Many of the poorest children in Thailand, particularly
migrants and ethnic minorities, still miss out on a basic
Despite broad improvements to the well-being
of children and women in Thailand, many of those belonging to
marginalised groups are still missing out on basic requirements for
survival and development
Story and photos courtesy of UNICEF OFFICE FOR
Three-year-old Gongsak, an ethnic Karen boy, lives with his
mother in a flimsy wooden shack off a minor road in rural
Ratchaburi. Here, some 30 kilometres from the border with Burma,
Gongsak and his mother, Noy Meer, subsist in poverty, without access
to adequate health care, sanitation or other services many Thai
families take for granted.
Gongsak's household was one of 43,000 covered by a nationwide
survey carried out last year by the National Statistical Office
(NSO). The survey, officially called the Multiple Indicator Cluster
Survey (MICS), was the largest assessment ever of the situation of
children and women in Thailand.
The results of the survey, which was conducted with support from
Unicef, were announced in Bangkok last week by the NSO.
The survey's results confirm that Thailand's remarkable economic
progress over recent decades has brought many social benefits to a
large proportion of the population, said Unicef representative for
Thailand, Tomoo Hozumi. These include significant improvements in
children's nutritional status, widespread access to safe drinking
water and sanitation and high coverage of essential health services.
"But at the same time, the survey has confirmed that there are
still challenges to ensuring the well-being of all children in
Thailand, including exclusive breastfeeding and the low levels of
iodised salt consumption," Hozumi said. "The survey has also
underlined the disparities among different geographical areas and
social groups that require attention."
Late last year, three of the nearly 1,000 NSO staff members
working on the survey visited Gongsak and Noy Meer to ask questions
about their basic situation. The questions covered access to health
care and education, nutritional status, levels of exclusive
breast-feeding and iodised salt coverage, knowledge of HIV/Aids and
a host of other issues critical to children's survival and
While the questions were asked, little Gongsak, dressed only in a
filthy T-shirt, played in the dirt with one of his dogs. Another
local boy, Naing, who has not been sent to school since his family
migrated from Burma several years ago even though he is clearly of
school age, sat on the shack's rickety wooden steps, idly watching
The lives of Gongsak and Naing are examples of what some of the
survey's results show: The disparity in the living conditions
between the majority of Thai children and children in remote and
isolated areas, particularly the children of ethnic minorities and
At the national level, for example, great progress has been made
in ensuring universal primary school education. The survey showed
that 98 per cent of all children aged seven to 12 are attending
school. But in Ratchaburi, this figure drops to 83 per cent for boys
of the poorest households, meaning that nearly one in five boys in
poor households are not receiving a basic education.
This may be the fate that awaits Gongsak. Although his older
brother is currently in the third grade at a primary school, Noy
Meer explained that keeping him there is difficult.
"School books cost 200 baht, and then there is the cost of
uniforms and travel," she said. "This is a lot of money for us. The
only income we have is from my husband, who earns 100 baht a day
cleaning cars. But there isn't work for him every day, and on the
days he doesn't work, he doesn't get paid."
Gongsak should start primary school when he is six, but with
their meagre income already stretched to the limit, his family will
find it difficult to send him. Naing, who is old enough to be
enrolled in school, is already missing out on an education.
The chances of children like Gongsak and his brother attending
secondary school are even slimmer. Although the survey found that 80
per cent of children between 13 and 18 years of age attend secondary
school nationwide, only 74 per cent do so in Ratchaburi. For
children whose mothers have no education, such as Noy Meer, that
figure falls to 54 per cent.
If Thailand is to achieve its Millennium Development Goals (MDG)
Plus target of universal secondary schooling by 2015, progress for
children like Gongsak and Naing needs to be much accelerated.
The MDG Plus targets are a set of long-term development goals
that Thailand has committed itself to achieve by 2015, and they are
more ambitious than the targets agreed to by other countries.
There is similar disparity in health care coverage. Nationally,
90 per cent of children are immunised against the six major
preventable childhood diseases by the age of two. But the rate drops
to 81 per cent for children in households where Thai is not the
first language. Gongsak's mother, whose first language is Karen,
said she forgot to take Gongsak to be vaccinated. Gongsak is one of
the roughly 200,000 young children in Thailand at risk of a serious
illness or death from easily preventable diseases.
Naing also received no vaccinations. In his community, few are
aware that children could be crippled or killed by illnesses for
which immunisation is easily available. For parents who have heard
of immunisation, a common attitude is that since their parents never
had them vaccinated and they are still fine, there is no need to
vaccinate their own children. They do not take into account the
children who died from vaccine-preventable illnesses.
Nationally, only five per cent of infants are exclusively
breastfed for the first six months of life _ which is the best way
to guarantee that infants get all the nutrients they need during
this crucial period of early development. This is the lowest
exclusive breastfeeding rate in Asia and among the lowest in the
Thailand also lags behind many other countries in Asia in terms
of iodised salt consumption _ the best and the most economical way
to ensure that the population has an adequate amount of this
essential nutrient in their daily diet. Iodine deficiency disorders
are the world's largest cause of preventable mental retardation, and
they can substantially lower children's mental capacity. At the
national level, only 58 per cent of households consume iodised salt.
In other parts of the country, such at the Northeast, coverage is as
low as 35 per cent.
Armed with the survey's results, the government and its partners
will be able to design better policies and programmes to address
disparities at the sub-national level and the challenges that remain
for the country as a whole.
One clear remaining challenge for Thailand is HIV/Aids. The
survey showed that less than half of all women aged 15 to 49 had
comprehensive knowledge of HIV transmission _ measured by knowing a
minimum of two ways of preventing HIV transmission and rejecting
three common misconceptions. Among women with no education, nearly
one-third did not know how to protect themselves, and one-quarter
said they had never heard of Aids.
In addition, negative attitudes towards people living with
HIV/Aids still persist _ 29 per cent of the survey's respondents
replied that an HIV-positive teacher should not be allowed to work,
and 65 per cent said they would not buy food from a vendor with
Gongsak's mother says she has never used a condom, although she
knows what one looks like. As for the HIV/Aids virus, she has no
idea how to prevent it, but thinks it can be spread by mosquitoes _
a misconception held by nearly a third of all women aged 15 to 49,
according to the survey's results.
This lack of HIV/Aids awareness was noted by Sumontha Kamkaen,
one of the NSO staff who helped to conduct the survey.
"Most of the ethnic Thais know the basics about HIV/Aids,
although they may not be too sure of things like whether a mother
can pass it on to her child," Sumontha said. "But few of the ethnic
minority women even know what HIV/Aids is."
Sumontha said carrying out this survey helped government staff
better understand local needs and also introduced those interviewed
to the importance of some of the issues covered.
During the survey, Sumontha said, interviewers began to realise
that malnutrition is a serious problem among the children of ethnic
minorities. Twenty per cent of ethnic minority children are
underweight, and that many children cannot afford to go to
pre-school. Less than half off all children in non-Thai speaking
households get a pre-school education.
At the end of the interview with Gongsak's mother, she was
reminded of the importance of taking him to school and getting him
immunised. This would greatly benefit her young son, but the real
improvements will come later _ when the data generated by the survey
leads to policies that will benefit not just Gongsak, but all
children in Thailand.