Access to Non-Communicable Disease (NCD) Services Among Urban Refugees and Asylum Seekers, Relative to the Thai Population, 2019: A Case Study in Bangkok, Thailand

Mathudara Phaiyarom,1 Hathairat Kosiyaporn,1 Nareerut Pudpong,1,2 Pigunkaew Sinam,1 Rapeepong Suphanchaimat,1,3 Sataporn Julchoo,1 Watinee Kunpeuk1 1International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand; 2Sirindron College of Public Health, Chonburi, Thailand; 3Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, 11000, ThailandCorrespondence: Mathudara PhaiyaromInternational Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, ThailandTel +66 2 590 2382Fax +66 2 590 2385Email mathudara@ihpp.thaigov.netBackground: The health of urban refugees and asylum seekers (URAS) in Thailand has been under-researched compared with other groups of non-Thai populations, especially in the area of chronic non-communicable diseases (NCD). The objectives of this study were to i) examine NCD prevalence; ii) access to NCD services; and iii) factors associated with access to NCD services among urban refugees and asylum seekers (URAS) in comparison with the Thai population.Methods: A cross-sectional study, using a self-administrative questionnaire adapted from the Thai Health and Welfare Survey (HWS), was conducted in 2019. URAS were randomly selected from the register of the Bangkok Refugee Center. One hundred and eighty-one URAS participated in the survey. The data were combined with 2941 Thai records from the HWS. The population scope was confined to Bangkok. Bivariate analysis by Chi-square, Fisher’s exact, and Mann–Whitney U-tests was conducted to examine difference in demographic and access to NCD services between URAS and Thais. Multivariable logistic regression was performed to identify factors associated with access to NCD services.Results: Overall, URAS were young, less educated, and poorer than Thais. The trend of NCDs was similar to the Thai population, except mental health disorders appeared to be more prevalent in URAS. Almost half of the URAS did not receive any formal treatment. Being insured, abiding with Buddhism, and living in more affluent households were factors associated with better access to NCD services. URAS from Asian countries had greater access to NCD care than those from non-Asian countries.Conclusion: Policymakers should consider expanding the insurance coverage to URAS, similar to coverage for Thai populations. Additional studies on refugees’ health status and service utilization in other settings outside Bangkok are strongly recommended.Keywords: urban refugee, asylum seeker, NCD, healthcare, Thailand