Advertisement

Association of Time since Migration from Rural to Urban Slums and Maternal and Child Outcomes: Dhaka (North and South) and Gazipur City Corporations

  • Abdur Razzaque
  • Kimberly ClairEmail author
  • Brian Chin
  • Mohammad Zahirul Islam
  • Mohammad Nahid Mia
  • Razib Chowdhury
  • AHM Golam Mustafa
  • Randall Kuhn
Article
  • 62 Downloads

Abstract

This study analyzes data from a new Urban Health and Demographic Surveillance (UHDSS) in five slums in Dhaka (North and South) and Gazipur City Corporations to examine the relationship between migration status and maternal and child health service utilization. Migration status was determined by duration in urban slums (<= 9.99 years, 10–19.99 years, 20+ years, and urban-born). Compared to those born in the city, migrants were characterized by significant disadvantages in every maternal, neonatal, and child health (MNCH) indicator under study, including antenatal care, facility-based delivery, doctor-assisted delivery, child immunization, caesarean-section delivery, and use of modern contraceptives. We found that the level of service coverage among migrants gradually converged—but did not fully converge—to that of the urban-born with increasing duration in the city. We observed a strong positive association between wealth and total MNCH coverage, with a more modest association with higher levels of schooling attainment. Women who were engaged in market employment were less likely to receive adequate coverage, suggesting a tradeoff between livelihood attainment and mother-and-child health. After controlling for these socioeconomic and neighborhood variations in coverage, the duration gradient was diminished but still significant. In line with existing studies of healthcare access, this study highlights the persistent and widespread burden of unequal access to maternal and child health care facing migrants to slum areas, even relative to the overall disadvantages experienced in informal settlements.

Keywords

Maternal and child health Rural-urban migration Dhaka Bangladesh 

Notes

Funding information

The study was funded by the Government of the People’s Republic of Bangladesh, Local Government Division, Ministry of Local Government, Rural Development and Cooperatives, Embassy of Sweden and Asian Development Bank. icddr,b gratefully acknowledges these donors for their support and commitment to the Centre’s research effort. icddr,b is grateful to the Government of Bangladesh, Canada, Sweden, and the UK for providing core unrestricted support.

Supplementary material

11524_2019_395_MOESM1_ESM.docx (19 kb)
ESM 1 (DOCX 18 kb)
11524_2019_395_MOESM2_ESM.docx (26 kb)
ESM 2 (DOCX 26 kb)
11524_2019_395_MOESM3_ESM.docx (32 kb)
ESM 3 (DOCX 31 kb)

References

  1. 1.
    Afsar R. International migration and the development nexus: the case of Bangladesh. Regional Conference on Migration, Development and Pro-Poor Policy Choices in Asia, June 22–23 (2003). Dhaka, Bangladesh.Google Scholar
  2. 2.
    Al-Shoaibi AAA, Matsuyama A, Md K, et al. Perceptions and behavior related to noncommunicable diseases among slum dwellers in a rapidly urbanizing city, Dhaka, Bangladesh: a qualitative study. Nagoya J. Med. Sci. 2018;80(4):559–69.  https://doi.org/10.18999/nagjms.80.4.559.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Hossain S. Rapid urban growth and poverty in Dhaka city. Bangladesh e-J Sociol. 2008;5(1):57-80.Google Scholar
  4. 4.
    United Nations Development Programme [UNDP]. Bridging the urban divide in Bangladesh: towards a strategic approach to urban poverty reduction. Dhaka, Bangladesh; 2010.Google Scholar
  5. 5.
    Kuhn R. Internal migration: developing countries. Int Encyclopedia Soc Behav Sci. 2015:433–42.  https://doi.org/10.1016/B978-0-08-097086-8.31120-5.CrossRefGoogle Scholar
  6. 6.
    Kuhn R. Identities in motion: Social exchange networks and rural- urban migration in Bangladesh. Contrib Ind Sociol. 2003;37(1-2):311–37.CrossRefGoogle Scholar
  7. 7.
    Haque MS. Migration trends and patterns in South Asia and management approaches and initiatives. Asia-Pac. Popul. J. 2005;20(3):39–57.CrossRefGoogle Scholar
  8. 8.
    Palloni A, Morenoff JD. Interpreting the paradoxical in the Hispanic paradox: demographic and epidemiologic approaches. Ann. N. Y. Acad. Sci. 2006;954(1):140–74.  https://doi.org/10.1111/j.1749-6632.2001.tb02751.x.CrossRefGoogle Scholar
  9. 9.
    Lu Y. Test of the ‘healthy migrant hypothesis’: a longitudinal analysis of health selectivity of internal migration in Indonesia. Soc. Sci. Med. 2008;67(8):1331–9.  https://doi.org/10.1016/j.socscimed.2008.06.017.CrossRefPubMedGoogle Scholar
  10. 10.
    Nauman E, VanLandingham M, Anglewicz P. Migration, urbanization and health. In: White MJ, editor. International Handbook of Migration and Population Distribution, vol. 6; 2016. p. 451–64.Google Scholar
  11. 11.
    Ginsburg C, Bocquier P, Béguy D, Afolabi S, Augusto O, Derra K, et al. Healthy or unhealthy migrants? Identifying internal migration effects on mortality in Africa using health and demographic surveillance systems of the INDEPTH network. Soc. Sci. Med. 2016;164:59–73.  https://doi.org/10.1016/j.socscimed.2016.06.035.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Srinivasan S, Ilango P. Occupational health problems of women migrant workers in Thogamalai, Karur district, Tamil Nadu, India. SSRN J. 2013;2(2):21–6.Google Scholar
  13. 13.
    Li ML, Morrow M, Kermode M. Vulnerable but feeling safe: HIV risk among male rural-to-urban migrant workers in Chengdu, China. AIDS Care. 2007;19(10):1288–95.  https://doi.org/10.1080/09540120701402855.CrossRefPubMedGoogle Scholar
  14. 14.
    Nauman E, VanLandingham M, Anglewicz P, Patthavanit U, Punpuing S. Rural-to-urban migration and changes in health among young adults in Thailand. Demography. 2015;52(1):233–57.  https://doi.org/10.1007/s13524-014-0365-y.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Abas MA, Punpuing S, Jirapramukpitak T, Guest P, Tangchonlatip K, Leese M, et al. Rural–urban migration and depression in ageing family members left behind. Br. J. Psychiatry. 2009;195(1):54–60.  https://doi.org/10.1192/bjp.bp.108.056143.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Islam MM, Gagnon AJ. Use of reproductive health care services among urban migrant women in Bangladesh. BMC Womens Health. 2016;16(1):15.  https://doi.org/10.1186/s12905-016-0296-4.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kusuma YS, Kumari R, Kaushal S. Migration and access to maternal healthcare: determinants of adequate antenatal care and institutional delivery among socio-economically disadvantaged migrants in Delhi, India. Trop Med Int Health. 2013;18(10):1202–10.  https://doi.org/10.1111/tmi.12166.CrossRefPubMedGoogle Scholar
  18. 18.
    Gawde NC, Sivakami M, Babu BV. Utilization of maternal health services among internal migrants in Mumbai, India. J Biosoc Sci. 2016;48(6):767–96.  https://doi.org/10.1017/S0021932016000195.CrossRefPubMedGoogle Scholar
  19. 19.
    Schwartz SJ, Unger JB, Lorenzo-Blanco EI, Des Rosiers SE, Villamar JA, Soto DW, et al. Perceived context of reception among recent Hispanic immigrants: conceptualization, instrument development, and preliminary validation. Cultur Divers Ethnic Minor Psychol. 2014;20(1):1–15.  https://doi.org/10.1037/a0033391.CrossRefPubMedGoogle Scholar
  20. 20.
    Zulu EM, Beguy D, Ezeh AC, et al. Overview of migration, poverty and health dynamics in Nairobi City’s slum settlements. J. Urban Health. 2011;88(S2):185–99.  https://doi.org/10.1007/s11524-011-9595-0.CrossRefPubMedCentralGoogle Scholar
  21. 21.
    Adams AM, Islam R, Ahmed T. Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh. Health Policy Plan. 2015;30(Suppl 1):i32–45.  https://doi.org/10.1093/heapol/czu094.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Kamal N, Curtis S, Hasan MS, Jamil K. Trends in equity in use of maternal health services in urban and rural Bangladesh. Int. J. Equity Health. 2016;15(1):27.  https://doi.org/10.1186/s12939-016-0311-2.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Ezeh A, Oyebode O, Satterthwaite D, Chen YF, Ndugwa R, Sartori J, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet. 2017;389(10068):547–58.  https://doi.org/10.1016/S0140-6736(16)31650-6.CrossRefPubMedGoogle Scholar
  24. 24.
    Shafique S, Bhattacharyya DS, Anwar I, Adams A. Right to health and social justice in Bangladesh: ethical dilemmas and obligations of state and non-state actors to ensure health for urban poor. BMC Med Ethics. 2018;19(S1):46–69.  https://doi.org/10.1186/s12910-018-0285-2.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    de Snyder VNS, Friel S, Fotso JC, Khadr Z, Meresman S, Monge P, et al. Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action. J. Urban Health. 2011;88(6):1183–93.  https://doi.org/10.1007/s11524-011-9609-y.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Jolly SP, Rahman M, Afsana K, Yunus FM, Chowdhury AMR. Evaluation of maternal health service indicators in urban slum of Bangladesh. PLOS ONE. 2016;11(10):e0162825.  https://doi.org/10.1371/journal.pone.0162825.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    McNab S, Freedman L. Maternal newborn health and the urban poor: a global scoping. July 2016. https://www.mailman.columbia.edu/sites/default/files/pdf/amdd-urban-mnh-report_july-20-2016-final-report.pdf. Accessed May 24, 2019.
  28. 28.
    van de Vijver S, Oti S, Oduor C, Ezeh A, Lange J, Agyemang C, et al. Challenges of health programmes in slums. Lancet. 2015;386(10008):2114–6.  https://doi.org/10.1016/S0140-6736(15)00385-2.CrossRefPubMedGoogle Scholar
  29. 29.
    van der Heijden J, Gray N, Stringer B, et al. ‘Working to stay healthy’, health-seeking behaviour in Bangladesh’s urban slums: a qualitative study. BMC Public Health. 2019;19(1):600.  https://doi.org/10.1186/s12889-019-6750-0.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Ndugwa RP, Cleland J, Madise NJ, Fotso J-C, Zulu EM. Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi urban slums. J. Urban Health. 2011;88(S2):341–55.  https://doi.org/10.1007/s11524-010-9452-6.CrossRefGoogle Scholar
  31. 31.
    Govindaraj R, Raju D, Secci F, Chowdhury S, Frere J-J. Health and nutrition in urban Bangladesh: social determinants and health sector governance. Washington DC, USA; The World Bank; 2018.Google Scholar
  32. 32.
    Mannan MA. Burden of disease on the urban poor: a study of morbidity and utilisation of healthcare among slum dwellers in Dhaka City. Bangladesh Institute of Development Studies: Dhaka, Bangladesh; 2018.Google Scholar
  33. 33.
    Angeles G, Ahsan KZ, Streatfield PK, El Arifeen S, Jamil K. Reducing inequity in urban health: have the intra-urban differentials in reproductive health service utilization and child nutritional outcome narrowed in Bangladesh? J. Urban Health. 2019;96(2):193–207.  https://doi.org/10.1007/s11524-018-0307-x.CrossRefPubMedGoogle Scholar
  34. 34.
    Smith Greenaway E, Leon J, Baker DP. Understanding the association between maternal education and use of health services in Ghana: exploring the role of health knowledge. J. Biosoc. Sci. 2012;44(6):733–47.  https://doi.org/10.1017/S0021932012000041.CrossRefGoogle Scholar
  35. 35.
    Fotso J-C, Ezeh A, Madise N, Ziraba A, Ogollah R. What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya. Matern Child Health J. 2009;13(1):130–7.  https://doi.org/10.1007/s10995-008-0326-4.CrossRefPubMedGoogle Scholar
  36. 36.
    Moyer CA, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reprod. Health. 2013;19(40)  https://doi.org/10.1186/1742-4755-10-40.
  37. 37.
    Singh S, Sahu D, Agrawal A, Vashi MD. Ensuring childhood vaccination among slums dwellers under the National Immunization Program in India: challenges and opportunities. Prev. Med. 2018;112:54–60.  https://doi.org/10.1016/j.ypmed.2018.04.002.CrossRefPubMedGoogle Scholar
  38. 38.
    Cotton C. Migration and young women’s access to maternal healthcare in sub-Saharan Africa. Health & Place. 2019;55:136–44.  https://doi.org/10.1016/j.healthplace.2018.12.006.CrossRefGoogle Scholar
  39. 39.
    Kusuma YS, Kaushal S, Garg R, Babu BV. Birth preparedness and determinants of birth place among migrants living in slums and slum-like pockets in Delhi, India. Sex Reprod Healthc. 2018;16:160–6.  https://doi.org/10.1016/j.srhc.2018.04.004.CrossRefPubMedGoogle Scholar
  40. 40.
    Crocker-Buque T, Mindra G, Duncan R, Mounier-Jack S. Immunization, urbanization and slums: a systematic review of factors and interventions. BMC Public Health. 2017;17(1):556.  https://doi.org/10.1186/s12889-017-4473-7.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Essendi H, Mills S, Fotso J-C. Barriers to formal emergency obstetric care services’ utilization. J. Urban Health. 2011;88(2):356–69.  https://doi.org/10.1007/s11524-010-9481-1.CrossRefGoogle Scholar
  42. 42.
    Anyait A, Mukanga D, Oundo GB, Nuwaha F. Predictors for health facility delivery in Busia district of Uganda: a cross sectional study. BMC Pregnancy Childbirth. 2012;12(1):132.  https://doi.org/10.1186/1471-2393-12-132.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Moran AC, Choudhury N, Uz Zaman Khan N, et al. Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study. BMC Pregnancy Childbirth. 2009;9(1):54.  https://doi.org/10.1186/1471-2393-9-54.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Kimani-Murage EW, Norris SA, Mutua MK, et al. Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study. J. Dev. Orig. Health Dis. 2016;7(2):172–84.  https://doi.org/10.1017/S2040174415007941.CrossRefPubMedGoogle Scholar
  45. 45.
    Razzaque A, Chowdhury R, Mustafa AHMG. Making slums visible: slums and their dynamics in urban Bangladesh. In: Hossain, et al., editors. Slum health in Bangladesh: insights from health and demographic surveillance. International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; 2019. p. 7–25.Google Scholar
  46. 46.
    Razzaque A, Chowdhury R, Mustafa AHMG. The context of slums in Bangladesh. In: Hossain, et al., editors. Slum health in Bangladesh: insights from health and demographic surveillance. International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; 2019. p. 26–53.Google Scholar
  47. 47.
    Clair K, Razzaque A, Islam MZ, Mia MN, Chowdhury R, Mustafa AHMG, et al. Identifying reproductive health coverage gaps for rural- vs. urban-born household heads in the slums in and around Dhaka City, Bangladesh. In Health and Socio-demographic Scenario: Slums of Dhaka (N & S) and Gazipur City Corporations. International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; 2019.Google Scholar

Copyright information

© The New York Academy of Medicine 2019

Authors and Affiliations

  1. 1.International Centre for Diarrheal Disease Research, Bangladesh, Health System and Population Studies DivisionDhakaBangladesh
  2. 2.Department of Community Health SciencesUniversity of California, Los Angeles, Fielding School of Public HealthLos AngelesUSA
  3. 3.Asian Development BankManilaPhilippines
  4. 4.Embassy of SwedenDhakaBangladesh

Personalised recommendations