Well-Being and Healthcare Inequality on Bulon-Don Island in Southern Thailand-Results of a Pre-Intervention Field Survey.

Abstract

Background and objectives: Children living in an area distant from or associated with barriers to travelling to health service centres usually experience health and well-being disparities. This is a survey of child health and well-being on Bulon-Don Island, located 22 kms. from the southern mainland of Thailand, to gather essential background data before activating responses from local service provider agencies.

Methods: Demographic data, physical and crude psychological health, harm to health, and living conditions of Bulon-Don children aged 1-14 years were studied and compared with the results of the corresponding national child health survey. Descriptive statistics were used for the statistical analysis of significance (p < 0.05).

Results: A total of 21 male and 41 female children (N = 62) participated in the survey after obtaining consents from parents or care providers. The islanders are Indigenous people who use their own languages and have traditional beliefs. Comparing with the children of the national survey, most children aged <5 years were found to have significantly lower height and weight according to their age (p = 0.044 and p = 0.043, respectively), whereas those aged >5 years had a similar nutritional status. In addition, there is a lack of facilities for healthy living. However, the mean total psychological and ethical standards scores were significantly higher in the 1-5 and 6-9-year-old children.

Conclusions: Disparity of socio-political status, cultural beliefs and practices, socioeconomic basis, and geographic distance from the mainland were the social determinants and barriers of low health service accessibility for the islander children. Comprehensive child health and well-being evaluation in an enclave of isolation like this is mandatory before an integrated intervention carried out by the local healthcare and living facilities providers is implemented.