Empowerment of Myanmar migrant workers as health volunteers for improving community health knowledge of common infectious diseases in Tak Province, Thailand

Abstract

About two million migrants from Myanmar are residing in Thailand. Incidence of infectious diseases such as diarrhea, acute respiratory infections, malaria, Tuberculosis is higher among the Myanmar migrants compare to the incidence in the host community. Formation of teams of community health volunteers in the migrant community would improve the knowledge of people about common infectious diseases and mitigate the problems. There were 2 phases in the study. Phase (I) was a cross sectional study and the objective was to investigate the community health knowledge in relation to socio-demographic factors. Phase (II) was a quasi-experimental study to assess the changes in self esteem and self efficacy among the Myanmar migrant community health volunteers (CHV) after participating in empowerment program and their ability in improving health knowledge of common infectious diseases in their communities. There were 2 groups of participants in the study. One group was community members and another group was Community Health Volunteers (CHV). In Phase (II), recruited CHV from both intervention and control clusters received initial 2 day training related to common infectious diseases. After initial training, only CHV in the intervention clusters received follow-up booster trainings once a month for six months. The knowledge about infectious diseases was significantly related to age (χ² = 26.39, P < 0.001) education level (χ² = 21.64, P < 0.001), occupation (χ² = 39.3, P < 0.001), legal stay status in Thailand (χ² = 21.16, P < 0.001) and income (χ² = 9.81, P = 0.044), duration of stay in the community (χ² = 21.51, P < 0.001) and Thai language proficiency (χ² = 6.16, P = 0.046). In phase (II), there were significant improvements in self-esteem and self-efficacy mean scores of CHV in intervention clusters. There were also significant increases in the community health knowledge in intervention clusters at the end of project. Based on the findings of the phase (I), uneducated young migrant agricultural farmers, without any legal stay documentation, with limited Thai language skill were marginalized people and therefore further health promotion intervention for Myanmar migrants should focus on this vulnerable group. The findings in phase (II) indicate that regular follow up meetings with technical and moral supports were necessary for a successful migrant CHV program. For sustainability, it should be linked up to CHV system of the host country.