Background: Equitable access to healthcare is a fundamental human right. However, for many migrant workers, this right remains unattainable due to persistent legal, economic, and social barriers. While socio-environmental determinants of health are increasingly acknowledged, there is limited evidence on how acculturation and social support influence migrant workers’ access to healthcare in low- and middle-income countries. This study examined how acculturation (language proficiency and social interaction) and social support (from family, friends, and third parties) are associated with outpatient care use among Indonesian migrant workers in Malaysia. It also explored whether social support mediates the relationship between acculturation and healthcare access.
Methods: A cross-sectional survey was conducted with 322 Indonesian migrant workers in the Klang Valley region of Peninsular Malaysia from October 2024 to February 2025. Participants were recruited through convenience and snowball sampling methods, with support from community organizations. Analysis involved descriptive statistics and partial least squares structural equation modelling (PLS-SEM).
Results: Most participants were middle-aged, Javanese, Muslim, and had completed secondary education. The majority were documented workers employed in the services sector, with about 8 years of work experience and a monthly income of ringgit Malaysia (RM)1,700. Acculturation and social support showed limited influence on outpatient care use. Better language proficiency was significantly associated with greater support from friends (β=0.198, P=0.02), but it was not linked to support from family or third parties, nor did it predict outpatient care use. No significant mediation effects of social support were observed. However, greater social interaction (β=−0.165, P=0.02) and undocumented status (β=−0.143, P=0.005) were significantly associated with lower use of outpatient care services.
Conclusions: These findings highlight the complex pathways through which socio-environmental factors influence healthcare access for migrant workers. Ensuring equitable healthcare access for migrant workers requires inclusive, affordable health services and culturally responsive policies to build trust and encourage engagement with formal healthcare systems.
