Tackling TB and MDR-TB on the Thai-Myanmar border : A qualitative study based on stakeholder perspectives

Background: Myanmar and Thailand ranked in the top 22 high burden countries for Tuberculosis (TB) in 2010. Healthcare organizations play an essential role in addressing cross-border TB control in the two bridging border towns, Tak Province, Thailand and Myawaddy district, Myanmar. However, the stakeholders face significant difficulities in the TB control effort due to the challenging nature of fluid population movements, resource constraints and insufficient mechanisms to implement the cross-border collaboration. Methods: The researcher conduced an in-depth interview with stakeholders on site. An In-depth semi-structured interview was the main method of data collection. The interviewees were health policy makers and health care providers in charge of developing and implementing policies and program of TB in Tak Province, Thailand and Mywaddy district, Myanmar, representing governmental, United Nations, community based organizations, and international NGOs. One or two key persons from each organization were approached to participate in the study. Results: Respondents identified the following as barriers to cross-border TB control: a) insufficient formal communications, collaboration among stakeholders in the country and across the border, b) uncertain patient transfer mechanisms, c) shortage of human resources, d) lack of staff capacities, e) limited funding, and f) language barriers. Conclusion: Healthcare organizations faced many challanges in effectively addressing TB control in collaboration with service organizations. These findings may contribute to developing a practical road map for collaborative TB control on the Thai-Myanmar border. It is also expected that these findings may give new insights to cross-border TB control in the similar settings worldwide.