Abstract
Migrant health is an important issue that has caught much political attention for years, particularly at the present where migrant birth rate is rapidly increasing. The objectives of this study are to 1) explore the operational system of the provision of essential vaccines for migrant children in Thailand through views of policy makers and health professionals, 2) analyze the extent to which migrant children have accessed to vaccination services in Thailand, and 3) estimate the budget impact in the provision of essential vaccines to all migrant children in Thailand. Parallel mixed methods design was employed. Data collection techniques comprised in-depth interviews for qualitative part and secondary data analysis for quantitative part. Study sites were public hospitals in four migrant-populated provinces. The results showed that although there was no explicit policy to provide basic vaccination for uninsured migrant children in Thailand but practically, health providers at the hospitals catered vaccination services free of charge for all migrant children regardless of their insured status through the leftover vaccines which were initially provided to Thai children. From migrants’ perspectives, buying health insurance is not the most important reason that influenced migrant parents to pay for health insurance for their children. Some migrant children travelled back to their country of origin when they grew up. The vaccination utilization rates amongst migrant children were quite low relative to standard utilization rate. If the government wished to provide basic vaccinations specifically for migrant children, the additional budget impact would be around 6.9-73.9 million Baht. In terms of policy recommendations, the Thai government should consider imposing essential vaccination as basic rights for all children regardless of their insured status, and such a service should be independent from nationality precondition and financial barriers. The government might consider investing more on vaccination at the cost suggested above. However adequate supporting mechanisms for the health facilities should be in place in order to ensure the country’s health system and financing sustainability.
