Migrant women's experience of antenatal care in an urban and rural setting in north and North-West Thailand: A cross sectional survey

Background: Nearly 50 % of women in low- and middle-income countries fail to obtain adequate antenatal care due to barriers in reaching the health facility. A key element of the quality of care is women's perception of treatment they receive. This study aims to compare the perspectives of urban and rural migrant women from Myanmar in Thailand and the obstacles they face when trying to access care. Methods: From October-2023 to May-2024, a survey was conducted among migrant women, 74 at Sarapee hospital in Chang Mai Province, and 148 at the clinics of Shoklo Malaria Research Unit (SMRU), Tak Province. Questions based on REPRO-Q were used for scoring satisfaction in several domains using a Likert scale ranging from dissatisfied to satisfied. Results: The majority of women in Sarapee and SMRU reported pleasant visits, 86.5 % (64/74), 99.3 % (144/145) respectively. Disrespectful behaviour against migrant women was low and mentioned by 14.9 % (11/74) in Sarapee and 1.4 % (2/148) at SMRU. The women attending care at Sarapee reported significantly lower satisfaction 60.8 % (45/74) on being able to refuse examination or treatment compared to women attending care in SMRU 83.0 % (122/147) P < 0.001. Conclusion: Both urban and rural settings had high rates of perceived pleasant visits and recommending the service to friends, although this could result from hesitancy to give negative feedback. At this critical stage of the life course both institutions can improve, to eliminate experiences of perceived disrespectful behavior.