Grant: Travel Awards - Institute Community Support

Background In Tak province, Thailand migrants from neighboring Myanmar receive tuberculosis (TB) care from government and non-governmental treatment providers with the assistance of community health volunteers. Migrants experience barriers to accessing TB care related to their legal and socioeconomic status. Methods We conducted fieldwork in Tak province in the summer and fall of 2014 to examine pathways to TB treatment and health system responsiveness to patient barriers to treatment access. Data was collected through focus group discussions with migrant and refugee TB patients as well as key informant interviews with individuals providing TB care or working in related public health programs. Results In this paper we compare and contrast the barriers to TB treatment as perceived by TB patients and clinicians and describe the individual and collective actions that treatment providers have taken to improve migrant's access and adherence to TB treatment. We found that organizations working primarily with migrant populations have a keen sense of the barriers and have adjusted their programs to provide comprehensive services intended to help patients receive and adhere to treatment. Conclusions There is a dynamic interplay between the social determinants of health and TB in migrant populations that necessitates interventions to increase equity. Comprehensive interventions are required to improve migrant's health care access.