http://mfuir.mfu.ac.th:80/xmlui/handle/123456789/205 Border Health Management 2026-07-25T14:06:25Z http://mfuir.mfu.ac.th:80/xmlui/handle/123456789/1843 Health insurance status and its associated factors among Myanmar migrant workers in Chiang Rai province, Thailand Toe Yamone Myat Noe Pamornsri Inchon Thailand, one of the Southeast Asian countries, the country’s geographical location, its economic development and cultural diversity, such characteristics attract millions of migrants, especially its neighboring countries, Cambodia, Lao PDR, Myanmar and Vietnam. Thailand is seen as a pioneer of migrant health coverage in the ASEAN region with the expansion of UHC program. However, the rate of healthcare service utilization by migrants and the enrollment of migrant health insurance schemes still remains lower than the main insurance scheme of Thai citizens (UHC). This community-based cross-sectional study aimed to assess the health insurance status and identify factors associated with insurance enrollment among Myanmar migrant workers in Chiang Rai Province, Thailand. A structured questionnaire was administered to 350 participants recruited via snowball sampling in Chiang Rai Province. Data were collected through face-to-face interviews and analyzed using descriptive statistics, Chi-square or Fisher’s Exact tests and logistic regression to identify significant predictors of health insurance status with significance p-value <0.05. The results revealed that 41.1% of the participants were uninsured, while 58.9% were covered. Among those with insurance, the Social Security Scheme (SSS) was the most common type of coverage (61.5%), followed by the Migrant Health Insurance Scheme (MHIS) at 40%. Among them, some participants are covered by both schemes. The predisposing profile showed a young adult population (mean age 35) largely employed in the construction and factory sectors. Despite 65.1% being long-term residents in Thailand, a significant health security gap remains. Enabling factors highlighted economic barriers, with 50% of workers earning 9,000 THB or less monthly, forcing insurance costs to compete with basic survival needs. Furthermore, 50.6% possessed poor knowledge regarding insurance schemes and health literacy levels were largely constituted of interactive level (67.7%). Multivariable analysis identified several critical predictors for having no health insurance: residing in Mueang (AOR=6.52) or Mae Sai (AOR=6.68), compared to those who live in other districts of Chiang Rai Province and having no legal documentation (AOR=30.94) compared to those under the MOU system. Most significantly, participants whose family members had no health insurance faced 37.6 times higher odds of being uninsured compared to those with insured family members (AOR=37.64, 95% CI=8.84-160.29). Other significant factors included having never paid out-of-pocket for health services (AOR=3.89) compared to those having out-of-pocket experience, lack of awareness of insurance (AOR=21.8) and holding a negative perception of health insurance (AOR=22.6). To improve enrollment, the study recommends streamlining documentation processes, utilizing Migrant Health Volunteers (MHVs) to bridge language gaps, and implementing community-centered outreach to shift perceptions of insurance from a financial burden to a protective safety net. Thesis (M.P.H.) -- Border Health Management, School of Health Science. Mae Fah Lung University, 2025 2025-01-01T00:00:00Z http://mfuir.mfu.ac.th:80/xmlui/handle/123456789/1833 Factors associated with immunization status of Myanmar migrant children in Chiang Rai province,Thailand Shin Moe Oo Shin Moe Oo Myanmar migrant children in Thailand have consistently shown lower immunization coverage compared to their Thai counterparts, leaving them vulnerable to vaccine-preventable diseases. Despite the growing migrant population and ongoing public health concerns in border regions, limited evidence exists regarding age-appropriate immunization among Myanmar children in Chiang Rai, an important migration corridor along the Northern Thailand–Eastern Myanmar border. Thus, this study aimed to assess the immunization status and identify its associated factors among children from Myanmar migrants in Chiang Rai province, Thailand. A cross-sectional study was conducted to collect data from Myanmar migrant caregivers aged 15 years and above, who have children under 7 years of age, living in Mueang District and Mae Sai District of Chiang Rai province using a validated questionnaire through face-to-face interviews. Chi-square or Fisher’s Exact tests and binary logistic regression were used to identify factors associated with incomplete age-specific immunization, with a significance level of p-value less than 0.05. Among 423 children analyzed, 91 children (21.5%) were found to be incompletely immunized according to their age-specific schedule. Regarding intrapersonal-level factors, over half (57.0%) were boy, 87.2% were born in Thailand, 46.3% were aged above five years, and the majority of children (82.3%) were covered by Thai health insurance schemes. Multivariable analysis identified six significant predictors of incomplete immunization. Children without birth registration in Thailand (aOR = 9.52; 95% CI: 3.74–24.27), children without health insurance (aOR = 14.03; 95% CI: 6.45–30.54), children with return migration history (aOR = 19.35; 95% CI: 8.48–44.13), caregivers with negative peer practice (aOR = 8.09, 95% CI: 1.47–44.54), caregivers mentioning time barrier (aOR = 4.09, 95% CI: 1.20–13.94), and those mentioning financial barrier (aOR = 7.07, 95% CI: 1.67–29.91) were significantly more likely to have incomplete immunization. This study revealed a moderate prevalence of incomplete immunization (21.5%) among Myanmar migrant children, which was statistically significantly associated with factors across all three levels of the modified socio-economic model: intrapersonal, interpersonal, and institutional levels. At individual level, caregivers should be encouraged to have their children are registered at birth in Thailand, enrolled in appropriate health insurance schemes, and keep immunization records when traveling between Thailand and Myanmar. Community outreach activities and migrant health volunteer training are also recommended to promote practice among peers, reduce access related barriers such as time and money. Moreover, digital tracking system for immunization records and cross-border collaboration between Myanmar and Thailand should be developed to maintain consistent vaccination records and reduce gaps in immunization coverage among migrant populations. Thesis (M.P.H.) -- Border Health Management, School of Health Science. Mae Fah Lung University, 2025 2025-01-01T00:00:00Z http://mfuir.mfu.ac.th:80/xmlui/handle/123456789/1818 Quality of life and Its associated factors among Myanmar migrant workers in Chiang Rai province, Thailand Tin Mi Mi Ohn Tawatchai Apidechkul Quality of life among migrant workers is shaped by multilevel determinants across intrapersonal, interpersonal, institutional, and community levels. However, limited recent evidence exists on how these factors influence the quality of life of Myanmar migrant workers, particularly in border areas of Chiang Rai Province, Northern Thailand. This study aimed to assess the quality of life (QoL) and identify its associated factors among Myanmar migrant workers in Chiang Rai Province using the social-ecological model as the theoretical framework. A community-based cross-sectional study was conducted among 420 Myanmar migrant workers from eight randomly selected communities in Mueang and Mae Sai districts. Data were collected using validated structured questionnaires, including the WHOQOL-BREF, through self-administered and face-to-face interviews after obtaining informed consent. Chi-square tests and binary logistic regression were used to identify significant associations at a significance level of p-value < 0.05. A total of 420 Myanmar migrant workers participated in the study, with 53.1% being male and a mean age of 32.3 years (SD = 9.9). About 16.2% had chronic diseases and 21.2% were undocumented, while construction was the most common occupation (45.8%). Most participants reported moderate quality of life (68.6%), followed by poor (20.2%) and good quality of life (11.2%). Multivariable logistic regression identified chronic disease, type of residence, depressive symptoms, social support, job satisfaction, and discrimination as significant factors associated with poor quality of life. The odds of having poor quality of life were 2.96 times (95% CI = 1.29-6.81) higher for those who had chronic diseases like hypertension and diabetes mellitus compared to those who did not have any chronic diseases. Those who lived in house provided by employer, on-site work compound or shared housing with other families had a greater chance of poor quality of life than those who were staying in rented house with 3.59 times (95% CI = 1.75-7.38). Moreover, participants who had moderate to extremely severe depressive symptoms had 15.33 times (95% CI = 5.86-40.08) higher chance of poor quality of life compared to those who had no to mild depressive symptoms. Those who received low to moderate social support had a greater chance of having poor quality of life than those with high social support with 6.35 times (95% CI = 2.15-18.74). The odds of poor quality of life were 6.72 times (95% CI = 3.33-13.56) higher for the individuals who had very low to low job satisfaction compared to those who had average to very high job satisfaction. Lastly, participants who reported moderate to high discrimination had 3.50 times (95% CI = 1.44-8.53) higher odds of having poor quality of life compared to those who reported low discrimination. Targeted interventions addressing chronic disease management, mental health support, and workplace conditions are needed to improve the quality of life of Myanmar migrant workers. Strengthening social support systems and reducing discrimination through community and policy-level actions are also essential to promote their overall well-being. Thesis (M.P.H.) -- Border Health Management, School of Health Science. Mae Fah Lung University, 2025 2025-01-01T00:00:00Z http://mfuir.mfu.ac.th:80/xmlui/handle/123456789/1817 Prevalence of depressive symptoms and Its determinants among Myanmar migrant workers in Chiang Rai province, Thailand Theint Nandar Aung Tawatchai Apidechkul Depressive symptoms are a serious mental health condition and represent a growing public health concern worldwide, particularly among vulnerable populations such as migrant workers. However, evidence-based research focusing on depressive symptoms among Myanmar migrant workers in Chiang Rai Province remains limited. Therefore, this study aimed to estimate the prevalence of depressive symptoms and identify key determinants among Myanmar migrant workers in Chiang Rai Province, Thailand. A community-based cross-sectional study was conducted among 425 Myanmar migrant workers aged 18 years and above from eight randomly selected communities in Mueang Chiang Rai and Mae Sai districts. Data were collected using a structured and validated questionnaire, including the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms. Descriptive statistics were used to summarize participant characteristics and prevalence, while chi-square tests and multivariable logistic regression were performed to identify associated factors, with statistical significance set at α = 0.05. The majority of participants were female (51.3%), with a mean age of 33.72 years (SD ± 10.28), and most were employed in construction work. The prevalence of depressive symptoms was 37.6% (95% CI: 33.2%–42.4%). Seven factors were significantly associated with depressive symptoms, including being a family member rather than head of household (aOR = 1.74; 95% CI: 1.02–2.58), undocumented legal status (aOR = 2.32; 95% CI: 1.09–4.91), underlying diseases (aOR = 2.53; 95% CI: 1.51–4.25), lack of formal healthcare utilization (aOR = 1.82; 95% CI: 1.12–2.97), moderate to high perceived stress (aOR = 1.85; 95% CI: 1.06–3.25), history of violence (aOR = 3.16; 95% CI: 2.00–4.99), and low social support (aOR = 1.86; 95% CI: 1.18–2.92). A substantial proportion of Myanmar migrant workers experienced depressive symptoms. Targeted public health interventions focusing on legal protection, improved access to healthcare, stress management, violence prevention, and strengthened social support are recommended to reduce this burden. Thesis (M.P.H.) -- Border Health Management, School of Health Science. Mae Fah Lung University, 2025 2025-01-01T00:00:00Z