The COVID-19 pandemic has led to one of the most significant health crises in recent human history. Digital communication platforms have become the primary tools in health policy for communicating with different target groups, including migrants. This essay discusses the challenges regarding the formulation and implementation of digital health communication measures for migrants. The ideas in this article have been constructed through 40 interviews with policy stakeholders, including local Thai health policy actors, NGO staff, and migrant volunteers from the two border provinces of Tak and Nong Khai on Thailand’s borders with Myanmar and Laos PDR. 

 

The first challenge of the digital health communication design comes from its political centralisation, sidelining other stakeholders, such as NGOs or migrants. The policy-making process starts by gathering data from government local units and headquarter offices so that experts can verify and analyse the data, and then formulate appropriate communication responses, disseminated to migrants through both online and offline platforms. Aspects of this design have been criticised by local implementators, volunteers and NGOs as time-consuming, resulting in outdated responses and limited engagement with the perspectives of frontline staff facing the challenges on the ground. Therefore, these local frontline actors adjust the government’s top-down measures by using personal connections to collect their own data and formulate more effective communication responses. They disseminate these adapted messages through both formal online platforms, such as websites or official Facebook accounts, and informal online group chats for each community via the Line application. However, there are two main challenges. Firstly, there are problems in producing the appropriate health information for migrants, as most of the disseminated content relates to self-prevention and compliance with rules. There is less content about migrant health rights during a pandemic. Secondly, there are problems in managing the disinformation that circulates among migrant communities. Frontline staff struggle to understand the different channels that migrant groups use for receiving, perceiving, and reacting to online information. Hence, the platforms used by authorities to provide information are still limited to websites, official Facebook accounts and group chats. This has made it difficult to counter disinformation shared on other digital platforms used by young migrant workers searching for COVID-19 information.

 

Secondly, the government launched applications to monitor the Thai population’s behaviour and, at the local level, the behaviour of migrants. A variety of apps were created for different purposes over a relatively short period of time, which caused confusion. Therefore, their usage rates were very low for both Thais and migrants. Additionally, most apps were developed for high-speed smartphones and require fundamental digital literacy. All local implementators from both border provinces remarked that there were many middle-aged migrants and Thais who were not keen on technology and were, therefore, left behind. This reflects a poor digital communications plan and the problems of digital gaps. However, this study found that certain conditions or characteristics allowed some migrants to adjust to digital communication technologies and benefit from them. The migrants who were able to adjust were not only those adept at new technologies, but also groups who understood Thai rules well, were able to communicate in Thai, and had been in Thailand for over one year, having strong migrant networks or relationships with NGOs. One migrant leader said:

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‘I am not used to IT things, but since COVID-19, I have learned from my friends, Thai health volunteers and NGOs. This is the benefit of understanding Thai rules. I think the translated posters and information are not updated nor address our concerns. I can read Thai a bit, so I know there is more information about COVID-19 that has not been translated.’

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The third digital communication challenge involves countering health disinformation among migrants. In Tak, the main challenge for digital communication is monitoring misinformation and rumours via online platforms, due to their fast spread, an unawareness of the channels used by migrants, and language barriers. Authorities in Nong Khai faced fewer linguistic barriers or communication problems, although they still encountered an infodemic of false and misleading health information shared between the Thai community and Lao migrants. This study found a novel counterargument to linguistic barriers, as migrants can use automatic translation via social media or Google; but the challenges in countering a large amount of false information are significant. A concerning issue is the difference in health beliefs and health literacy when screening false information online. This affects migrants’ behaviours and compliance with health prevention rules. Erroneous health beliefs may cause misunderstandings about self-care and health risks, such as thinking that fake vitamins, available online, can kill the virus. In order to fight this fake news problem, health workers, together with employers, asked migrant health volunteers and migrant networks to train the young generation of migrant workers to identify the main digital communication channels among their communities, and monitor and report rumours. Today, the Thai authorities rely on officers to screen online content and identify misinformation and disinformation. However, they have planned to start using technology as a tool to detect false information online in the future.

 

Finally, there is limited collaboration between Thailand and its neighbouring countries in developing digital health communication and sharing information. Most cooperation efforts focus mainly on sharing medical data for cross-border disease prevention, such as the incidence of new cases and disease prevalence. The degree of collaboration depends on the neighbouring countries’ context. Cooperation with the government of Myanmar is difficult, while collaboration with Lao PDR is less complicated because there is less political conflict, and Thais and Lao share the same linguistic and cultural roots. This has led to limited cross-border support and an insufficient cooperation policy regarding digital health information. Indeed, this lack of cooperation hampered the collection of migrant health data that could be used to produce better health communication responses, improve collaboration between countries, and ensure the rights of migrants and their access to health information to enhance their health and wellbeing.

 

Exploring these challenges provides an opportunity to draw on lessons learned and improve the policy on digital health communication directed at migrants to prepare for future pandemics. 

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