Barriers to Healthcare Access for Myanmar Migrants in Thailand and Japan during COVID-19

Authors

  • Lalita Kaewwilai Faculty of Public Health Nursing, Mahidol University. Email: lalita.kae@mahidol.ac.th
  • Ei Thinzar Khin Department of Medical Education, Juntendo University, Tokyo, Japan.Email: k-ei@juntendo.ac.jp
  • Su Myat Han School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine. Email: pearl.june@gmail.com
  • Nana Moriguchie Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan. Email: nana.moriguch7@gmail.com
  • Napaswan Namboonsri Department of Public Health Nursing, Faculty of Nursing, Mahidol University, Thailand. Email: napaswan.nam@mahidol.ac.th
  • Niaya Harper Igarashi Health and Global Policy Institute (HGPI), Japan. Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Japan. Email: niaya-igarashi@g.ecc.u-tokyo.ac.jp
  • Joji Sugawara Health and Global Policy Institute (HGPI), Japan. Email: joji_sugawara@hgpi.org
  • Kwanjai Amnatsatsue Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand. Email: kwanjai.amn@mahidol.ac.th
  • Orawan Kaewboonchoo Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand. Email: orawan.kaew@mahidol.ac.th

Keywords:

Healthcare access, Myanmar migrants, Thailand, Japan, COVID-19

Abstract

The COVID-19 pandemic has profoundly impacted global health systems, affecting migrants who face multiple barriers to healthcare access. This study explores and compares the healthcare access experiences of Myanmar migrants in Thailand and Japan during the COVID-19 pandemic. A qualitative study was conducted with semi-structured interviews with 20 Myanmar migrants (10 each in Thailand and Japan) and focus group discussions with healthcare professionals in both countries. Data was analyzed thematically using the Health Care Access Barriers (HCAB) model to identify financial, structural, and cognitive barriers. The study revealed multifaceted barriers across financial, structural, cognitive, and cultural dimensions. Financial barriers were particularly pronounced, with migrants in Thailand experiencing significant income loss when seeking medical care. Structural challenges included limited-service accessibility, complicated administrative processes, and geographical constraints. Cognitive barriers manifested through language difficulties, limited health literacy, and fear of discrimination. In Thailand, while the government provided free COVID-19 services to all migrants, challenges persisted in communication and service delivery. Japan presented similar complexities, with migrants facing additional difficulties in system navigation and cultural integration.

Enhancing migrant health equity requires systemic interventions that go beyond individual-level health education. Strengthening community outreach, translation services, and migrant-inclusive policies are crucial. Future efforts should foster collaborative partnerships among healthcare facilities, local governments, NGOs, employers, and the Myanmar government or its embassies in Thailand and Japan, ensuring shared responsibility for the health and well-being of migrant populations.

References

Núñez A, Sreeganga SD, Ramaprasad A. Access to Healthcare during COVID-19. Int J Environ Res Public Health. 2021; 18(6). DOI: 10.3390/ijerph18062980

Paudel S, K C Bhandari A, Gilmour S, Lee HJ, Kanbara S. Barriers and facilitating factors to healthcare accessibility among Nepalese migrants during COVID-19 crisis in Japan: an exploratory sequential mixed methods study. BMC Public Health. 2023; 23(1): 1226. DOI:10.1186/s12889-023-16107-7

Kosiyaporn H, Julchoo S, Phaiyarom M, Sinam P, Kunpeuk W, Pudpong N, et al. Strengthening the migrant-friendliness of Thai health services through interpretation and cultural mediation: a system analysis. Glob Health Res Policy. 2020; 5(1): 53. DOI: 10.1186/s41256-020-00181-0

Htet H, Chuaychai A, Sottiyotin T, Htet KKK, Sriplung H, Wichaidit W, et al. Association between Thai language proficiency and adherence to COVID-19 protective behaviors (CPB) among Myanmar migrant workers in Southern Thailand. PLoS One. 2024; 19(10): e0312571. DOI: 10.1371/journal.pone.0312571

Khin YP, Owusu FM, Nawa N, Surkan PJ, Fujiwara T. Barriers and facilitators for healthcare access among immigrants in Japan: a mixed methods systematic review and meta-synthesis. Lancet Reg Health West Pac. 2025 Jan 10; 54: 101276. DOI: 10.1016/j.lanwpc.2024.101276

Tangcharoensathien V, Sachdev S, Viriyathorn S, Sriprasert K, Kongkam L, Srichomphu K, et al. Universal access to comprehensive COVID-19 services for everyone in Thailand. BMJ Glob Health. 2022; 7(6). DOI: 10.1136/bmjgh-2022-009281

Pocock NS, Chan Z, Loganathan T, Suphanchaimat R, Kosiyaporn H, Allotey P, et al. Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand. PLoS One. 2020; 15(4): e0231154. DOI: 10.1371/journal.pone.0231154

Uansri S, Kunpeuk W, Julchoo S, Sinam P, Phaiyarom M, Suphanchaimat R. Perceived Barriers of Accessing Healthcare among Migrant Workers in Thailand during the Coronavirus Disease 2019 (COVID-19) Pandemic: A Qualitative StudyInt. J. Environ. Res. Public Health. 2023; 20(10): 5781. DOI: 10.3390/ijerph20105781

Matsuoka S, Kharel M, Koto-Shimada K, Hashimoto M, Kiyohara H, Iwamoto A, et al. Access to Health-Related Information, Health Services, and Welfare Services among South and Southeast Asian Immigrants in Japan: A Qualitative Study. Int J Environ Res Public Health. 2022;19(19). DOI: 10.3390/ijerph191912234

Yamashita T, Quy PN, Nogami E, Yamada C, Kato K. Difficulties Faced by Vietnamese Migrants in Japan in Accessing Healthcare During the COVID-19 Pandemic and Their Self-Reported Health Perceptions. Cureus. 2024; 16(11): e74058. DOI: 10.7759/cureus.74058

Langkulsen U, Mareke P, Lambonmung A. Migrants and Healthcare during COVID-19, the Case of Kanchanaburi Province in Thailand. Healthcare (Basel). 2023; 11(20). DOI: 10.3390/healthcare11202724

Rajatanavin N, Tuangratananon T, Suphanchaimat R, Tangcharoensathien V. Responding to the COVID-19 second wave in Thailand by diversifying and adapting lessons from the first wave. BMJ Glob Health. 2021; 6(7). DOI: 10.1136/bmjgh-2021-006178

Phattharapornjaroen P, Carlström E, Sivarak O, Tansuwannarat P, Chalermdamrichai P, Sittichanbuncha Y, et al. Community-based response to the COVID-19 pandemic: case study of a home isolation centre using flexible surge capacity. Public Health. 2022; 211: 29-36. DOI: 10.1016/j.puhe.2022.06.025

Tuangratananon T, Rajatanavin N, Khuntha S, Rittimanomai S, Asgari-Jirhandeh N, Tangcharoensathien V. Governance, policy, and health systems responses to the COVID-19 pandemic in Thailand: a qualitative study. Front Public Health. 2024; 12: 1250192. DOI: 10.3389/fpubh.2024.1250192

Kyaw PP, Geater AF. Healthcare seeking preferences of Myanmar migrant seafarers in the deep south of Thailand. Int Marit Health. 2021; 72(1): 1-9. DOI: 10.5603/IMH.2021.0001

Thandar MM, Iwamoto A, Hoshino HA, Sudo K, Fujii M, Kanda M, et al. Factors associated with the uptake of COVID-19 vaccination, testing and medical care among Myanmar migrants in Japan: a cross-sectional study. Tropical Medicine and Health. 2024; 52(1): 53. DOI: 10.1186/s41182-024-00621-4

Song P, Mitsuya H, Kokudo N. COVID-19 in Japan: An update on national policy, research, clinical practice, and vaccination campaign. Glob Health Med. 2022; 4(2): 64-6. DOI: 10.35772/ghm.2022.01036

Carrillo JE, Carrillo VA, Perez HR, Salas-Lopez D, Natale-Pereira A, Byron AT. Defining and targeting health care access barriers. J Health Care Poor Underserved. 2011; 22(2): 562-75. DOI: 10.1353/hpu.2011.0037

Liu A, Yazdani Y, Elias M, Patel K, Budzi D, Saad A, et al. Transition in care interventions for Refugee, Immigrant and other Migrant (RIM) populations: a health equity-oriented scoping review. Globalization and Health. 2025; 21(1): 25. DOI: 10.1186/s12992-025-01114-7

Stevenson M, Guillén JR, Bevilacqua KG, Arciniegas S, Ortíz J, López JJ, et al. Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia. J. Migr. Health. 2023; 7: 100187. DOI: 10.1016/j.jmh.2023.100187

Kunpeuk W, Julchoo S, Phaiyarom M, Sinam P, Pudpong N, Loganathan T, et al. Access to Healthcare and Social Protection among Migrant Workers in Thailand before and during COVID-19 Era: A Qualitative Study. Int J Environ Res Public Health. 2022; 19(5). DOI: 10.3390/ijerph19053083

Santalahti M, Sumit K, Perkiö M. Barriers to accessing health care services: a qualitative study of migrant construction workers in a southwestern Indian city. BMC Health Serv Res. 2020; 20(1): 619. DOI: 10.1186/s12913-020-05482-1

Istiko SN, Durham J, Elliott L. (Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. Int. J. Environ. Res. Public Health. 2022; 19(5): 2981. DOI: 10.3390/ijerph19052981

Kosiyaporn H, Julchoo S, Sinam P, Phaiyarom M, Kunpeuk W, Pudpong N, et al. Health Literacy and Its Related Determinants in Migrant Health Workers and Migrant Health Volunteers: A Case Study of Thailand, 2019. Int. J. Environ. Res. Public Health. 2020; 17:2105. DOI: 10.3390/ijerph17062105

Downloads

Published

2025-12-22