Maternal Health and Access to Healthcare among Migrant Workers Engaged in Informal Construction Work, Ahmedabad, India

Abstract

Background:A large proportion of migrant women in India are employed in the urban informal economy, which is often characterized by low wages, precarious work conditions, poor living conditions and lack of social security. Circumstances such as these have deep implications for the health and overall wellbeing of workers. Our paper focuses on the intersection of migration, informal work and maternal health among female workers in the construction sector. We specifically seek to understand women’s perception and experience of morbidity and examine their ability to seek and access maternal healthcare during pregnancy, childbirth and during the postpartum period.Methods:The field work for this study was undertaken in Ahmedabad, India. We recorded anthropometric measurements and conducted in depth interviews with our primary sample of female migrant workers. We also conducted two focus group discussions (FGDs) with male workers and reached out to other stakeholders.Results:Anthropometric measurements (N=55) suggested that a significant proportion of women (47%) suffered from low BMI (M= 18.36, SD= 1.7). Participants reported that physical ailments, diseases and illnesses were a constant feature of their lives. Women associated morbidity with poor work and living conditions, exposure to pollution and lack of safety measures during work. Women reported working until the last month of pregnancy and returned to work within few weeks of childbirth. Only 32% of the women (N=50) in our study sample had received two or more antenatal care check-ups, 64% had had an institutional delivery and 62% had received postpartum care within two days of childbirth. Women suggested that their access to seek healthcare services in the city was limited due to time constraints, inability to take break from work, irregular wage patterns and lack of familiarity with urban health systems. Pregnant women expressed desire to go to the village for childbirth and postpartum care as there was likely to be familial support for care. Conclusion: Our study finds that informal work conditions and migration have diverse and complex implications for women in need of maternal health care. Future policy needs to take into account particular and peculiar needs of migrant women to address their health needs.

Child Birth Practices and Utilization of Antenatal Care (ANC) Services Among Migrant Tribal Women in Urban Areas of Gujarat

“…This study observed that almost half of the women had made four ANC visits to the hospital or health center. This percentage is lower than the national average of 58% [13] as per NFHS-5 survey and lower than the Gujarat state average of almost 77% [6]. Thus, the ANC coverage was low, but it was still higher than that of the DLHS-3 survey of 2007-08, wherein ANC coverage was just 4%-14% among tribal women in Madhya Pradesh, Rajasthan, Odisha, and Chhattisgarh [14].…”

“…The construction sector relies heavily on short-term migrant workers, offering dual work opportunities to both female and male workers. Female workers are often considered to be ‘helpers’ or ‘less skilled’ due to which they receive less than minimum wages, despite engaging of long hours of laborious and hazardous work [ 6 ].…”

Health Condition of Internal Migrants in India: A Review

“…Ravindranath and Iannotti (2019) in their study based in Ahmedabad reveal that a considerable proportion of women workers (47%) suffered from low BMI. Participants reported that physical ailments, diseases and illnesses were a constant part of their lives.…”