Primary Healthcare Services Among a Migrant Indigenous Population Living in an Eastern Indian City

Babu, B.V.; Swain, Basanta Kumar; Mishra, Suchismita; Kar, Shantanu Kumar

doi:10.1007/s10903-008-9181-z

Cited by 29 publications

(27 citation statements)

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“…Socioeconomically disadvantaged people experience illness considerably compared to their better-off counterparts, the treatment costs are often high and catastrophic for the poor as evident from that the poorest income category had the highest reported illness compared to middle and wealthy income categories and the poor seek healthcare to a less extent (Babu, Swain, Mishra, & Kar, 2010;Herbert, Lee, Chandran, Lee, Chandran, Rudan, & Baqui, 2012;Kusuma, Kumari, & Kaushal, 2013;Kusuma, Kumari, Pandav, & Gupta, 2010;Steinhardt et al, 2009;Wang et al, 2015). The This paper aims to report the treatment-seeking behaviour and treatment costs by the labour migrants in Delhi when challenged with illness.…”

Section: Introductionmentioning

confidence: 99%

The costs of seeking healthcare: Illness, treatment seeking and out of pocket expenditures among the urban poor in Delhi, India

Kusuma

Babu

2019

Health Soc Care Community

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The poor often experience illness and the treatment costs are high and even catastrophic for the poor. This paper reports the extent of illness, treatment‐seeking behaviour and out of pocket healthcare expenditures and the determinants of treatment‐seeking behaviour and healthcare expenditures among the urban poor living in Delhi. A total of 2,998 households participated in the study. Socio‐demographic details, illness experiences (episodic illness in the past 3 months, hospitalisation in the past 1 year and any chronic illness), treatment seeking and healthcare expenditures were collected for all household members through a pretested, interviewer‐administered questionnaire. Logistic regressions were carried out for factors associated with treatment‐seeking choices. Multiple linear regressions were carried for factors associated with out of pocket expenditures (OOPE). Of the total 15,218 household members (of the 2,998 households), 4,052 (26.6%) experienced episodic illness (mainly fever, respiratory illnesses, food‐ and waterborne diseases and eye infections) in the past 3 months, 230 (1.5%) were hospitalised and 976 (6.4%) have chronic illness (mainly hypertension, diabetes, arthritis and respiratory problems). Of the 2,998 households, 2,225 (74.2%) households reported at least one event of illness. Unqualified practitioners were the main source of care for episodic illnesses. Perceived seriousness of the illness, having Employees State Insurance Scheme (ESIS) benefit, higher educational status of the head of the household, higher monthly household incomes, belonging other backward castes and settled‐migrant status led to seeking formal care. Dengue was the main reason for hospitalisation. Government including ESIS hospitals were mainly utilised for hospitalisation. Healthcare expenditures were higher for private healthcare. Possession of mandatory health insurance was protective against OOPEs. OOPEs were more for the men/boys and for the young. Improving access to government healthcare services is important. Extending the ESIS to the unorganised workers including urban poor migrants should be considered so as to bring them under mandatory social protection.

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Section: Introductionmentioning

confidence: 99%

The costs of seeking healthcare: Illness, treatment seeking and out of pocket expenditures among the urban poor in Delhi, India

Kusuma

Babu

2019

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“…Migrant workers seeking employment in urban settings are often from tribal and rural communities with low levels of literacy and skills, making them ignorant about available HIV prevention services resulting in low utilization of these services at the places of destination [2]. A number of studies have documented that migrants have higher risky sexual behaviors than non-migrants [4-12] and that they serve as bridge population for spreading HIV from destination areas to their place of origin [13-16].…”

Section: Introductionmentioning

confidence: 99%

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

et al. 2011

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BackgroundRecent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India.MethodsA cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes.ResultsThe average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex.ConclusionFindings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants’ destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations.

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“…Most of them rely on unqualified medical practitioners and spend huge proportion of their earnings in seeking health care services. (2)…”

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confidence: 99%

Migrants to urban India: Need for public health action

Nitika¹,

Lohiya²,

Nongkynrih³

et al. 2014

Indian J Community Med

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Primary Healthcare Services Among a Migrant Indigenous Population Living in an Eastern Indian City

Cited by 29 publications

References 11 publications

The costs of seeking healthcare: Illness, treatment seeking and out of pocket expenditures among the urban poor in Delhi, India

The costs of seeking healthcare: Illness, treatment seeking and out of pocket expenditures among the urban poor in Delhi, India

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

Migrants to urban India: Need for public health action

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