A Cross-Sectional Study on Disparities in Unmet Need among Refugees and Asylum Seekers in Thailand in 2019.

Watinee Kunpeuk,Pigunkaew Sinam,Mathudara Phaiyarom,Sataporn Julchoo,Nareerut Pudpong,Rapeepong Suphanchaimat

doi:10.3390/ijerph18083901

Abstract

The health of urban refugees and asylum seekers (URAS) in Thailand has been under-researched compared with other groups of non-Thai populations, especially on the topic of unmet need. The aim of this study is to examine the level of unmet need among URAS in Thailand, focusing on out-patient (OP) and in-patient (IP) care. A cross-sectional study was conducted between October and December 2019. Stratified random sampling was undertaken and a total of 181 participants were included. A bivariate analysis was used to explore the level of unmet need among different URAS groups. Multivariate logistic regression was undertaken to examine the association between potential correlations and unmet need of IP and OP care. The majority of participants were female and aged below 30 years, with a low educational background and poor economic status. Most of them had experienced an illness in the past month before the interview, and some suffered from chronic diseases. The prevalence of both OP and IP unmet needs was more frequent among URAS from Arab countries. Furthermore, being from Arab countries indicated a strong link with OP and IP unmet need. Additionally, having illness over the past six months and chronic diseases were found to be significant determinants of IP unmet need. Our analysis showed that nationality had a strong association with both IP and OP unmet need, especially among those from Arab countries. Therefore, culturally appropriate health services should be considered to promote healthcare access among diverse groups of URAS. Further qualitative studies on barriers to accessing OP and IP care, such as communication, interpretation, and social dimensions, are required.

Highlights

Access to healthcare is a leading indicator of how well health systems perform in different contexts [1,2]
This study found that 45.2% of healthcare visits were at government facilities, 43.3% were at private health facilities, and 11.5% were at non-governmental organization (NGO) facilities [7,12]
Without any health insurance coverage, the majority of urban refugees and asylum seekers (URAS) experience unmet need for healthcare in terms of both IP and OP care

Summary

Introduction

Access to healthcare is a leading indicator of how well health systems perform in different contexts [1,2]. While complexity is embedded in the core concept of access to care, health service utilization and unmet need have been used as the best proxies to measure it [3,4]. Vulnerable groups such as refugees and asylum seekers (URAS) are facing great barriers in accessing healthcare. Both physical and mental health problems—arising from the countries of origin, during the transition to, and in the period of arrival in host countries—are significant among them [5]. Many countries worldwide are unable to guarantee medical and social services to URAS due to legal restrictions and bureaucracy that limit their rights for health and social welfare [4]

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