城市环境中无家可归妇女在产前自我报告的健康状况和医疗保健利用率方面的差异：移民身份是否重要？

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Migration and Health Pub Date : 2024-01-01 DOI:10.1016/j.jmh.2024.100246

Margubur Rahaman , Kailash Chandra Das

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引用次数: 0

摘要

背景对无家可归、移民和孕产妇健康之间关系的研究有限。然而，大多数无家可归的妇女都是移民，并且有高风险的生育行为。因此，本研究以移民身份为重点，探讨了无家可归妇女产前健康和医疗保健行为的差异。定量研究采用时间和地点抽样法（TLS）和面对面访谈法进行横断面定量调查。此外，还通过有目的抽样的深度访谈收集了定性数据。描述性统计、使用皮尔逊卡方检验的双变量分析和多变量逻辑模型对定性结果进行了估计。结果在 400 名受访者中，76% 是移民，57% 报告性健康和生殖健康状况不佳。移民性健康和生殖健康状况不佳的可能性是非移民的 1.07 倍。乞丐和拾荒者性健康和生殖健康状况不佳的可能性更高。同样，独居受访者（主要是移民）中也普遍存在这种情况。近 80% 的移民报告患有抑郁症。在研究人群中，未得到满足的医疗就诊需求相当大（41%），而在移民中这一需求尤为突出（51%）。一些个人、社会经济和结构性因素被认为是利用医疗保健服务的障碍。在无家可归的移民妇女中，公共和私人医疗保健服务不足。一些个人、社会经济和结构性因素影响了医疗保健的使用。这项研究强调，迫切需要引入以人口为中心的计划和政策，以促进无家可归妇女的生殖健康。

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Differentials in self-reported health status and healthcare utilization among homeless women during the antenatal period in urban settings: Does migration status matter?

Background

Limited studies have covered the nexus between homelessness, migration, and maternal health. However, most homeless women are migrants and have high-risk fertility behaviors. Therefore, the present study examines the variation in antenatal health and healthcare behavior among homeless women, focusing on migration status.

Methods

The present study employed a mixed-methods approach. A cross-sectional quantitative survey using Time and Location sampling (TLS) and face-to-face interviews was carried out for the quantitative component. Further, qualitative data was gathered through in-depth interviews using purposive sampling. Descriptive statistics, bivariate analysis with the Pearson chi-square test, and multivariate logistic models estimated qualitative results. Further, the thematic analysis presented qualitative findings.

Results

Out of 400 respondents, 76 % were migrants, and 57 % reported poor SRH. The likelihood of poor SRH was 1.07 times higher among migrants than non-migrants. A higher likelihood of poor SRH was found among beggars and ragpickers. Similarly, it was prevalent among the respondents who lived alone, mainly migrants. Almost 80 % of migrants reported experiencing depression. The unmet need for health visits was substantial among the study population (41 %), and it was found to be noteworthy among migrants (51 %). Several individual, socioeconomic, and structural factors were identified as barriers to healthcare utilization.

Conclusion

Poor antenatal health was substantial among homeless women, mainly migrants. Public and private healthcare visits were inadequate among homeless women who were migrants. Several individual, socioeconomic, and structural factors affected healthcare utilization. The study highlights the urgent need to introduce population-centric programs and policies to promote reproductive health among homeless women.

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