Maternal health care seeking behaviour during pregnancy, delivery and postpartum among Myanmar migrant women in Thai-Myanmar border
DOI:
https://doi.org/10.62992/2aw3nk47Keywords:
Maternal health care, Seeking behaviour, Thai-Myanmar borderAbstract
Background: Women in border areas often face barriers to healthcare access due to geographic, informational and cultural factors. However, limited evidence exists on how these challenges affect their health-seeking behaviour.
Objectives: This study aims to address this gap by exploring maternal health-seeking behaviour during pregnancy, delivery and postpartum among women on the Thai-Myanmar border, Tak Province, Thailand.
Methods: A cross-sectional analytical study was conducted from October 2023 to November 2024 among 362 women selected through simple random sampling. Data were collected through face-to-face interviews using a structured questionnaire. Multiple logistic regression was performed to identify factors associated with health-seeking behaviour utilization. A P-value of less than 0.05 was considered statistically significant.
Results: Among the 362 respondents, 25.1% (95% CI: 20.92-29.88) exhibited low maternal healthcare-seeking behaviour. Multivariable analysis identified several significant predictors of low health-seeking behaviour: low education level (AOR = 2.46, 95% CI: 1.34-4.52), poor knowledge of maternal health (AOR = 11.46, 95% CI: 6.16-21.30), lack of decision-making autonomy (AOR = 2.77, 95% CI: 1.48-5.16), poor social support (AOR = 2.87, 95% CI: 1.27-6.49), travel time of more than one hour to a health facility (AOR = 2.48, 95% CI: 1.08-5.66) and inability to afford medical services (AOR = 2.86, 95% CI: 1.33-6.15).
Conclusion: A substantial proportion of women demonstrated low maternal healthcare-seeking behaviour influenced by educational, informational, socioeconomic and accessibility factors. Interventions aimed at enhancing maternal health knowledge, empowering women in decision-making, strengthening family support systems, and reducing both financial and geographic barriers are critical for improving maternal health service utilization in this population.
References
WHO. Maternal mortality 2024 [cited 2024 Sep 3]. Available from: https://www.who.int/data/gho/data/themes/maternal-and-reproductive-health.
UNFPA. Safe birth for all: Thailand project (October 2020 to December 2021). 2021.
Bank W. Maternal mortality ratio 2023 [cited 2024 Jan 12]. Available from: https://data.worldbank.org/indicator/SH.STA.MMRT?locations=TH-Z4&view=map.
[MOPH] MoPH. Thai maternal mortality ratio per 100,000 live births n.d. [cited 2025 Jan 12]. Available from: https://dashboard.anamai.moph.go.th/dashboard/mmr/index?year=2016.
Gilder ME, Pateekhum C, Hashmi A, Aramrat C, Aung KK, Miket W, et al. Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic. International Journal for Equity in Health. 2022;21(1):190.
Wongsuwanphon S, Chottanapund S, Knust B, Wongjindanon N, Suphanchaimat R. Access to healthcare services and factors associated with unmet needs among migrants in Phuket Province, Thailand, 2023: a cross-sectional mixed-method study. BMC Health Services Research. 2024;24(1):1161.
Win N, Laohasiriwong W, San AA. Health seeking behavior among Myanmar migrant workers in Khon Kaen province, Thailand. International Journal of Public Health Asia Pacific. 2023:27-38.
Khemanitthathai S. Situation on migrant workers and border crossing during the Covid-19 pandemic. Migrant Working Group, November. 2021:2022-02.
Khongthanachayopit S, Laohasiriwong W. Accessibility to health services among migrant workers in the Northeast of Thailand. F1000Research. 2017;6:972.
Tschirhart N, Jiraporncharoen W, Angkurawaranon C, Hashmi A, Hla S, Nosten S, et al. Giving birth on the way to the clinic: undocumented migrant women’s perceptions and experiences of maternal healthcare accessibility along the Thailand–Myanmar border. Reproductive Health. 2023;20(1):178.
Phanwichatkul T, Burns E, Liamputtong P, Schmied V. Migrant Burmese women living in southern Thailand and motherhood: An ethnographic study. Nurs Health Sci. 2019;21(3):390-8.
Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Statistics in medicine. 1998;17(14):1623-34.
Bloom BS. Taxonomy of Educational Objectives, Handbook I: Cognitive Domain. New York: David McKay Company. Inc, 1956 207 Pp. 1956.
Simieneh MM, Mengistu MY, Gelagay AA, Gebeyehu MT. Mothers’ health care seeking behavior and associated factors for common childhood illnesses, Northwest Ethiopia: community based cross-sectional study. BMC health services research. 2019;19:1-7.
Kifle D, Azale T, Gelaw YA, Melsew YA. Maternal health care service seeking behaviors and associated factors among women in rural Haramaya District, Eastern Ethiopia: a triangulated community-based cross-sectional study. Reproductive Health. 2017;14(1):6.
Tawfiq E, Azimi MD, Feroz A, Hadad AS, Soroush MS, Jafari M, et al. Predicting maternal healthcare seeking behaviour in Afghanistan: exploring sociodemographic factors and women’s knowledge of severity of illness. BMC Pregnancy and Childbirth. 2023;23(1):561.
Guo F, Xiong H, Qi X, Takesue R, Zou BMS, He PQ, et al. Maternal health-seeking behavior and associated factors in the Democratic Republic of the Congo. Health Education & Behavior. 2021;48(5):700-9.
Tsawe M, Moto A, Netshivhera T, Ralesego L, Nyathi C, Susuman AS. Factors influencing the use of maternal healthcare services and childhood immunization in Swaziland. International Journal for Equity in Health. 2015;14(1):32.
Wenjuan Wang, Soumya Alva, Shanxiao Wang, Fort A. Levels and Trends in the Use of Maternal Health Services in Developing Countries DHS Comparative reports 26. 2011.
Amin R, Shah NM, Becker S. Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis. International journal for equity in health. 2010;9:1-11.
Shahabuddin A, Nöstlinger C, Delvaux T, Sarker M, Delamou A, Bardají A, et al. Exploring maternal health care-seeking behavior of married adolescent girls in Bangladesh: a social-ecological approach. PloS one. 2017;12(1):e0169109.
Okoronkwo IL, Odira CC, Nwaneri AC, Okpala PU, Okafor CN. Patterns of antenatal care seeking behavior in South East Nigeria: Exploring relationship with age, education, and socioeconomic status. Journal of Basic and Clinical Reproductive Sciences. 2016;5(1):40-5.
Wilunda C, Quaglio G, Putoto G, Takahashi R, Calia F, Abebe D, et al. Determinants of utilisation of antenatal care and skilled birth attendant at delivery in South West Shoa Zone, Ethiopia: a cross sectional study. Reprod Health. 2015;12:74.
Dhakal S, van Teijlingen E, Raja EA, Dhakal KB. Skilled care at birth among rural women in Nepal: practice and challenges. J Health Popul Nutr. 2011;29(4):371-8.
Khan BAA, Mahmood H, Ahmed JM, Anwar B, Muhammad A, Jabeen R. Exploring challenges in accessing primary healthcare for pregnant women in Pakistan: a qualitative descriptive study. BMC Health Serv Res. 2025;25(1):482.
Wado YD. Women’s autonomy and reproductive health-care-seeking behavior in Ethiopia. Women & health. 2018;58(7):729-43.
Qureshi RN, Sheikh S, Khowaja AR, Hoodbhoy Z, Zaidi S, Sawchuck D, et al. Health care seeking behaviours in pregnancy in rural Sindh, Pakistan: a qualitative study. Reproductive health. 2016;13:75-81.
Moyer CA, Adongo PB, Aborigo RA, Hodgson A, Engmann CM, DeVries R. “It’s up to the woman’s people”: how social factors influence facility-based delivery in Rural Northern Ghana. Maternal and child health journal. 2014;18:109-19.
Nayeem J, Stennett C, Sharmeen A, Hossain MM, Al Kibria GM. Rural-urban differences in distributions and determinants of facility delivery among women in Bangladesh. Global Health Journal. 2023;7(4):222-9.
Banke-Thomas A, Ayomoh FI, Abejirinde I-OO, Banke-Thomas O, Eboreime EA, Ameh CA. Cost of utilising maternal health services in low-and middle-income countries: a systematic review. International Journal of Health Policy and Management. 2020;10(9):564.
Smith KT, Monti D, Mir N, Peters E, Tipirneni R, Politi MC. Access Is Necessary but Not Sufficient: Factors Influencing Delay and Avoidance of Services. MDM Policy Pract. 2018;3(1):2381468318760298.
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