The purpose of this study is to examine the effect of internal migration on the use of reproductive and maternal health services in Nepal, using data from the 2016 Nepal Demographic and Health Survey. The study population is married women age 15-49. The study used descriptive and logistic regression analysis, with three outcome measures: current use of modern contraception, at least four antenatal care visits, and place of delivery.
Overall, 44% of eligible women reported current use of modern contraception, 71% of women made at least four antenatal visits, and 58% of women delivered their most recent birth in the past 5 years in a health facility. Our findings show that, after adjusting for background characteristics, women who are recent migrants to the current district (arrived 0-4 years ago) have lower odds of using modern contraceptives, higher odds of attending at least four antenatal visits, and higher odds of delivering in a health facility. By migration streams, modern contraceptive use is significantly higher among urban-to-urban migrants and urban non-migrant women. Urban-to-urban migrant women and rural-to-urban migrant women have significantly higher odds of attending at least four antenatal visits for the most recent birth compared with rural-to-rural migrant women. Women who moved between urban areas, women who moved from an urban to a rural area, women who moved from a rural area to an urban area, and urban non-migrants are significantly more likely to deliver in a health facility compared with women who moved between rural areas.
Several socioeconomic and demographic factors are also significant in their association with contraceptive use, antenatal visits, and place of delivery. These differences by internal migration status should be considered in reproductive and maternal health services interventions.
KEY WORDS: Migration, migration streams, migrant, non-migrant, contraceptive use, antenatal care, duration of stay, place of delivery