Policy Literacy and Barriers Impact on Accessibility to Health Care Services under Social Security Scheme among Myanmar Migrant Workers in Thailand

Documented migrants working in formal sectors in Thailand are entitled to the Social Security Scheme. However, they often experience barriers and have limited literacy to access health care. Migrants with limited policy literacy have difficulty in accessing available health care services and this condition worsens in combination with various barriers. Little is known about health care accessibility under this scheme. This study aims to explore levels of policy literacy, barriers, accessibility and predictability of personal factors, policy literacy and barriers on accessibility to health care services among Myanmar migrant workers. A structured questionnaire with closed- and open-ended questions was employed to collect data among 240 participants recruited with purposive sampling from five factories in Hat Yai District, Songkhla Province. Socio-demographic characteristics, policy literacy, barriers and health care accessibility were presented descriptively. Stepwise linear regression was used to test the predictability of personal factors, policy literacy and barriers on health care services accessibility. Open-ended questions were analysed with simple content analysis. Migrants had low levels in total scores of policy literacy, barriers and health care accessibility. Although overall individual barriers were found to have low level, there was moderate level in overall system barriers among migrants. Policy literacy (beta = 0.53) and barriers (beta = -0.28) were able to predict accessibility to health care services. Findings indicated that actions to improve health care access, enhance policy literacy and reduce barriers are needed among Myanmar migrant workers.