Leaving No One Behind: Statelessness and the Sustainable Development Goals ! G) Thailand: inequalities in access to health care revealed by comprehensive survey data In 2001, the Thai government introduced a subsidized “30-baht plan” for universal access to health care. To participate in the programme, a person must present identity documents proving Thai citizenship in order to receive a card that then allows them to obtain basic health services for a fixed fee of 30 baht, or roughly $0.88. The programme reached nearly 14 million people who had previously been uninsured, yet roughly 4.4 per cent of the population still lacked health insurance. A primary reason that people were denied access to the 30-baht plan was a lack of documentary proof of Thai citizenship. The effects of this denial are magnified for groups that already had other vulnerabilities, such as children and women of childbearing age. For example, the rate of child malnutrition is much higher among “hill tribe” children, more likely to be stateless, than it is for their urban peers. These children also tend to have comparatively high rates of conditions associated with nutritional deficiencies, such as scabies, diarrhoea, and lung infections. Lack of nationality was also linked to women and girls being denied access to reproductive health services.113 In 2005 and 2010, UNESCO supported two mixed-method research surveys in the Thai Highlands, known to host many stateless people, in order to assess barriers to documentation or acquisition of citizenship, as well as inequalities associated with a lack of citizenship documents. The first Highland Peoples’ Survey (HPS I) surveyed more than 60,000 people in nearly 200 villages in 3 provinces; HPS II surveyed more than 70,000 people representing 18 ethnic groups in over 300 villages in 5 provinces. Analysing the data from the surveys in relation to health care, it was possible to show that: “Indigenous and ethnic minority peoples, as well as people who experience precarious legal status and statelessness, disproportionately experience poor health outcomes as well as relatively low access to reliable and appropriate health-care services … The HPS data shows why the omission of stateless, indigenous and ethnic minority peoples from censuses matters for those populations when it comes to characterizing access to health-care services in the entire population of a country or region, as well as the critical importance of gathering ethnically disaggregated data. The study and its findings illustrate the ongoing need for pairing survey data with ethnographic research to design strategies that address the complex and heterogeneous reasons these populations experience barriers to essential health-care services.”114 113. Lindsey N Kingston, Elizabeth F Cohen, and Christopher P Morley, “Limitations on universality: the ‘right to health’ and the necessity of legal nationality”, BMC International Health and Human Rights 10, No. 1 (2010): 11, https://doi.org/10.1186/1472-698X-10-11. 114. Amanda Flaim et al., “The UNESCO highland peoples surveys: tracing inequalities in health care access and provision in northern Thailand”, Journal of Health Science and Alternative Medicine 3 (2021): 30–42, https://doi.org/10.14456/JHSAM.2021.10. 36