Tackling social exclusion and inequalities: barriers to accessing health- perspectives from a 'community of practice' working with migrants in Thailand




Poster session 1


Sunday 16 September 2018 - 12:30 to 14:00

All authors in correct order:

Bangpan M1, Dickson K1, Ratanamanee K2, Harabut C2, Chaiyakunapruk N3
1 EPPI-Centre, UCL Institute of Education, UK
2 Faculty of Law, Naresuan University, Thailand
3 Faculty of Pharmaceutical Science, Naresuan University, Thailand
Presenting author and contact person

Presenting author:

Mukdarut Bangpan

Contact person:

Abstract text
Background: Universal healthcare provision supports greater social cohesion and plays a key role in the economic and social development of a country. Many Southeast Asian (SEA) countries, including Thailand, have been successful in improving health systems and implementing policies to reduce inequalities to healthcare (Van Minh 2014). However, with an estimated 3.5 million migrants living in Thailand (IOM 2015), universal access for all poses significant challenges. In rural areas along the Thai-Myanmar border, migrants and refugees still face barriers to accessing primary healthcare, such as financial costs, legal status, languages, or institutional discrimination (Ford 2015). Understanding these barriers, from a health systems perspective, can potentially identify and address the wider social determinants of health inequalities and social exclusion of migrant and refugee populations in Thailand.

Objective: To identify barriers to accessing healthcare services and explore good practices in addressing social inequalities of migrants living in the Tak, Thailand.

Method: A reflexive account of our visit to four community-based health services and hospitals in Tak will be undertaken in March 2018. Applying a problem-learning based approach (Barrows 1996), we will work closely with a local 'community of practice' to gain a deeper understanding of the challenges in accessing health services and opportunities for addressing inequalities; guided by the social determinants of health model (Dahlgren 1991).

Results: It is expected that the perspectives of people working in local contexts will provide a richer and more in-depth perspective of current issues in the region, to inform the development of effective strategies for policy and practice change.

Conclusion: Taking a health-systems lens and engaging with a 'community of practice' to identify challenges and opportunities to address inequalities and improve healthcare access of migrants in Thailand can produce contextually relevant policy and practice findings.

Patient or healthcare consumer involvement: Via a 'community of practice' involving migrants-patients and students, educators, health service providers, and voluntary workers.

Relevance to patients and consumers: 

We will work closely with a ‘community of practice’ of migrants living in Thailand who receive healthcare services. This community of local people includes students, educators, researchers, policy analysts, and voluntary workers. The aim of research will be to gain a deeper understanding of key issues of importance to them; taking a particular focus on how best to address health inequalities and social exclusion of this vulnerable population group. The perspectives from the this ‘community of practice’ will be used to identify research gaps and foster dialogues for future research and policy change.