Search Results (14)

This study examines the intentions of foreign workers living in Okayama, Japan, to stay long-term in Japan. Utilizing a Bayesian multinomial logistic regression model, this research provides a novel analytical approach that captures parameter uncertainty and accommodates the categorical nature of migrants’ settlement intentions using primary data collected via a questionnaire survey from January to March 2024. The findings reveal that residence status, previous experience of living in Japan, and graduation from a Japanese education institution significantly influence long-term settlement intentions. In addition, respondents aged 26–35 intend to stay longer than those of other ages, and those from less developed countries, such as Myanmar and Vietnam, intend to stay longer than those from China. Conversely, highly educated migrants express lower settlement intentions, suggesting a potential loss of skilled foreign labor in Japan. Notably, migrants in the Technical Intern Training Program are more likely to stay longer than those with other residence statuses, such as Highly Skilled Professional. In contrast, workers with higher education levels tend to have less intention to stay long-term, indicating a high probability of Japan losing educated foreign labor in the future. These findings contribute to understanding the dynamics of migrant workers in Japan, which is crucial for creating policies for foreign workers that can attract and support long-term settlement. These findings have important implications for policy, particularly in enhancing community integration, reducing workplace discrimination, and designing residence pathways that support long-term retention. Full article

The 2021 military coup in Myanmar triggered a severe humanitarian crisis, forcing many to flee through regular and irregular channels to neighboring countries like Thailand. This study explores the resulting migration patterns and precarious situation of Myanmar nationals seeking refuge in Thailand. Drawing on contemporary sources, it highlights how the crisis, worsened by military conscription laws, displaced many citizens. Refugees face constant fear of incarceration and forced repatriation while struggling with limited access to basic services in Thailand, which worsens mental health and reduces quality of life. The military’s revenue tactics, such as taxing overseas workers and remittances, have contributed to their hardships. In response, Thailand introduced a cabinet resolution to legalize work and residence for irregular migrants for four years. However, ongoing detentions and deportations risk forced military enlistment upon return, raising doubts about the resolution’s effectiveness, accessibility, and affordability. The study concludes with policy recommendations to address the humanitarian needs of Myanmar’s displaced population both at home and abroad. It also suggests ways to implement protective measures effectively, such as the Thai Cabinet resolution, to safeguard the dignity and rights of Myanmar’s people. Full article

Since the outbreak of COVID-19, as reported by the WHO in December 2019 and subsequently declared a public health emergency of international concern, a distinct set of risk factors and vulnerabilities faced by migrants are affecting their exposure to the pandemic and its associated outcomes. This study aims to analyze the social determinants of health among migrants and their associated factors and compare the socio-demographic characteristics, patterns of COVID-19, and healthcare attendance and utilization among migrant workers and non-migrants. A descriptive study design was used to analyze COVID-19 morbidity among migrant workers. There were a total of 73,762 migrants living in the province by December 2021, with varied statuses and nationalities. Most of the migrants were from Myanmar, constituting about 80.1%. A total of 24,837 COVID-19 cases in Kanchanaburi province were recorded in 2020–2021. COVID-19 cases among migrant workers accounted for 22.3% during the period under review. Half, 2914 (52.7%) of the migrant female workers were victims of COVID-19 infections. Persons under the age of 18 accounted for about one-fifth of all the COVID-19 cases. Older, over 60 years old, Thais had about twice (10.1%) the COVID-19 cases compared with the older migrants (5.5%). There was a significant increase in healthcare attendance and utilization by non-migrants and migrants during the year under review. Migrants are at high risk of COVID-19 infection. Therefore, public health guidance for the prevention of COVID-19 should prioritize safeguarding the health of migrants by considering their individual characteristics and actions. Enhancing health insurance schemes for migrants, particularly vulnerable migrant groups, is critical for inclusive and expanded healthcare access. Physical, social, and economic environments that impact the health and well-being of migrants should be integral to pandemic prevention, preparedness, response, and recovery. Full article

Migrant populations have always been vulnerable to a high burden of social exclusion, mental disorders, physical illnesses, and economic crises. The current COVID-19 pandemic has further created a frantic plight among them, particularly for undocumented migrant workers in the global south. We have conducted a mixed method study among the undocumented Myanmar migrant workers (UMMWs) in Thailand to explore how the COVID-19 disruption has impacted their mental health and what coping strategies they have adopted. Following the onset of COVID-19 and the recent coup d’état in Myanmar, our current study is the first attempt to understand the mental health status and predicament of this neglected migrant group. A total of 398 UMMWs were included in the online survey, of which 23 participated in qualitative interviews. The major mental health issues reported by the study participants were depression, generalized anxiety disorder, frustration, stress, and panic disorders, while loss of employment, worries about the pandemic, social stigma, lack of access to healthcare, lockdown, and fear of detention were the predominant contributing factors. In response, we identified two key coping mechanisms: coping at a personal level (listening to music, playing online game, praying, and self-motivation) and coping at a social level (chatting with family and friends and visiting religious institutions). These findings point to the importance of policy and intervention programs aimed at upholding mental health at such humanitarian conditions. Sustainable institutional mental health care support and social integration for the migrant workers, irrespective of their legal status, should be ensured. Full article

Success in eradicating COVID-19 will rely on the rate of vaccination adoption worldwide. Vaccine acceptance among vulnerable groups is critical for preventing the spread of COVID-19 and decreasing unnecessary deaths. The purpose of this study was to report on the willingness to obtain COVID-19 immunization and the factors related to its acceptance among Myanmar migrant workers in southern Thailand. This cross-sectional study consisted of 301 samples collected between October and November 2021 and analyzed using multiple logistic regression. Thirty-nine percent of workers intended to receive the COVID-19 vaccine within a year. The following factors were associated with obtaining the COVID-19 vaccine: a high level of perception of COVID-19 (AOR = 5.43), income less than or equal to 10,000 baht/month (AOR = 6.98), financial status at a sufficient level (AOR = 7.79), wearing a face mask in the previous month almost all the time (AOR =4.26), maintaining 1–2 m of distance from anyone in the last month (AOR =2.51), and measuring temperature in the previous month (AOR = 5.24). High reluctance to accept the COVID-19 vaccine among Myanmar migrant workers can influence efforts to eliminate COVID-19. Collaboration with all stakeholders is critical to helping Myanmar workers understand COVID-19, social measures, and preventive beliefs to increase vaccine uptake. Full article

Thailand has the highest HIV burden in the Asia-Pacific region, with the majority of cases occurring in specific populations. Migrant Sex Workers (MSWs) in Thailand are an important population for HIV risk, yet there has been limited literature on this group and their protective sexual behavior. A cross-sectional study was conducted among 396 MSWs 18–49 years old from 23 sex work-identified venues in Chiang Mai. Participants were surveyed on their own sociodemographic information, health behavior, sexual risk behavior, quality of life, and depression. Male respondents were significantly younger than females (p = 0.003). Most respondents were from Myanmar and were ethnic Shan. In the month preceding the survey, 17.0% of MSWs had consistent condom use with regular partners, 53.7% with casual partners, and 87.9% with clients. Condom use was least practiced with regular partners and most practiced with clients (17% and 87.9%, respectively; p < 0.001). There was a significant positive association between condom use and starting high school (χ² = 8.08, p = 0.018). Education was the only variable that was significantly correlated with condom use with any sexual partner (OR = 0.41; 95%CI 0.20–0.82). Findings of the study indicate that further efforts are needed to promote condom use among migrant sex workers and their sexual partners in Thailand. Full article

Background: Non-communicable diseases (NCDs) are showing an increasing trend worldwide, and the COVID-19 pandemic may interrupt or delay NCD care, the leading cause of mortality in Thailand, which is hosting 2–3 million migrant workers. The transition of epidemiological risk factors, limited access to health-promoting activities, and pandemic containment measures may adversely impact NCD risks. Therefore, hypertension and associated risk factors were determined among registered Myanmar migrant workers in Thailand. Methods: A cross-sectional survey with structured questionnaires was conducted in Thailand in 2017. Having hypertension was analyzed as a dependent variable, and the associated risk factors were explored by binary logistic regression analysis. Results: A total of 414 participants with a mean age of 29.45 ± 9.03 years were included, and 27.8 percent of the study participants were hypertensive, which was a rate higher than that in their host country (24.7%) and country of origin (26.4%). An older age, being male, current alcohol drinking, and being overweight and obese with reference to the body mass index (BMI) were significantly associated with hypertension. Conclusions: Our findings reaffirmed the idea that NCDs are important public health concerns, and a simple BMI measurement would be a valuable tool with which to determine hypertension risks. Targeted surveillance and an appropriate health policy are necessary for such a vulnerable population in Thailand. Full article

Thailand is a popular host nation for international migrant workers, particularly those from Cambodia, Lao PDR, and Myanmar. Thailand has introduced approaches to protect their rights for health and social welfare, using various mechanisms over many years. However, the implementation of these policies is dynamic and has been influenced by national security, economic necessity, and public health concerns. The aim of this study was to explore how Thailand designs and implements health and social welfare policies for migrants in Thailand, both before and during COVID-19. A qualitative analysis was used alongside interviews with 18 key informants in various sectors in this field. Thematic coding was applied. Results show that there were seven key themes emerging from the analysis, including: (i) sustainability of the HICS; (ii) people dropping out from the Social Security Scheme (SSS); (iii) quality of health screening in the Memorandum of Understanding (MOU) migrants; (iv) health screening problems and state quarantine management in response to COVID-19; (v) managing the migration quota and dependency on migrant workers; (vi) influx of migrants in the backdrop of COVID-19; and (vii) poor living conditions of migrants and the impact of COVID-19. The majority of interviewees agreed that undocumented migrants is a critical concern that impedes access to migrants’ health and social welfare. This situation was especially pronounced during the second wave of COVID-19 in Thailand, which took hold in migrant communities. In the short term, the poor living conditions of migrants urgently need to be addressed in order to contain and mitigate this crisis. In the long term, there needs to be an improved health system design that includes migrants, regardless of their immigration status. This requires intersectoral policy coherence, including the hastening of nationality verification to sustainably mitigate undocumented migrants. Full article

Migrant workers commonly face many health disparities when they relocate to a foreign work environment. Many workers migrating to Thailand are young unskilled workers from Myanmar. In this study, we examine factors associated with Myanmar migrant workers’ smoking status and characterized smoking-related knowledge, attitudes, and behavior in one seafood factory in Thailand. This descriptive study utilized person-to-person interviews among 300 Myanmar migrants in one seafood factory in Thailand, of which 94.3% were young males between 18 and 39 years of age. Results demonstrated that 90% were current daily smokers, over 90% smoked 30–60 times per month, and 95% spent less than 500 baht (US $16) per month on smoking. About 70% of current smokers had 6–10 friends who smoked, compared with 40% of non-smokers (chi-square, p-value ≤ 0.07). Among this sample of mainly male migrant workers, smoking is very common, in part driven through social contact, but levels of dependence appear relatively low. The results suggest potential intervention approaches to reduce high smoking prevalence among this population, such as targeting young males and addressing their concerns about negative attitudes by peers to tobacco use and the unhealthful exposures of women and children in their families and the larger community. Full article

Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants (n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants’ access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities. Full article

Thailand hosts many workers who have migrated from neighboring countries and is facing a large burden of non-communicable diseases (NCDs). Health screening for migrant workers routinely emphasizes infectious diseases but overlooks NCDs. We surveyed prevalent health behaviors for NCDs and their influencing factors, particularly cultural adaptation patterns among Myanmar migrant workers in Chiang Mai, Northern Thailand. A total of 414 migrant workers consented to participate in the study. Lack of exercise (75.8%), current alcohol consumption (40.8%), current smoking (26.9%), and central obesity (24.3%) were major lifestyle problems. Being female and uneducated was associated with a lack of exercise. Current alcohol consumption was significantly associated with being male and being of Myanmar ethnicity, with an integrative strategy for acculturation, and with a higher income. Male participants and participants with a lower mean score of marginalization were more likely to smoke. Central obesity was associated with being older than 40 years, being female, engaging in an assimilation strategy, and being uneducated. These findings highlight the need for gender inclusive health promotion, the screening of NCD risk behaviors, and timely health education for migrant workers. It may assist authorities to devise strategies to extend health promotion and universal health coverage to the migrant population. Full article

On 22 March 2019 the Thai Department of Disease Control (DDC) was notified that 16 workers, including Thai and Myanmar migrant workers, from two factories located in Nakhon Phathom Province, had presented with a fever with rash during the previous 2 weeks. Active case finding was conducted among workers in both factories using face-to-face interviews. Suspected cases were defined as a worker who developed fever with rash with one of the following symptoms: cough, coryza or conjunctivitis. Testing for measles IgM antibodies and viral identification through throat swabs by polymerase chain reaction (PCR) were performed to confirm diagnosis. Vaccination history among cases was reviewed. Nationality and age-specific attack rates (AR) were calculated. An environmental study and a social network analysis were conducted to better understand the transmission process. A total 56 cases (AR = 0.97%) were identified. Of 21 serum measles IgM collected, 8 (38.0%) were positive. Of 8 throat swabs collected, 5 (62.5%) were positive for measles genotype D8. The disease attack rate in migrant employees was twice as large as the rate in Thai counterparts (AR = 0.7 and 1.4%). The first case was identified as a Myanmar worker who arrived in Thailand two weeks prior to his illness. The Myanmar workers’ accommodation was more crowded than that for Thai workers. The hot spots of transmission were found at a drinking water tank which had shared glasses. Among the cases, 62.5% could not recall their vaccination history, and 25% had never had an injection containing a measles vaccination. The majority of migrant cases had never completed a two-dose measles vaccination. To halt the outbreak, measles vaccines were administered to the employees, particularly those working in the same sections with the cases and shared glasses were removed. For future policy action, a vaccination program should be incorporated into the work permit issuance process. Full article

Hepatitis B vaccination (HBV) is recommended for high-risk groups, such as people who inject drugs (PWIDs). As part of a harm reduction program by a non-governmental organization, hepatitis B screening, vaccination and antibody (HBAb) testing after completion of the vaccination schedule were offered to PWIDS in Myanmar. We determined the proportions of HBV non-completion and sero-unprotection among PWIDs enrolled in the program and their association with socio-demographic and clinical characteristics. We conducted a descriptive study based on routine program data in five selected clinics in Hpakant Township, Myanmar. PWIDs who were Hepatitis B antigen negative at screening during January 2015–December 2018 were included. Among 5386 participants eligible for HBV, 9% refused vaccination. Among those who accepted vaccination (n = 3177 individuals), 65% completed vaccination. Of those tested for HBsAb (n = 2202), 30% were sero-unprotected. Young-adults (aged 18–44 years) and migrant workers had a higher risk of incomplete vaccination. However, participants who used methadone had a lower risk of incomplete vaccination. Migrant workers had higher risk of not returning for HBsAb testing and HIV-positive participants had a higher risk of being HBV sero-unprotected. Efforts to increase HBV vaccination in PWIDs for young adults and clients during methadone and anti-retroviral services should be prioritized. Full article

Immunization is a core component of the human right to health. However, accessibility to the Expanded Program on Immunization (EPI) might be difficult among migrant children. This study aims to assess the vaccination coverage of migrant children under a mobile immunization program, initiated by the Thai government in 2014. A cross-sectional, mixed-methods study was conducted in five districts along the Thailand–Myanmar border during July–December 2018. The immunization history during their first year of life was obtained. Focus group discussions were conducted among stakeholders to explore their satisfaction toward the immunization service. Mothers/guardians of 1707 migrant children participated in the survey, with a 71% response rate. The vaccination coverage increased during 2014–2017. The highest vaccination coverage was observed for Bacillus Calmette-Guérin vaccine, with 83.2% coverage in 2017. The vaccination coverage of three doses of diphtheria-tetanus-pertussis vaccine and Hepatitis B vaccine and oral polio vaccine increased from 34.8% in 2014 to 56.3% in 2017. For measles-containing vaccine, the vaccination coverage increased from 32.4% in 2014 to 54.6% in 2017. Overall, all stakeholders were satisfied with the immunization service. Increased workload and communication barriers were the main factors that influenced the satisfaction toward the immunization program. Full article