Access to health care among internal migrants in Chhattisgarh, India: critical perspectives on the question of health equity and urban development

Abstract

Purpose Migrants face some unique health-care challenges, which often remain unaddressed by the health system. The purpose of this study is to determine health-care access among migrants in Chhattisgarh, from a lens of health equity. Design/methodology/approach This study was conducted in a government-built tenement under the Integrated Housing and Slum Development program in Bilaspur district of Chhattisgarh state of India. It is a mixed-methods study which used a survey method, focus group discussion, in depth-interviews, semi-structured interviews and non-participant observations of health facilities in the area. Respondents included residents (migrants) and other local stakeholders like the Chief Medical Officer of the district, elected representatives of the local government and frontline health workers. This paper focuses on the findings from the qualitative component of the study. Findings The move to resettle the people living in the slums to the periphery of the city had a negative impact on their health-care access. They find it difficult to access public health services, given the services are concentrated in the city. Women, elderly people and disabled people grapple with additional challenges in being able to access basic reproductive health services and care for chronic illnesses. Equity in health-care access is linked to various social determinants of health including access to housing and social security. However, the authors found that the migrant community is being deprived of appropriate housing facilities and social security. Originality/value This paper explores the health-care access of internal migrants in Chhattisgarh state of India in the larger context of urban development with a focus on health equity.