Evaluation of Immunization Services for Children of Migrant Workers Along Thailand-Myanmar Border: Compliance with Global Vaccine Action Plan (2011-2020).

Chamnan Pinna,Weerawan Hattasingh,Aree Moungsookjareoun,Saranath Lawpoolsri,Rakdaw Methakulchart,Witaya Swaddiwudhipong,Jaranit Kaewkungwal

doi:10.3390/vaccines8010068

Abstract

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.

Highlights

Immunization is the most cost-effective health intervention and is recognized as a core component of the human right to health
About 42% of the respondents were temporary migrants, who might have crossed the border for work in Thailand during harvesting season, and 22.6% had lived in Thailand for more than 10 years
The overall vaccination coverage for diptheria-tetanus-pertussis vaccine (DTP)–HepB3 and OPV3 was gradually increased from 34.8%

Summary

Introduction

Immunization is the most cost-effective health intervention and is recognized as a core component of the human right to health. Plan (GVAP), which aims to accelerate immunization for all people worldwide [1]. The GVAP’s mission is to expand immunization to all people by 2020, regardless of their nationality and accessibility status. In Thailand, the coverage of basic immunization, including Bacillus Calmette–Guérin vaccine. Migrants are the main underserved population for immunization [3]. In the Tak province, along the Thailand–Myanmar border, the vaccination coverage among migrant children was estimated to be only 56.7% in 2013 [4]. The major barriers to immunization include continuous mobility, living in remote areas, lack of knowledge, and language barriers. Illegal migrants may not want to expose themselves to public health officers because they fear getting arrested [4,5]

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Discussion

Conclusion