Multi-Stakeholder Primary Health Care for Migrant Populations in Thailand’s Border Regions: A Qualitative Study of Barriers and Opportunities

Primary health care (PHC) in Thailand's border regions remains challenged by the needs of mobile and marginalized populations, despite the country's progressive Universal Health Coverage (UHC). This qualitative study explores the dynamics of cross-border PHC systems along Thailand's borders with Myanmar, Lao PDR, and Cambodia through a people-centered lens. We conducted 101 semi-structured interviews with diverse stakeholders across six border provinces. Findings reveal that migrants and refugees face complex barriers, including legal exclusion, geographic isolation, and fear of deportation, leading to reliance on self-medication and delayed care. Health priorities consistently included communicable diseases, maternal and child health, and occupational risks, yet the context varied significantly by border. The Myanmar border was characterized by Non-Government Organizations (NGOs)-dependent, fragmented services for undocumented migrants and refugees. In contrast, the Lao PDR border demonstrated more stable, seasonal migration and smoother bilateral health cooperation. The Cambodia border was defined by labor migration and inconsistent employer-based health arrangements. Multi-stakeholder collaboration-particularly through migrant health volunteers and NGOs-was identified as both feasible and essential for service delivery, but remains ad hoc and donor-dependent. Sustainable solutions require formalizing the roles of community-based actors, creating institutionalized coordination platforms, and developing tailored, context-specific strategies that address the fundamental social determinants of health. Achieving health equity in these borderlands necessitates inclusive policies that bridge the gap between national UHC ambitions and the realities of cross-border mobility.