Thailand alone receiving an estimated 100 000.Data from Thailand's Immigration Bureau indicate that most SSA migrants in Thailand come from Nigeria, Kenya, South Africa, Ghana, Mali, Zimbabwe, and Tanzania. In April 2015, the Ministry of Public Health in Thailand introduced measures targeted at improving access to healthcare services among migrant workers.These developments allow migrant workers from Myanmar, Laos, Cambodia and Vietnam to buy healthcare insurance which covers first health-checks, chronic diseases, surgeries, and even high cost anti-retroviral drugs, benefits which are similar to the Thai nationals. Migrants from other countries can only buy healthcare insurance which covers free medical treatments, vaccinations and first health checks.While language is a key determinant to healthcare access, especially for migrants, only premium private sector health services use English. Migrants from SSA often have different cultural values, health seeking behaviour and religious beliefs from the Thai who are a predominantly Buddhist society and this poses challenges.Given the increasing trend of SSA migrants to new Asian destinations particularly Thailand, the study hypothesised that SSA migrants face challenges in accessing healthcare services in Bangkok, and that they rely on certain coping strategies in dealing deal with those barriers. No research on barriers associated with access to healthcare and strategies in coping with these barriers among SSA migrants exists in Thailand. This study explored barriers to access healthcare services and the common coping strategies by SSA migrants in Bangkok, Thailand.