Page 18 - IJPS-10-4

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

has further endangered the lives of patients, especially migrants are unaware of these possible implications or are
internal migrants, who are already in a precarious condition indifferent to their impact. Furthermore, most internal
with regard to healthcare access (Cooper et al., 2019). migrant rely on divine intervention or religious beliefs as
their source of relief for health ailments. This observation
It was, further, revealed that the absence of qualified
translators increased the risk of internal migrants receiving agrees with scientific arguments that spirituality has a
improper care or being unable to follow physicians’ positive impact on health behaviors (Kharitonov, 2012;
instructions. This lack of translation services echoes Unterrainer et al., 2014). However, despite the positive
observations in other studies, which revealed that language influence of spirituality on general well-being, it may lead
barriers threaten physicians’ communication with their to undetected sicknesses without proper healthcare and
patients and affect their ability to give adequate medical may influence migrants to forego needed medical care or
advice (Floyd & Sakellariou, 2017; Woofter & Sudhinaraset, refuse life-saving procedures (Saeed et al., 2016; Thomson
2022). In addition to obvious cultural barriers such as et al., 2015).
language differences, there are also invisible cultural Moreover, internal migrants in Ghana were found to
barriers, including gender influence, body language, notions use monies from their savings or borrow to meet their
of modesty, rules of conduct, gestures, and childbearing health needs. This strategy is also prevalent in other African
practices, which have been proven to influence a person’s low- and middle-income countries such as Zambia, Cote
perception and approaches to healthcare (Woofter & d’Ivoire, and Chad (Etiaba et al., 2015). Although this
Sudhinaraset, 2022). As this review finds, gender influence approach helps internal migrants pool money to cover
and childbearing practices influence internal migrants’ health-care costs, it may worsen their future well-being
behavior toward seeking reproductive health-care services as it leads to further impoverishment (Badurdeen et al.,
in Ghana. Often, cultural differences are overlooked in 2013). In this regard, they compromise future financial
their role in healthcare delivery, disregarding the fact that returns and well-being, suffering food insecurity, poor
they can cause misunderstandings between patients and nutrition, child labor, and reduced resilience against
health professionals. These misunderstandings reiterate poverty.
the importance of considering patients’ diverse cultural Another coping strategy adopted by internal migrants
values in healthcare delivery and planning (Ferdous et al., is taking a break from work to recover from illness without
2020; Moyer et al., 2013; Robertshaw et al., 2017). taking any specific medication. A similar coping strategy
Moreover, this review demonstrates a widespread lack is found among female migrant domestic workers in
of awareness of NHIS guidelines and exemptions, such as Singapore (Markova & Sandal, 2016; Van Bortel et al.,
free maternal healthcare for internal migrants who work 2019). This strategy allows internal migrants to avoid the
as head porters. The NHIS has been one of the key drivers financial and physical burdens of accessing healthcare.
for promoting universal access to affordable and equitable
healthcare, irrespective of socioeconomic background. 4.3. Potential interventions to improve healthcare
However, the high level of ignorance and illiteracy poses a access and utilization
threat to achieving these goals and undermines the NHIS’s A well-functioning health system is crucial for bridging
ability to remove financial barriers to healthcare (Alhassan health inequity gaps and achieving “Health for All” and
et al., 2016). This lack of awareness highlights the relevance “Healthy People 2030” targets, which seek to improve the
of health campaigns and awareness creation, as proposed health and well-being of all populations (Atun, 2012). This
by Dzúrová et al. (2014), who argue that there is no health review highlights key interventions to improve access to
equity without awareness. and utilization of healthcare for internal migrants. The
implementation of mobile health services and NHIS
4.2. Coping strategies of internal migrants for their registration vans was cited as relevant strategies to help
health needs meet the needs of populations in slum and deprived
Our review found that self-diagnosis and self-medication communities. Findings support this argument, revealing
are common strategies among internal migrants. They rely that the use of mobile vans greatly helps to identify and
on local chemists, drug peddlers, traditional healers, and meet the health needs of people in slum areas (Atun,
local herbs brought from the north. Scientific evidence 2012). Evidence from a previous study (Sorensen et
suggests that such practices could complicate their health al., 2019) revealed that many health professionals lack
status, as self-medicating may lead to drug addiction, allergy, adequate training in cultural competence in medical
incorrect diagnosis and dosage, disability, or premature practice. Therefore, it is important for health managers and
death (De Sanctis et al., 2020). However, many internal policymakers to prioritize this area.

Volume 10 Issue 4 (2024) 12 https://doi.org/10.36922/ijps.2314