Page 17 - IJPS-10-4

International Journal of
Population Studies Healthcare access and use among rural–urban migrants

mobile health services and the construction of fully 4. Discussion
equipped health centers closer to slum areas (Boateng,
2020). Our review discovered that the majority of well- Most of the reviewed articles focused on internal migrants
resourced health centers are situated in large residential – rural – urban migrants’ access to and utilization of health-
areas, while the few available health facilities in smaller care services in Ghana – examining the institutional, health
system, and socioeconomic factors. Differences in the
communities (slum areas) lack adequate resources, utilization rate of health-care services between different
negatively impacting health-care delivery services, groups show inequity in access to and use of these services
particularly reproductive health services (Owusu & (Rodney & Hill, 2014).
Yeboah, 2018). This review, therefore, suggests the
need for increased government investment in the 4.1. Barriers to accessing and utilizing healthcare
health sector in Ghana. In addition, a study conducted Financial barriers to healthcare were commonly identified
by Boateng et al. (2017) examined the impact of the among internal migrants in Ghana. Despite the financial
political environment on healthcare accessibility, protection the NHIS guarantees, our review found that
especially in meeting the needs of the underserved.
In their view, a clear political commitment to health NHIS users, particularly vulnerable internal migrants, still
had to pay some medical bills, discouraging them from
equity is essential to tackle inequalities in health-care seeking healthcare. It was discovered that due to internal
provision.
(c) Community participation and intensive awareness migrants’ low income levels, they struggle to meet their
basic needs (such as food, shelter, and clothing) and cannot
campaigns afford additional health-care expenses. The authors argued
To enhance the utilization of health services for that internal migrants’ inability to access formal health
internal migrants, two articles (Boateng, 2020; Owusu services was due to their low income. Similarly, evidence
& Yeboah, 2018) reported the need for intensive from the previous studies affirmed that economic status
health awareness campaigns and health outreach is a key social determinant of health (Adjei & Buor, 2012;
programs to change migrants’ cultural orientation Alfers, 2013; Gyasi et al., 2016).
regarding their health-seeking behavior. Our review
identified that the participation of the community Institutional barriers such as physical inaccessibility
in defining problems, planning, implementing, and and inconvenient opening hours at health-care facilities
evaluating community resources makes individuals were other common obstacle for internal migrants to
feel responsible not only for their own health but also access and utilize formal health-care services. It was
for that of others. reported that many internal migrants live in slum areas
(d) Change in behavior of health workers toward clients far from health facilities. The previous studies (Apanga
In terms of health professionals’ attitudes toward & Adam, 2015; Eliason et al., 2014; Farmer et al., 2015;
vulnerable migrants, three articles (Akazili et al., 2018; Fayehun et al., 2022; Ganle et al., 2016; Otu, 2019; Saeed
Owusu & Yeboah, 2018; Teye, 2019) recommended et al., 2016) in other West African countries found similar
the need for behavioral change by introducing regular results with regard to physical barriers to health facilities.
training programs for health professionals on the This violates the WHO’s recommendation of ensuring
principles of healthcare and instituting a feedback that health facilities are located within a 5 km radius of
system through client satisfaction surveys to improve residential communities for quality health-care delivery
health-care delivery services, particularly concerning (World Health Organization, 2018). On the contrary,
patients’ satisfaction. It was, further, reported that the Owusu-Ansah et al. (2016) reported that neither distance
attitude of health workers significantly influenced nor access to transportation hindered participants from
internal migrants’ help-seeking behavior. accessing health facilities for their health needs. However,
(e) Appropriate health technology and culturally their study reported other barriers to healthcare access
appropriate care among internal migrants.
Three articles (Akazili et al., 2018; Lattof, 2017; Owusu Another major obstacle to healthcare access identified
& Yeboah, 2018) suggested the need for adequate in this review was the negative attitude and discriminatory
health resources and equipment, as well as training of behavior of health professionals (Sahile et al., 2019).
staff on culturally appropriate care techniques to work Evidence from other studies (Cooper et al., 2019; Dauvrin
at health-care facilities. Adequate training involves & Lorant, 2014; Jakič & Pavlič, 2016) affirms that this
identifying methods and equipment that facilities can negative attitude not only influences internal migrants’
afford to invest in, ensuring they do not contravene health-seeking behavior but also affects their confidence in
local beliefs and cultural practices. the orthodox health system. The existence of poor attitudes

Volume 10 Issue 4 (2024) 11 https://doi.org/10.36922/ijps.2314