AN EXPLORATORY STUDY OF HEALTH SEEKING BEHAVIOR

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AN EXPLORATORY STUDY OF HEALTH SEEKING BEHAVIOR
REPRODUCTIVE HEALTH PROBLEMS OF MIGRANT WOMEN
CONSTRUCTION WORKERS, MUMBAIShubha Nagesh,
Mumbai, India
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Migration into Maharashtra Mumbai
MUMBAI
Reference Census of India, 2001
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Source www.census.gov.in
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Reproductive Health Status of migrant women is
important because

• Substantial share of the total population
• Young, with migration and reproduction
• often taking place at the same stage of
• life
• Migrant women carry a disproportionate
• burden of accommodating into the new
• urban environment- living conditions
• deteriorate, affects their reproductive
• health status

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Factors influencing health care utilization of
migrant women Reproductive Health Problems of
migrant womenBarriers to utilization of
reproductive health services
Research Objectives
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Methodology

• Exploratory and Qualitative
• Face-to-Face In-depth interviews with 20 migrant
  women construction workers
• Criteria for selection Women migrants
• Mumbai in the last five years,
• Reproductive age group (18-40 years),
• Borne at least one child, and
• Volunteered to take part in the interview

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Methodology
Illiterate/ Basic schooling Backward
Classes Associational migrants (moved to Mumbai
after marriage) Reason for employment
supplement the meagre household earnings
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Findings

• Perceptions of Health and Illness
• Reproductive health problems
• Health seeking behaviour
• Barriers to seeking Health Services

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Perceptions of Illness
Illness not an issue Perceived need for
services small actual need is great Perception
of health Freedom from pain and stress,
Ability to be functional, Perform well at
work Social networks important- determined
health seeking behavior Visit health
facilities- Illness severe (unable to
work) Preference for Private Practitioners
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Reproductive Health Problems
Common presentations Back ache, excessive white
discharge Related to maternal health within the
context of marriage Women feared seeking help
due to the stigma attached Did not seek
treatment for reproductive morbidity!!
Gynaecological checkups- accompanied by
husband/ women relatives Reproductive health
decisions were not made by the women
themselves
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Health Seeking Behaviour
Decisions for health Time, Money, Service fees,
Transport, Distance, Work schedule, Social
network perceptions, familiarity with the health
systems, etc Urban infrastructure- Challenge to
the migrant population Power equations in
households determined most health decisions
Social networks with their kin, seemed to
impact healthcare decisions, including when and
where to seek treatment for their health
problems. Crucial determinant Perceived
severity of illness
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Barriers to Treatment

• Cost of medical care
• Distance to the facility
• Availability of affordable transport
• Constant mobility
• Non familiarity with the health systems
• Hesitation- avoid having internal examinations,
  especially by male doctors
• Diagnosis treatment is a difficult and long
  process!!

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Factors responsible for Reproductive morbidity

• Living conditions Poor housing
• Limited sanitation
  facilities
• Inadequate diet
• Overcrowded living
  conditions
• Working conditions Occupational health hazards
• Lack of toilets
  washing facilities
• Carrying heavy
  loads at work
• Lack of rest
• Inadequate education awareness regarding
  reproductive health

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Recommendations

• Role of Government outreach programs
• Migrant Health Care Clinics
• Mobilize train migrant women- effective and
  acceptable agents of change
• Active participation by migrant communities
• Protect migrant women construction workers
  empower them- networks of information and social
  support

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• Welfare programs financed by the employers or
  contractors
• Welfare facilities like rest rooms, crèches,
  medical doctor, mobile dispensary, etc
• 90 days of maternity leave with full pay
• Alternative work for women during and after
  pregnancy
• Reduction in working hours
• Provision of personal protective equipment

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Conclusion

• Reproductive health, neglected and ignored
• Poor utilization of reproductive health services
• Views are rooted in culture migration
  experiences health care providers should create
  health care environments accordingly
• Breaking down barriers through sustained action,
  establishment of policies and processes that
  ensure easy access, research on specific migrant
  health challenges, promotion of culturally
  appropriate health habits.