DEMAND, SUPPLY AND ACCESS TO HEALTH SERVICES: PERCIEVED BARRIERS AND OPPERTUNITIES IN MIGRANT SLUMS
The third millennium could be characterized as an era of migration. The relation between migration and health is complex. Slum dwellers (Migrants) in cities suffer from adverse health conditions owing to uneven distribution of services including clinics and health care personnel.
Objectives:
- To determine the demographic and socio-economic characteristics of the migrant communities.
- To assess the availability, accessibility, affordability and acceptability of the existing system of healthcare delivery to the migrants, in view of distinct features of migrants.
- To assess the provider’s perception regarding barriers in availability and access.
METHODS:
Of the total urban population of Aligarh, 52.42% resides in slums. A cross sectional study with both quantitative and qualitative research methods was used to study the newer slum pockets (<=10 years establishments). A total of 3409 households were studied with the help of questionnaires, FGD s and Interviews. Atlas Ti and SPSS 17 were used for statistical analysis.
RESULTS:
A large majority of the subjects had migrated for livelihood (94.6%). Government health facilities were used by only 5.3% migrants, reason being barriers like, illiteracy, poverty, lack of information and dissatisfaction. Environmental conditions were uniformly poor. Health system (personnel) perceived that community have to face lots of problems because of their migrant status and lack of awareness about services provided by the government.
CONCLUSIONS:
Newly migrated families living in slums constitute a high risk group. There is a need to improve their access to health services. Effort must be made to remove barriers like lack of knowledge and information. An integrated approach to development, water and sanitation is essential.
Perception and attitude of health providers needs improvement, along with participatory approach of all stakeholders and community participation.
Acknowledgements (Indian Council of Medical Research, New Delhi
)