Post-COVID-19: Health Insurance Challenges for Migrant Children in Thailand

Abstract

This study aims to examine the impacts of the COVID-19 pandemic on access to health insurance and essential health services for migrant children during early childhood, a critical period for human development and long-term human capital formation. It also seeks to propose policy directions for developing age-appropriate health insurance systems for migrant children in the post-COVID-19 context. The study employs qualitative research design, collecting field data through in-depth interviews and focus group discussions. The target groups include migrant worker households, civil society organizations, community-based organizations, community leaders, and relevant agencies involved in health and child protection. Study sites were purposively selected in six provinces—Chiang Mai, Tak, Samut Sakhon, Ranong, Chonburi, and Bangkok—to reflect diverse socioeconomic contexts. The sample comprised 36 migrant worker households and 82 participants from focus group discussions representing relevant organizations and agencies.
The findings reveal that migrant children face multidimensional vulnerabilities, particularly limitations in accessing health insurance due to parents’ legal status, household financial constraints, and caregiving priorities that do not adequately support children’s health needs. Gaps in maternal and child health services were also identified, affecting newborns’ health rights. Regarding immunization, disparities across areas were observed in terms of follow-up systems, information dissemination, and service continuity. In addition, the COVID-19 pandemic adversely affected children’s nutritional status as a result of income loss, parental quarantine, and the closure of child care centers that previously provided regular meals.
The study highlights the need to develop a flexible health insurance system that is not tied to legal status, alongside emergency nutrition measures and accessible communication mechanisms, in order to reduce health inequities and protect the fundamental rights of all children residing in Thailand.