BackgroundIn Tak province of Thailand, a number of adolescent students who migrated from Burma have resided in the boarding houses of migrant schools. This study investigated mental health status and its relationship with perceived social support among such students.MethodsThis cross-sectional study surveyed 428 students, aged 12–18 years, who lived in boarding houses. The Hopkins Symptom Checklist (HSCL)-37 A, Stressful Life Events (SLE) and Reactions of Adolescents to Traumatic Stress (RATS) questionnaires were used to assess participants’ mental health status and experience of traumatic events. The Medical Outcome Study (MOS) Social Support Survey Scale was used to measure their perceived level of social support. Descriptive analysis was conducted to examine the distribution of sociodemographic characteristics, trauma experiences, and mental health status. Further, multivariate linear regression analysis was used to examine the association between such characteristics and participants’ mental health status.ResultsIn total, 771 students were invited to participate in the study and 428 students chose to take part. Of these students, 304 completed the questionnaire. A large proportion (62.8%) indicated that both of their parents lived in Myanmar, while only 11.8% answered that both of their parents lived in Thailand. The mean total number of traumatic events experienced was 5.7 (standard deviation [SD] 2.9), mean total score on the HSCL-37A was 63.1 (SD 11.4), and mean total score on the RATS was 41.4 (SD 9.9). Multivariate linear regression analysis revealed that higher number of traumatic events was associated with more mental health problems.ConclusionsMany students residing in boarding houses suffered from poor mental health in Thailand’s Tak province. The number of traumatic experiences reported was higher than expected. Furthermore, these traumatic experiences were associated with poorer mental health status. Rather than making a generalized assumption on the mental health status of migrants or refugees, more detailed observation is necessary to elucidate the unique nature and vulnerabilities of this mobile population.
In Thailand, a health-promoting school (HPS) program is in place nationwide. However, this policy has not covered Burmese migrant schools. Therefore, to ensure the feasibility of the implementation of a HPS program, we conducted evaluations and an intervention on school health in migrant schools in Thailand. We included 44 primary-level schools in the Tak province in 2008. We were able to evaluate the results of the intervention in 43 of 44 schools in the subsequent year. For measurement, we used a comprehensive school-health checklist with five components: 'personal health and life skills', 'healthy school environment', 'health and nutrition services', 'common disease control and prevention', 'school and community partnership'. The checklist contained 59 items; item scores ranged from 0 to 3. We compared the results of the two surveys (performed before and after the intervention) by calculating the mean score of each item. A 1.3-fold increase was seen in the mean of all items measured in the evaluation (from 1.7 to 2.2, n= 43). Out of the five components, the greatest difference was detected in 'school and community partnership', which increased from 1.0 to 2.4. Notably, the mean score of item 4 of component 5, 'clear definition of the roles and responsibilities with the Burmese community', increased from 0.4 to 2.7. Although further study is necessary to investigate the association between our intervention and the improvements among schools, our school health evaluation and intervention were successfully implemented in Burmese migrant schools.
Background and context: Pun Hlaing Siloam Hospital (PHSH), the only Joint Commission International (JCI) accredited hospital in Myanmar, is committed to provide comprehensive breast health services through “You Can Breast Health Club” in accordance with its vision; international quality, reach, scale and compassion. A free of charge membership-based club led by a dedicated medical oncology team that includes health care personnel, family members of breast cancer patients and healthy women of all walks of life. Aim: To promote awareness and take action on breast health and breast cancer so as to empower women to commit to lifelong breast health. Strategy/Tactics: The club executed its strategy through three pillars: 1) hospital-based comprehensive breast cancer care services, 2) community-based breast cancer education programs and 3) partnership with local and international organizations. The theme is “You can prevent the preventable; you can check for early detection; you can survive with effective treatment” with an aim to encourage women to play an active role in their own health. Program/Policy process: As part of a comprehensive approach to breast health, “one stop” hospital-based program provides breast health education on basic breast health and breast cancer facts, teaching breast self-exam, personal risk assessment and advise on risk reduction and to make healthy life choices. Interdisciplinary breast clinic provides clinical breast exam, state-of-the art breast imaging, diagnostic evaluation, referral for surgical and treatment options and patient family education. A training-of-trainers workshop on breast health was conducted for the hospital staff to facilitate program participants in turn to educate other club members and women in the local community. The club was launched in October Breast Cancer Awareness Month campaign held in October 2017 at PHSH. As a strategic partnership supported Shwe Yaung Hnin Si Cancer Foundation to host the World Cancer Day 2018 Community Cancer Awareness campaign held in Yangon. Outcomes: The number of club members increased to (282) within five months. Among the members, (204) women are from the community including family members of breast cancer patients, office staff, industry workers, and housewives reflecting the various socioeconomic status. The outcome was encouraging given that 60% of members are below the age of 40. What was learned: Community outreach breast cancer education programs combined with access to hospital-based services at affordable prices enhanced interest in club membership. The hospital-based strategy readily provides healthy women the facilities for early diagnosis and prompt access to quality care without any delays. Partnership with other advocacy groups accelerated the club process.
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