Insurance shapes TB care-seeking among Myanmar migrants in southern Thailand

Tuberculosis remains a concern in communities where crowded living conditions, physically demanding work and barriers to healthcare combine. In Thailand, Myanmar migrant workers often live and work in such conditions, putting them at higher risk of tuberculosis (TB). To better understand how health insurance might influence what migrants do when TB symptoms appear, researcher Nyan Lin Htet led a study among factory workers from Myanmar in southern Thailand. The research asked two straightforward questions: would workers seek formal healthcare if they developed TB symptoms, and would they stay in Thailand to complete a full course of TB treatment if they were diagnosed? To answer these questions, the study surveyed 330 Myanmar migrant factory workers using a self-administered questionnaire written in Myanmar language. By focusing on stated intentions rather than observed behavior, the study aimed to capture how coverage—or the lack of it—might shape early decisions about care and the willingness to complete treatment once diagnosed.

The research used a cross-sectional design and gathered responses from 330 participants. Key outcomes were the reported intention to seek formal healthcare if TB symptoms developed and the reported intention to complete the full course of TB treatment if diagnosed. To examine the role of insurance while accounting for other factors, the authors used logistic regression analyses with adjustment for age, sex, income, education, marital status, length of stay in Thailand, and TB history. Results showed that most participants reported having health insurance (96.1%). Overall, 73.3% of respondents said they would seek formal healthcare if they developed TB symptoms, and 83.6% said they would complete the full course of TB treatment in Thailand if diagnosed. Uninsured participants were more likely to report that they would not seek formal care (37.5% vs. 17.5%; Adjusted OR = 4.71, 95% CI = 0.60, 36.88). Notably, all uninsured respondents who answered the treatment question indicated they would complete the full treatment.

These findings highlight a gap between care-seeking and treatment intentions among Myanmar migrant workers in southern Thailand. While most workers reported having insurance and a majority said they would pursue formal healthcare if symptomatic, uninsured workers were substantially more likely to say they would not seek formal care. At the same time, intent to complete a full TB treatment course was high overall, and even uninsured respondents who answered that question indicated they would stay for treatment if diagnosed. For public health, this pattern suggests that barriers to initial diagnosis—such as lack of insurance or other access challenges—may delay care even when willingness to undergo treatment is strong. The authors caution that the results should be interpreted considering limitations in the measurement question and possible selection bias and information bias. Still, the study provides focused evidence about how insurance status is associated with intended TB-related actions among a vulnerable workforce, information that could inform targeted outreach, policy discussions and further research.