Table 2 KAP survey findings, corresponding explanatory questions, and main themes and related recommendations

• Only 4% of migrants reported awareness of thalassemia, vs 80% of Thai.

• What do migrants know about thalassemia?

Migrants lack awareness and knowledge about thalassemia, leading to negative attitudes toward thalassemia carriers and thalassemia screening.

An optimal initial strategy includes implementation of targeted education, delivered in migrants’ native languages through antenatal care (ANC), public education, or mass media.

• 45% of migrants and 33% of Thai believed thalassemia to be an infectious disease.

• How do migrants learn about thalassemia?

• 64% of migrants (vs. 57% of Thai) believed that thalassemia carriers require blood transfusions.

• What do migrants think about people with thalassemia?

• 91% of migrants (vs. 54% of Thai) believed that carriers can develop thalassemia major.

• What do providers think migrants know or feel about thalassemia?

• Migrants more “strongly disagreed” with termination of pregnancy compared to Thai.

• What do migrants think about the prevention of thalassemia in general?

Sociocultural factors influence uptake of thalassemia screening and termination of pregnancy for migrants.

Carrier screening may be more effective than prenatal screening for thalassemia prevention in migrant populations.

• Migrants felt strongly that they would not prevent the birth of a fetus affected by thalassemia.

• What do migrants think about termination of pregnancy?

• One-quarter of migrants surveyed were unregistered (likely undocumented or irregular).

• What systemic barriers or facilitators of thalassemia screening exist for migrants?

Structural and systemic factors affect migrants’ access to thalassemia screening.

Increasing migrants’ access to legal documentation and health insurance, providers’ access to interpreter services and cultural competency training, and conducting thalassemia screening in convenient settings for migrants will aid thalassemia prevention and control efforts.

• Migrants reported few doctor’s visits and low rates of health insurance utilization.

• What do Thai think about the prevention of thalassemia in migrants?