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THAILAND
Civil Society Report on the Implementation of the CEDAW(Replies to the List of Issues CCPR/C/THA/Q/2)
For the Review of the Eight Periodic Report of Thailand (CCPR/C/THA/8)
At the 91 session of the Human Rights Committee
(Geneva – June-July 2025)
“Restrictions on the Right to Equitable Access to Fundamental Health Protection”
Submitted by:Human Rights and Development Foundation (HRDF[1]) Migrant Working Group (MWG[2])
Contact: info@hrdfoundation.org and contact@mwgthailand.org
Thailand, 15 May 2025
Content
- Background on Thailand’s Implementation of the Convention
on the Elimination of All Forms of Discrimination against Women (CEDAW) - Definitions and Challenges
a. Definition of Equitable Access to Health Services
b. Identified Challenges and Barriers
c. Recommendations - Critical Issues
- Conclusion
I. Background on Thailand’s Implementation of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)
Thailand acceded to the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) on 9 August 1985 and formally ratified the Convention on 14 September of the same year. This accession marked a significant milestone, demonstrating the Thai State’s commitment to promoting and protecting women’s rights in accordance with international human rights standards.
However, at the time of ratification, the Thai government entered several reservations to key provisions, particularly those relating to family law and nationality, reflecting conflicts between certain Convention obligations and the prevailing domestic legal framework. Subsequently, the government displayed increased political will and gradually withdrew most of these reservations. Notably, in 2012, Thailand withdrew its reservation to Article 16, which concerns equality between men and women in marriage and family relations. Currently, Thailand maintains a reservation solely to Article 29, which pertains to the settlement of disputes between States Parties through the International Court of Justice.
Since acceding to CEDAW, Thailand has been obligated to submit periodic reports on the status of women’s rights and has participated in constructive dialogues with the CEDAW Committee. The State has received recommendations aimed at fostering the development of laws, policies, and measures that advance gender equality and protect women’s rights. Despite progress in several areas, implementation at the policy and operational levels continues to face challenges, particularly regarding social inequalities, such as ensuring non-discriminatory access to health services for all population groups.
II. Definitions and Challenges
a. Definition of Equitable Access to Health Services
Equitable and non-discriminatory access to health services constitutes a fundamental principle of international human rights law, as recognized in key instruments such as the Universal Declaration of Human Rights (UDHR), the International Covenant on Economic, Social and Cultural Rights (ICESCR), and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), to which Thailand is a State party. Within the context of Thailand, although the Universal Health Coverage (UHC) system has expanded general access to healthcare services for the population, significant equity gaps persist in access for vulnerable groups, including migrant workers, ethnic minorities, persons with disabilities, sexual and gender minorities, and women in marginalized areas. These disparities arise from legal and registration status issues, language barriers, discriminatory attitudes among healthcare personnel, and bureaucratic structures that fail to accommodate the diversity of service users.
Thailand’s 8th Periodic Report to CEDAW (2011–2023) provides an overview of progress and ongoing challenges in achieving equitable access to health services:
Paragraph 117: The Ministry of Public Health issued a ministerial regulation on health screening of non-Thai nationals, enabling migrant workers outside the social security system to access annual health insurance. Regarding other protections for migrant workers, the Thai government has promoted inter-ministerial cooperation to uphold migrant workers’ rights based on human rights principles. It has also maintained continuous collaboration with international organizations to facilitate migrant worker registration and access to assistance for both documented and undocumented migrant workers. Paragraph 119: Public health services are provided to all individuals without discrimination based on sex, ethnicity, religion, or culture, in accordance with the right to health of each person. For those without entitlement to formal healthcare schemes, humanitarian assistance is provided by hospitals consistent with human rights principles.
b. Identified Challenges and Barriers
In Thailand’s 8th Periodic Report under CEDAW (2011–2023), progress and challenges related to equitable access to health services were outlined, notably in paragraphs 117 and 119, which indicate Thailand’s advancement in improving health service access for migrant workers. However, during the reporting period, the Foundation continues to observe discriminatory barriers to equitable healthcare access that contravene fundamental human rights principles.
In 2022, the mother of a one-year-old girl, a migrant worker in Thailand, sought to purchase health insurance for her child at a hospital. The hospital staff refused to sell the insurance card, citing the child’s congenital heart valve defect as a health condition. This decision represented an unlawful exercise of administrative discretion unsupported by legal criteria. Such conduct violates the principle of equitable health rights for migrant workers’ dependents under Section 7 of the 2019 Ministerial Regulation on Health Screening and Health Insurance for Migrant Workers, which forms part of the government’s approach to managing migrant workers from Myanmar, Laos, and Cambodia. The regulation requires health screening of workers and dependents before enrollment in the public health insurance scheme, screening for prohibited diseases including leprosy, active tuberculosis, tertiary syphilis, drug addiction, and chronic alcoholism. Congenital heart valve defects are not listed among prohibited conditions, and thus, refusal to grant health insurance coverage on this basis constitutes an arbitrary and unlawful administrative decision that infringes upon the fundamental human right to equal access to healthcare.
In 2024, a pregnant migrant worker seeking to renew her health insurance card was denied coverage after hospital staff identified her pregnancy. Consequently, she was unable to access health insurance benefits and had to pay out-of-pocket for childbirth-related medical expenses. When unable to pay, her identity documents were confiscated as collateral. The child born to the uninsured mother also faces barriers to healthcare access in case of illness. Within the broader context of migrant labor management in Thailand, the discretionary power exercised by state officials remains a critical mechanism that directly impacts workers’ rights and well-being—particularly regarding access to essential health and social protection services such as health screening and insurance. Although these procedures have been re-regulated under the 2019 Ministry of Public Health Regulation on Health Screening and Health Insurance for Migrant Workers, originally designed to control communicable diseases and promote public safety, its implementation is marked by inflexibility and lacks grounding in human rights standards. The absence of transparent and equitable criteria has led to discriminatory practices and corruption, resulting in the denial of access to essential health services even in urgent cases. When migrant workers are unable to access health insurance or are denied hospital services due to their legal status, lack of acceptable identity documentation, or discretionary rejection by officials, they become completely uninsured, rendering them a “double vulnerable” group at heightened risk of discrimination from both the state and society. Furthermore, exclusion from health insurance coverage means they cannot access treatment for communicable diseases with broader public health implications, such as tuberculosis, HIV, and other infectious diseases.
C. Recommendations
The promotion of health rights for migrant workers constitutes a critical issue within the broader context of human rights and social equity, particularly in countries such as Thailand with a significant migrant labor population. The development of a health insurance system for migrant workers that closely parallels the Universal Health Coverage (UHC) scheme should be actively promoted as a concrete policy measure. A key recommendation is to enable migrant workers enrolled in the health insurance system to access services at any public hospital nationwide, rather than being restricted to the specific healthcare facilities listed on their health insurance cards as is currently practiced. This approach would alleviate travel constraints and enhance flexibility in accessing essential health services on a continuous basis, particularly in cases of emergency or when migrant workers relocate. Concomitantly, there should be the development of an integrated health information system connecting all public healthcare facilities across the country, ensuring that migrant workers’ health data is accessible in a unified manner comparable to the system operated by the National Health Security Office (NHSO) for Thai citizens. Such an interconnected system would enable healthcare providers to promptly and accurately access patient histories, diagnoses, and entitlements, thereby improving the quality of care and reducing administrative redundancies. These measures collectively represent a significant enhancement of the health rights of migrant workers, promoting equity and compliance with international human rights obligations.
III. Critical Issues
Civil Society Replies to the Issues identified in the LOI
General Comment (1)The Committee requests that the State party provide disaggregated data and statistical information by sex, age, disability, ethnicity, nationality, geographic location, and socio-economic background concerning the current status of women within the State party. Such data is essential for effectively monitoring progress in the implementation of the Convention, in line with the State party’s obligations under Articles 1 and 2 of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), as well as Target 5.1 of the Sustainable Development Goals (SDGs), which aims to end all forms of discrimination against women and girls everywhere. The Committee further requests that the State party clarify whether it has adopted a national plan or strategy to improve the collection and analysis of data relevant to issues under the scope of the Convention. This data should serve to inform evidence-based policymaking, the development of targeted programs, and the assessment of progress in the implementation of the Convention, thereby promoting substantive equality between women and men, including in relation to the specific thematic concerns addressed in this report.
The Thai government, through the responsible ministry, has published monthly statistics on the registration of non-Thai nationals in the labor force on its official website. These disaggregated data categorize workers by sex, skill level, and legal status, including stateless persons and migrant workers from neighboring countries—namely Myanmar, Lao PDR, Cambodia, and Vietnam. As of the latest data, the total number of non-Thai workers registered is 3,391,217, comprising 1,892,925 men and 1,498,292 women. The three primary sectors employing the highest number of migrant workers from these countries are:
- Construction: 664,829 workers (including 246,283 women),
- Agriculture and Livestock: 282,591 workers (146,330 women), and
- Service sector: 260,803 workers (147,934 women).
- In addition, there are 134,135 domestic workers, of whom 115,437 are women.
The Human Rights and Development Foundation (HRDF) expresses concern regarding approximately 2,381,166 migrant workers, the majority of whom—approximately 2 million—are of Myanmar nationality, whose work permits and visas expired in February 2025. While the Thai government has allowed for the renewal of work permits and visas, it imposed a condition requiring migrant workers to exit the Kingdom or travel to designated locations for reprocessing, with the country of origin (Myanmar) required to verify personal data and reissue documentation under its own procedures.
However, due to the deteriorating political situation in Myanmar—including compulsory military conscription, burdensome travel costs, mandatory taxation of 2% of migrant workers’ wages by the Myanmar military junta, and bureaucratic delays in document processing—these workers, including a significant number of women, have been unable to proceed with the required administrative steps. As a result, the Thai Cabinet issued a resolution extending the renewal deadline to August 2025, yet the delay continues to adversely affect migrant workers’ employment security, access to health insurance, and personal safety, while increasing their risk of indebtedness—an underlying factor contributing to situations of forced labor.
Moreover, the Ministry of Labour has not published updated statistics on the implementation of the policy allowing migrant workers to register their dependents residing in Thailand. This omission makes it impossible to determine how many accompanying children—particularly girls—are able to access fundamental rights such as public health services and education, both of which are essential to prevent child labor exploitation.
Although monthly data on non-Thai nationals is published, HRDF notes that the Ministry of Labour has not integrated data on migrant workers covered by social security and health insurance schemes into a unified database. Discrepancies have been identified between the number of migrant workers employed in sectors where legal registration under the Social Security Act is required and those actually enrolled in the social security and health insurance systems. This data fragmentation leaves many migrant workers—especially women—in a legally and administratively vulnerable position, hindering their ability to exercise the right to social protection and equal access to public services.
Recommendation
The State should adopt policies that facilitate the timely and secure registration of migrant workers by establishing one-stop service centers. These centers would ensure the availability of accurate and disaggregated data that align with actual labor market demands, including data on registered dependents. Furthermore, the State should integrate and publicly report the number of migrant workers enrolled in the social security and public health insurance systems. Such measures would enhance equitable access to health and social protection, consistent with international human rights and labor standards.
| Trafficking in Persons and the Exploitation of Prostitution 10; With reference to the Committee’s previous concluding observations (CEDAW/C/THA/CO/6-7, paragraph 25), the State party is requested to clarify whether it has established a National Referral Mechanism (NRM) for the identification, protection, and assistance of victims of trafficking that is consistent with international standards and frameworks. The Committee further requests detailed information on the measures taken to: (a) Address the root causes of trafficking in women and girls, including economic vulnerability, gender inequality, and lack of legal status; (b) Ensure the early identification of victims, appropriate referral to assistance services, and access to comprehensive rehabilitation and social reintegration programs. The State should guarantee the non-criminalization of victims and provide adequate protection regardless of their ability or willingness to cooperate with law enforcement or prosecutorial authorities; (c) Prosecute and impose appropriate penalties on traffickers and all individuals involved, including state officials complicit in trafficking-related activities; (d) Strengthen international, regional, and bilateral cooperation in the prevention of trafficking in persons, in accordance with international obligations and human rights standards. |
In 2024, two girls, aged 12 and 14, were sent to work as hired laborers at a food establishment, where they were subjected to confinement and physical abuse, constituting acts consistent with the criminal offence of trafficking in persons. The victims were formally identified through the victim screening process and were immediately referred to a government-run shelter for victims of trafficking for protection and assistance.
However, the judicial proceedings in the case experienced significant delays, taking over nine months from the time the victims entered protective custody to the initiation of trial proceedings. This prolonged delay had serious psychological impacts on the child victims, exacerbated by restrictions on communication with their parents and administrative barriers related to documentation proving legal guardianship or family relationship, which prevented family members from visiting the children during the protection period.
Recommendation:
To prevent and mitigate such harm in the future, it is recommended that the State strengthen and expedite mechanisms for handling trafficking in persons cases, particularly those involving children and adolescents. This should be accompanied by the enhancement of child protection measures, ensuring a comprehensive approach that includes psychosocial rehabilitation, access to education, and preparation for social reintegration in accordance with the best interests of the child.
| Education 15: Case study – The Committee requests information on measures taken by the State party to ensure that girls have access to education at all levels, and to eliminate barriers that hinder their enrolment in non-traditional fields of study. The State party is further requested to provide details on targeted measures adopted to support girls belonging to vulnerable and marginalized groups who face intersectional discrimination based on poverty, disability, ethnicity, sexual orientation (including lesbian and bisexual identities), gender identity (including transgender persons), intersex status, religion, or migrant status. In addition, the Committee requests information on: (d) Investigations conducted into attacks on educational institutions, and the outcomes of such investigations, including any accountability measures taken. |
Following the circulation of a video clip by a foreign tourist depicting a migrant worker community and a migrant learning center in Phuket Province, a wave of online hate speech and xenophobic discourse was directed against the migrant community and their dependents via social media platforms. The response by government authorities failed to prevent or counteract the negative stereotyping and stigmatization of migrant workers and their children. Instead, on 17 March 2025, the authorities proceeded with the closure of one migrant learning center in the province. This action has had a direct adverse impact on the education rights of over 300 dependent children, including girls, who are now deprived of access to education during their critical developmental years. The closure contradicts Thailand’s national education policy, which affirms that all children, regardless of nationality or legal status, are entitled to access education. Migrant learning centers serve as alternative education institutions that are widely relied upon by migrant worker families due to barriers related to language, documentation, and administrative restrictions that often hinder access to public education for non-Thai children.
Recommendation
The State should issue an immediate moratorium on the closure of migrant learning centers and urgently conduct a nationwide assessment of such centers with the objective of formally registering them with the Ministry of Education. This would support the development of an appropriate and inclusive education system for all children. Concurrently, all public schools should be instructed to enroll non-Thai children in accordance with existing Ministry of Education regulations, ensuring access to education without discrimination. Additionally, a coordinated mechanism should be established between formal schools and migrant learning centers to facilitate language readiness and transitional support for children who are not yet proficient in the Thai language.
Employment 16; With reference to the Committee’s previous concluding observations (CEDAW/C/THA/CO/6-7, paragraph 37), the State party is requested to provide information on measures undertaken to eliminate all forms of discrimination against women in the workplace. The Committee also urges the State party to take concrete steps to ratify key International Labour Organization (ILO) Conventions, including:
– ILO Convention No. 190 (2019) concerning the elimination of violence and harassment in the world of work;
– ILO Convention No. 87 (1948) concerning freedom of association and the protection of the right to organize;
– ILO Convention No. 98 (1949) concerning the right to organize and collective bargaining; and
– ILO Convention No. 189 (2011) concerning decent work for domestic workers.
Thailand has ratified seven core international human rights treaties and 20 International Labour Organization (ILO) Conventions, along with one protocol. However, there remain two fundamental ILO Conventions which Thailand has yet to ratify: ILO Convention No. 87 (Freedom of Association and Protection of the Right to Organise, 1948), and ILO Convention No. 98 (Right to Organise and Collective Bargaining, 1949).
Under the First National Action Plan on Business and Human Rights (2019–2022), Thailand committed only to exploring the feasibility of ratifying Convention No. 98. The Second National Action Plan (2023–2027) expanded this framework to include consideration of the ratification of both Conventions Nos. 87 and 98.
The Migrant Workers Network has noted that in November 2023, the Ministry of Labour established a tripartite working group—comprising representatives of the government, employers, and workers—to drive the ratification process of both Conventions. The working group subsequently passed a resolution recommending that the government proceed with ratification. A proposed timeline was developed, including steps for domestic legal reform, particularly to amend the current Labour Relations Act, and to complete the ratification of both Conventions by April 2025.
Nevertheless, as of now, there has been no substantive progress either on amending domestic labor legislation in line with international standards or on formal ratification. As a result, migrant workers continue to face significant barriers to exercising freedom of association and collective bargaining, since the existing Labour Relations Act restricts the right to establish or serve as a union officer to Thai nationals only. This restriction constitutes a violation of Thailand’s obligations under international human rights law, particularly the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights (ICESCR), and the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD)—all of which Thailand has ratified. In addition, the government has not demonstrated any tangible progress or inclusive consultation regarding the development of a timeline or roadmap for the ratification of ILO Convention No. 189 (Decent Work for Domestic Workers, 2011) or ILO Convention No. 190 (Elimination of Violence and Harassment in the World of Work, 2019).
Accordingly, as a founding member of the International Labour Organization since 1919, Thailand must urgently undertake the necessary legal and institutional reforms to ratify the remaining core ILO conventions without further delay.
Economic and social benefits 18; Taking into account that the current social security system covers only certain segments of the labor market, the Committee requests the State party to provide information on the steps taken to expand social security coverage to all workers, with particular emphasis on migrant women workers, including those in the informal sector and women outside the formal labor market. The Committee further requests details on measures implemented to ensure that stateless women have equitable and comprehensive access to all necessary social and economic services.
The Network has observed that the Social Security Act B.E. 2533 (1990) and the Workmen’s Compensation Act B.E. 2537 (1994) are accompanied by subordinate legislation, ministerial notifications, and administrative guidelines that effectively exclude certain categories of employees from access to social security protections and workmen’s compensation benefits. This discriminatory treatment particularly affects seasonal workers in the agricultural and fisheries sectors, domestic workers, and undocumented migrant workers.
The Human Rights and Development Foundation (HRDF) has initiated litigation before domestic courts to establish legal precedents safeguarding equal access to workmen’s compensation benefits under the relevant legislation, irrespective of nationality or legal status. In 2015, the Supreme Administrative Court issued a landmark ruling affirming the principle of equal protection for all workers, including migrant workers, who suffer injury, death, or disappearance in the course of employment.
However, migrant workers continue to face significant challenges in accessing these remedies. A recent case brought by HRDF against the Social Security Office of Chiang Mai Province and the Workmen’s Compensation Fund Committee involved the latter’s refusal to recognize the entitlement of the deceased worker’s heirs to compensation from the Fund. The Committee argued that because the employer had failed to register with the Fund, liability for compensation rested solely with the employer.
Both the Trial Court and the Court of Appeal ruled against this position, holding that the Social Security Office’s internal directive, Document No. รง 0607/ว987 dated 31 May 2012, which requires migrant workers to possess registration evidence and a valid work permit or lawful entry authorization (in accordance with a Cabinet resolution of 13 February 2012) to be eligible for compensation from the Fund, was unlawful. The courts ordered the revocation of the Social Security Office’s decision and the Fund Committee’s ruling and mandated that compensation be paid from the Fund to the deceased migrant worker’s widow as rightful heir.
Despite this ruling, over five years have passed without the heirs receiving compensation, as the Social Security Office and Fund Committee continue to challenge the Court of Appeal’s decision before the Supreme Court.
Accordingly, the Social Security Office must adhere to the principle of equal protection for all workers and refrain from applying discriminatory criteria based on length of employment, employment type, or legal status when granting access to social security and workmen’s compensation benefits.
Additional Recommendations 25; The Committee requests that the State party prepare and submit any additional relevant information concerning legal, policy, administrative, or other measures undertaken to comply with the provisions of the Convention and the Committee’s previous concluding observations since the last periodic review in 2017. Such measures may include newly enacted legislation, recent developments, plans, programs, and ratification of human rights instruments, as well as any other information the State party deems pertinent.
IV. Conclusion
Access to Health Rights for Migrant Workers: Policy Gaps and Challenges to Thailand’s CEDAW Obligations
Although Thailand has ratified the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and consistently expressed its commitment to promoting women’s rights and gender equality, significant barriers persist in practice regarding the access of migrant women workers and their children to health services, particularly within the context of the health insurance system. These barriers stem from policy limitations, structural deficiencies, and the discretionary practices of state officials.
Case studies from 2022 and 2024 illustrate that migrant workers continue to face unlawful discrimination within the public health system, including being denied the right to purchase health insurance cards and being unable to access childbirth services free of charge. This is despite the principles enshrined in the 2019 Ministerial Regulation on Health Insurance for Migrant Workers, which ostensibly provides for such rights. These circumstances reveal a failure to fulfill Thailand’s international obligations, notably the object and purpose of CEDAW, which mandates the elimination of discrimination and the promotion of substantive health equality for all women.
[1] Since 2005, HRDF has been working to promote and protect rights of migrant workers by providing legal assistance, facilitating strategic litigations, promoting human rights education and awareness about existing laws and policies and initiating advocacy campaigns. The specific focus of HRDF’s work has been on the eradication of discrimination against migrant workers, and HRDF has been working closely with domestic and international trade unions, the National Human Rights Commission of Thailand, the Lawyer Council of Thailand, Law Reform Commission of Thailand and international organizations
[2] MWG is a network of non-governmental organizations working on health, education and migrant workers’ rights. The MWG aims to exchange information among a migrant workers network, analyze problems, set agendas and conduct campaign and advocacy activities with state sector, academic sector and civil society sector for migrant workers’ fundamental rights in order that they can have a better quality of life.
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