Health status of migrant population residing at urban field practice area, Mallasandra, Bangalore - A descriptive study.

INTRODUCTION

Migration is an integral part of population dynamics. According to the National Sample Survey 2007-08, the number of migrant households per 1000 households in India was 33 in urban areas.¹ Due to increase in industrialization and urbanization, migration has been a major cause of population change. The major reason for migration is employment and education. Other reasons for migration of households include forced migration (natural disaster, social/political problem, and displacement by development projects), acquisition of own flat/house, housing problems, health care, post-retirement, marriage and so on.² Migrant population is vulnerable to various health problems. They are at risk of contracting both communicable and non-communicable diseases. Women are more vulnerable to reproductive tract infections, under nutrition and problems related to pregnancy and child birth. Men may indulge in drug and alcohol abuse, smoking which are the major risk factors for various non-communicable diseases and also lead to mental health problems and domestic violence. Children are more susceptible for infections due to incomplete immunization, under nutrition and improper living conditions. Another major factor is stress which arises from displacement and reintegration into the former environment. Poor working and living condition, lack of job security, salary, inability to fulfil their own needs, exploitation by contractors are the other factors which also contribute to stress. Added to this is inadequate utilization of health care services due to decreased awareness about local health facilities

Since migrant population is a risk group, it is important to assess their current health status and design methods to integrate them into the local population.³ Hence, as an initial step in this direction, a study was undertaken with the following objectives:

• To determine the social-demographic and environment factors surrounding migrant population

• To assess their health status

• To determine the utilization of health services among migrant workers residing at Mallasandra.

Materials and Methods

A Descriptive cross sectional study was carried out among migrant population residing in urban field practice area of a teaching medical college hospital, Bengaluru during September to December 2018. The list of areas where migrant population resided was obtained from Medical officer, Urban Health Centre and the areas were identified with the help of Asha worker.

Data was collected using a semi-structured questionnaire and after obtaining informed consent from study participants, each individual in the household was interviewed. Data with respect to their socio-demographic profile, purpose of migration, environmental factors, knowledge regarding available health services and utilization of the same was collected.

Inclusion criteria:

Those who willingly gave consent for participation in the study.

Exclusion criteria :

Those who were not available at home even after 3 visits.

Statistical analysis

The data was entered in MS Excel sheet and analysis was carried out. The result was expressed in the form of descriptive statistics.

The study was carried out following approval by the Institutional Ethical committee.

Result

The present study was carried out among the migrant population residing in the urban field practice area of a teaching medical college hospital. A total of 27 families and 130 individuals were identified. Most of them were in the productive age group of 20-39 years with almost equal male female population. Majority of them were Hindus and 85.2% of them were in BPL category. About 35.3% were illiterate and there was one graduate also. The common work place was either garment factory or construction. The purpose of migration among all the families was for employment.

The environmental living conditions amongst them were highly unsatisfactory. Out of 27 houses, dampness was present in only 4 houses, overcrowding in 19 houses, inadequate ventilation (26 houses), inadequate lighting (26 houses), there was separate kitchen only in 4 houses and none of the houses had smoke vent. Sanitary latrine was present in 4 houses and purification of drinking water was practiced only in one house (boiling). Most of the migrants were apparently healthy. Of the married women aged 19 years and above, 9 (22.5 %) of them gave history of reproductive tract infections in the last one year. Among them only 2 had taken treatment from traditional healers. All the 6 pregnant mothers were utilizing antenatal services from government UHC. Out of 20 children aged < 6years, only 4 of them were enrolled in Anganwadi and utilizing the services provided. One positive aspect was that all the children were immunized till date. None of the study participants aged above 30 years gave history of any chronic illness (hypertension, diabetes mellitus, cardiovascular, cerebrovascular diseases) and none of them had undergone screening for hypertension and diabetes mellitus. Though 60 (77%) adult migrant population were aware of the available health care facilities in their vicinity, only 8 (13.3%) were utilizing the same.

Discussion

In the current study, 43.1% of migrant populations were in productive age group of 19 to 39 years. The male and female ratio was almost the same with predominance of Hindu religion (82.3%). Similar observations were put forth in a study conducted in urban slums of Delhi by Agarwal P etal⁴ . His study showed that majority of migrants were Hindus (61%), aged 24–29 years (44%) but with a literacy rate of 38%. But in a study conducted by Badge VL et al,⁵ majority were Muslims (73%), aged 18–23 years (39%) with 27% illiterates. It appears that the migrants of the present study were aware about the importance of education in everyday life as majority were educated at least up to high school.

The migrant populations were living in totally unhygienic conditions. It is difficult for them to avail the government housing schemes for BPL families as they were migrants and will always be on the move settling down near the place of employment. So, this poses a challenge in implementing any improvement programmes.

The migrant population was apparently healthy as they had never visited any health facility. Even the immunization status of the children was good probably due to increased coverage by Mission Indradhanush. It appeared that women utilized health care services only when they were pregnant probably through the efforts of ASHA workers as none of the women with Reproductive tract infections availed the same.

Ignorance was the main factor hindering the awareness about existing health care services and their utilization. Another reason might be that almost all of them were daily wage laborers who could not afford to lose a single day’s salary. These findings were similar to a study by Heaman M etal⁶ .

Conclusion

The present study revealed apparently healthy migrant population living in unhygienic environmental conditions. The healthy status was due to their ignorance and lack of time to get themselves investigated for any health issues. It also highlights the need to identify bottlenecks in providing them a safe environment to stay, and devise solution not only in this direction but also to initiate awareness programmes in improving the health status of migrants