The DHS Program

Internal Adult Women Migrants' Use and Access to Health Services in 15 DHS Countries (English) 

Document Type

Analytical Studies

Publication Topic(s)

Household and Respondent Characteristics

Country(s)

Benin, Cameroon, Kenya, Liberia, Rwanda, Sierra Leone, South Africa, Tanzania, Uganda, Zambia, Zimbabwe, Bangladesh, Nepal, Philippines, Haiti

Language

English

Recommended Citation

Assaf, Shireen, Naba Raj Thapa, and Jeff Edmeades. 2023. Internal Adult Women Migrants’ Use and Access to Health Services in 15 DHS Countries. DHS Analytical Studies No. 87. Rockville, Maryland, USA: ICF.

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Publication Date

August 2023

Publication ID

AS87

Abstract:

This report uses Demographic and Health Survey data from 15 countries to examine internal migration of adult women age 18–49 between rural and urban areas and its relationship with access to and use of health services. The analysis includes the study of migrants’ characteristics, trends in migration, and the relationship between migrant status and four outcomes related to access and use of health services. These outcomes are having at least four antenatal care visits, using modern contraceptives, having a major problem accessing health care for self due to obtaining money needed for treatment, and having a major problem accessing health care for self due to distance to facility. Migrant status included rural to urban migration and vice versa, while also distinguishing between recent (<3 years) and non-recent (3 to 9 years) migrants. The highest levels of rural to urban migration were found in Nepal, Kenya, Bangladesh, and South Africa (12 to 18%), but there were also high levels of urban to rural migration in Uganda and the Philippines (both at 10%). There were some moderate but statistically significant changes in migration levels as described in the trend analysis. Recent migrants were more likely to be young (age 18 to 24) and not currently in a union, while all migrant types had higher education than rural non-migrants. For the relationship with the outcomes, we find that there were few statistically significant findings for antenatal care (ANC) and modern contraceptive use outcomes. However, when there was statistical significance, the disparities by migrant status were often large, which warrants further country specific research. We also see some evidence of adaptation with disparities found between recent migrants and non-migrants, but no statistically significant difference between non-recent migrants and non-migrants. Overall, the largest and most consistent differences in the outcomes were found between those residing in urban or rural areas, regardless of duration of residence.