Maternal and Child Health System for the Hill Tribe in Northern Thailand: Outcomes and Barriers

  • Napaporn Jantakat Mae Fah Luang District Public Health Office, Chiang Rai, Thailand, 57240
  • Phornthip Ruangrit Mae Suai District Hospital, Chiang Rai, Thailand, 57180
  • Kaset Chimplee School of Medicine, Mae Fah Luang University, Thailand, 57100
  • Komkham Pattanaporn School of Dentistry, Mae Fah Luang University, Thailand, 57100
  • Chompunut Sopajaree School of Nursing, Mae Fah Luang University, Thailand, 57100
  • Tawatchai Apidechkul School of Health Science, Mae Fah Luang University, Thailand, 57100
Keywords: Maternal and child health, Health system, Hill tribe, Barriers, Health Outcomes

Abstract

Background: Maternal and child healthcare (MCH) services are a very significant health service for the safety of women and children during pregnancy, which is a standard and basic service for all people including the hill tribe and stateless populations lived in Thailand. This study aimed to investigate the health performance, health outcomes, and barriers to accessing MCH clinics from two district hospitals accessible to the hill tribe and stateless population in Chiang Rai, Thailand. Methods: Retrospective data collection and group discussions were performed to extract information to understand the situation and barriers to accessing MCH clinics among the hill tribe and stateless populations living in Mae Suai and Mae Fah Luang districts, Chiang Rai, Thailand.  Data were collected from July to August 2021. Results: A number of child deliveries were performed by the Mae Suai district hospital every year; a high proportion with preterm delivery and low birth weight, less than 50.0% of pregnant women had early and complete access to antenatal clinics (ANC); more than 15.0% of pregnant hill tribe women were pregnant before age of 20 years. Only a few children were on the right developmental track, according to the standard development assessment tools.  Several poor outcomes were detected among pregnant women and child births in Mae Fah Laung District; a low number  of pregnant women visited the antenatal clinic and postpartum clinic, a large proportion had a high risk for pregnancy, 17.9% of children aged 6-12 months of age  were diagnosed with anemia, 31.2% experienced asphyxia problems during delivery, and poor development among children had asphyxia and birth weight less than 2,500 g. Several challenges and barriers were detected in healthcare providers, such as poor attendance rate of early ANC due to their belief, poor personal hygiene related to postpartum care, substance use among pregnant women, and multiple pregnancies from poor rate family planning. In the clients’ aspects, distance, lack of family and community support, and financial problems were major barriers. Conclusion: There is an urgent need to strengthen the current MCH system to improve the health and safety of the hill tribe and stateless populations by focusing on linking health information among institutes, improving professional skills to health care providers, and engaging community members in the system, including improvement of individual socioeconomic characteristics.

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References

World Health Organization (WHO). Quality, equity, dignity: a network for improving quality of care for maternal, newborn and child health. Available from: https://www.who.int/maternal_child_adolescent/topics/quality-of-care/quality-of-care-brief-standards.pdf

World Health Organization (WHO). Maternal mortality. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality

World Health Organization (WHO). Maternal health. Available from: https://www.who.int/health-topics/maternal-health#tab=tab_1

Dahab R, Sakellariou D. Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review. IJERPH 2020;17:4292. https://doi.org/10.3390/ijerph17124292.

Franchi JV de O, Pelloso SM, Ferrari RAP, Cardelli AAM. Access to care during labor and delivery and safety to maternal health. Rev Latino-Am Enfermagem 2020;28. https://doi.org/10.1590/1518-8345.3470.3292.

Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. The Lancet 2018;391:1205–23. https://doi.org/10.1016/s0140-6736(18)30198-3.

Tejativaddhana, P, Briggs, D, Singhadej, O and Hinoguin, R. Developing primary health care in Thailand: Innovation in the use of socio-economic determinants, Sustainable Development Goals and the district health strategy. Public Administration and Policy: An Asia-Pacific Journal. 2018; 21(1): 36-49. https://doi.org/10.1108/PAP-06-2018-005

Apidechkul, T, Laingoen, O, & Suwannaporn, S. Inequity in Accessing Health Care Service in Thailand in 2015: A Case Study of the Hill Tribe People in Mae Fah Luang District, Chiang Rai, Thailand. Journal of Health Research. 2016; 30(1): 67-71.

Princess Maha Chakri Siridhorn Anthropology Center. Hill tribe. 2020. http://www.sac.or.th/main/index.php.

Apidechkul T. A 20-year retrospective cohort study of TB infection among the Hill-tribe HIV/AIDS populations, Thailand. BMC Infect Dis 2015;16. https://doi.org/10.1186/s12879-016-1407-4.

Chomchoei, C., Yeemard, F., Tamornpark, R., & Upala, P. Burden and Factors Associated with Hypertension Among the Adult Population of the Lisu Hill Tribe, Northern Thailand. Journal of Health Science and Alternative Medicine 2021;3:9–15. https://doi.org/10.14456/JHSAM.2021.3.

Chomchoei C., Apidechkul T, Khunthason S, Kullawong N, Keawdounglek V, Tamornpark R, et al. Prevalence and factors associated with type-2 diabetes mellitus among middle-aged and elderly Lisu hill tribe people, northern Thailand: a cross-sectional study. Journal of Health Science and Alternative Medicine. 2019; 1(3): 17-23.

Apidechkul T. Prevalence and factors associated with type 2 diabetes mellitus and hypertension among the hill tribe elderly populations in northern Thailand. BMC Public Health 2018;18. https://doi.org/10.1186/s12889-018-5607-2.

Thutsanti P, Apidechkul T, Inta C, Upala P, Tamornpark R. Adaptation to Thai citizenship: a case study of Thai-Chinese Yunnan, Mae Fah Luang District, Chiang Rai, Thailand. Journal of Health Science and Alternative Medicine. 2019; 1(1): 8-13.

Jongh T, Gurol‐Urganci I, Allen E, Jiayue Zhu N, Atun R. Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries. BJOG: Int J Obstet Gy 2016;123:549–57. https://doi.org/10.1111/1471-0528.13898.

Kusena P. Understanding barriers to utilization of maternal and childhood services through community dialogue in the context of result based financing. Texila International Journal of Public Health. 2017; 5(4): 1-8.

Tumuhimbise W, Atukunda E, Ayebaza S, Katusiime J, Mugyenyi G, Pinkwart N, et al. Maternal health-related barriers and the potentials of mobile health technologies: Qualitative findings from a pilot randomized controlled trial in rural Southwestern Uganda. J Family Med Prim Care 2020;9:3657. https://doi.org/10.4103/jfmpc.jfmpc_281_20.

Ochieng CA, Odhiambo AS. Barriers to formal health care seeking during pregnancy, childbirth and postnatal period: a qualitative study in Siaya County in rural Kenya. BMC Pregnancy Childbirth 2019;19. https://doi.org/10.1186/s12884-019-2485-2.

Nair M, Yoshida S, Lambrechts T, Boschi-Pinto C, Bose K, Mason EM, et al. Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview. BMJ Open 2014;4:e004749. https://doi.org/10.1136/bmjopen-2013-004749.

Mannava P, Durrant K, Fisher J, Chersich M, Luchters S. Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review. Global Health 2015;11. https://doi.org/10.1186/s12992-015-0117-9.

Pahwa P, Sood A. Existing practices and barriers to access of MCH services - a case study of residential urban slums of district Mohali, Punjab, India. Global Journal of Medicine and Public Health. 2013; 2(4):1-8.

Onasoga AO, Osaji TA, Alade OA, Egbuniwe MC. Awareness and barriers to utilization of maternal health care services among reproductive women in Amassoma community, Bayelsa State. Int J Nurs Midwifery 2014;6:10–5. https://doi.org/10.5897/ijnm2013.0108.

Milkowska-Shibata MA, Aye TT, Yi SM, Oo KT, Khaing K, Than M, et al. Understanding Barriers and Facilitators of Maternal Health Care Utilization in Central Myanmar. IJERPH 2020;17:1464. https://doi.org/10.3390/ijerph17051464.

Dahab R, Sakellariou D. Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review. IJERPH 2020;17:4292. https://doi.org/10.3390/ijerph17124292.

Fagbamigbe AF, Idemudia ES. Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming. BMC Pregnancy Childbirth 2015;15. https://doi.org/10.1186/s12884-015-0527-y.

Published
2021-09-08
How to Cite
Jantakat, N., Ruangrit, P., Chimplee, K., Pattanaporn, K., Sopajaree, C., & Apidechkul , T. (2021). Maternal and Child Health System for the Hill Tribe in Northern Thailand: Outcomes and Barriers. ournal of ealth cience and lternative edicine, 3(2), 15-22. https://doi.org/10.14456/jhsam.2021.8