Abstract
Coronavirus disease 2019 (COVID-19) is a new emerging infectious disease that needs effective
risk communication, one of the key components of public health emergency responses. During
the pandemic, migrant workers face many significant challenges especially language and cultural
barriers hampering access to health risk information. This study aims to explore health risk
communication structure and processes, identify the communication network, and explore factors
related to the outcomes of health risk communication practices among migrant workers during
the COVID-19 pandemic in Thailand.
We conducted a mixed-method cross-sectional design on in migrant workers who lived in the
headquarter district of Samut Sakhon, Ranong, and Phuket provinces between November 2020
and June 2021. For qualitative approach, representatives from central and local public health
organisations, non-governmental organisations, local government units, and migrant community
members were purposively recruited with some additional interviewees recruited by snowball
sampling. Thirty-six key informants participated in the semi-structured interview. Deductive
thematic analysis was applied. For quantitative approach, first, we used social network analysis.
Fifty-six respondents from migrant communication were purposively recruited and were asked to
complete the questionnaire. Results from the questionnaires were used to outline sociogram to
assess how the information flew and actors that influenced the data flow most. We also surveyed
a total of 288 migrant workers to evaluate risk communication outcomes and related factors that
affected awareness toward public health measures and self-reported practices during COVID-
19. Logistic regression with robust standard errors were employed.
The findings showed that there were various activities around health risk communication. Though
health risk communication plan viewed migrant workers as a target group, there was no formal
governing body responsible for guiding communication plan. Moreover, there was no monitoring
tool or evaluation process for health risk communication. For social network analysis, migrant
health volunteers and local media were key sources of information. The centrality score was
higher in rural migrant communities compared with the urban ones-implying huge dependency
of communication within limited number of actors in rural areas. For quantitative survey on attitude
and self-reported preventive practices, most of respondents were aware of public health
measures (85%) and performed preventive practices (70%) during COVID-19 pandemic. Frequent reception of health information and having up to primary school education showed a
statistically significant association with preventive practices compared with those who hardly
received health information and the uneducated. Middle-aged migrant workers demonstrated a
significantly lower level of preventive practices than the younger migrant workers. A long stay in
Thailand was significantly related to lower degree of awareness toward public health measures.
In conclusion, clear governing body led by the government with intersectional collaboration, and
active engagement from community members such as migrant health volunteers are key to
effective communication with migrants. Dissemination of information for migrants should be done
through various channels especially local media in migrants’ languages, for instance, print and
online media with consideration of different migrant characteristics and capabilities especially.
The communication strategies should not overlook certain groups of migrants who were likely to
face difficulty in accessing health information (such as elder migrant workers and the uneducated
ones).
