Internal Migration and Maternal Healthcare Services Utilization in Bangladesh

Background: Despite the significance of internal migration as an important social determinant of health that could potentially affect the utilization of maternal healthcare services, the magnitude of this relationship is yet to be fully explored in the context of different types of migration streams in Bangladesh. This study aims to examine the effects of internal migration on antenatal and institutional delivery care service utilization in Bangladesh.

Methodology: Analysing data from the 2017-18 Bangladesh Demographic and Health Survey, this study has examined a group of 3453 migrant women between the ages of 15-49 who sought maternal healthcare services after migrating and gave birth within the last three years, as well as 554 non-migrant women who also gave birth within the same time frame. Chi-square test as well as simple and multiple binary logistic regression is conducted to quantify the effects of migration on maternal healthcare service utilization (MHCSU). Two indicators of MHCSU, at least 4 ANC utilization (≥4 ANC) and institutional delivery (ID), are used in this study.

Result: Both of the MHCSU indicators differ among migrants and non-migrants, particularly when different categories of migration streams are considered, where the rural non-migrants are the most disadvantaged group. Urban to urban migrants (ID=OR=2.247, p<0.001; ≥4 ANC=1.866, p<0.01; ID=OR=2.247, p<0.001) and migrants from urban areas (ID=OR=1.689, p<0.05; ≥ 4 ANC= 1.24, p>0.05) are found to be utilizing more maternal healthcare than rural non-migrants. However, when compared against the urban non-migrants, all migrants of all streams are found to be utilizing less maternal healthcare.

Conclusion: The findings contribute to a comprehensive understanding of migration by stream on maternal healthcare services utilization in the context of Bangladesh. To develop effective maternal healthcare service utilization programs, it is essential to account for the variations in usage of health services by migration stream which will help programs to be designed to effectively cater to the unique needs and challenges faced by migrant populations.