Challenges to primary healthcare services in the management of non-communicable diseases in marginalised populations on the Thailand–Myanmar border: a pilot survey. (October 2018)

• Record Type: Journal Article
• Authors: Saito, Makoto; Keereevijit, Arunrot; San, Thi Dar; Thein, Yin Yin; Gilder, Mary Ellen; McGready, Rose
• Is Part Of: Tropical doctor. Volume 48:Number 4(2018)
• Page Start: 273
• Page End: 277
• Publication Date: 2018-10
• Subjects: Low-resource settings -- migrant -- non-communicable diseases -- primary healthcare; Tropical medicine -- Periodicals; Medical care -- Developing countries -- Periodicals; Developing Countries -- Periodicals; Tropical Medicine -- Periodicals; Tropische geneeskunde; 616.9883
• DOI: 10.1177/0049475518786853
• Languages: English
• ISSNs: 0049-4755

Abstract

Non-communicable diseases (NCDs) are emerging rapidly. This manuscript reports on a pilot survey of NCDs at a primary healthcare level in a marginalised migrant population on the Thailand–Myanmar border in the face of declining rates of malaria. A retrospective audit of routine clinic (2004–2016) and NCD patient survey data (2014–2016) was conducted. The length of follow-up was assessed by Kaplan–Meier analysis. From July 2014 to July 2016, 238 migrant patients were on the NCD register. Hypertension (n = 80) and diabetes mellitus (n = 51) were the most common diagnoses. After the first consultation, 41% (95% confidence interval = 35–47%) were lost to follow-up by 30 days. NCD retention rates were low: 50% of registered patients were lost to follow-up by 80 (95% CI = 49–132) days. After this survey, a novel low-cost insurance scheme for the migrant community has been launched in this area. Development of new schemes involving patients, healthcare providers and funding support are required for improved and sustainable NCD care for marginalised populations.