Barriers to maternal and child healthcare access for asylum seekers and migrants from Myanmar in Malaysia : a case study of Selayang, Kuala Lumpur

Abstract

This study was framed around the concept of the right to access healthcare services. Article 25, of the Universal Declaration of Human Rights 1948, states that everyone has the right to a standard of living that is adequate for their health and well-being, including medical care and necessary social services. The studies intended to describe the Myanmar migrant profile in Selayang, Kuala Lumpur, identify barriers to maternal and child healthcare (MCH) access in the population and analyse gender obstacles in health access. Research was via qualitative interviews with 15 Myanmar women, a health department personnel, a UNHCR representative and a Myanmar NGO Medical Coordinator. Maximum variation sampling of ethnic groups was used; with inclusion criteria comprising Myanmar migrant women who were pregnant or recently given birth in the past 2 years, been in Malaysia at least 6 months and experienced difficulty in accessing health services. Parameters assessed included antenatal and vaccination checkups compliance, family planning knowledge and HIV/AIDS awareness. Major barriers to MCH access comprised of fear/security issues, documentation and registration problems, cost, lack of knowledge on where and why to seek MCH services, and language barriers. Physical barriers were not a major problem. This study suggests that barriers to MCH access for Myanmar asylum seekers and migrants in Kuala Lumpur come from prior to the health service sector (security, documentation, and socio-cultural factors). This is because of the irregular status of the Myanmar migrant community affecting individual and socioeconomic outcomes in determining health decisions. System based factors such as national policy towards migrants and the need for security also may have great influence in determining healthcare access. Additionally, fear of enforcement authorities prevents effective access to services. A rights-based approach may facilitate addressing barriers in MCH access in the population.