# Effects of internal migration on healthcare services utilization in Bangladesh: an analysis of nationally representative survey

## TL;DR

The study explores how internal migration affects the use of maternal healthcare services in Bangladesh, finding that migrants often use more services than non-migrants, but less than urban non-migrants.

## Contribution

The paper provides novel insights into how different migration streams influence maternal healthcare utilization in Bangladesh using nationally representative data.

## Key findings

- Urban to urban and urban to rural migrants are more likely to use maternal healthcare services than rural non-migrants.
- Migrants of all streams are less likely to use maternal healthcare services compared to urban non-migrants.
- Rural non-migrants are the most disadvantaged group in terms of healthcare service utilization.

## Abstract

Despite the significance of internal migration as an important social determinant of health that could potentially affect the utilization of maternal healthcare services, the magnitude of this relationship by different migration streams is yet to be fully explored in Bangladesh.

This study using Bangladesh Demographic and Health Survey data, 2017–18 examined the effects of different migration streams on maternal healthcare service utilization, particularly four or more antenatal care (≥4 ANC) visits and institutional delivery (ID) care services.

The analysis identified significant variations in using antenatal and institutional delivery care services between migrants and non-migrants. The rural non-migrants were found to be the most disadvantaged group, particularly when different forms of migration streams were considered. For instance, after adjusting for covariates, urban to urban migrants (≥4 ANC = 1.866, p < 0.01; ID = 2.247, p < 0.001) and urban to rural migrants (≥ 4 ANC = 1.24, p > 0.05; ID = 1.689, p < 0.05) were more likely to utilize both types of maternal healthcare services than rural non-migrants. However, migrants of all streams were less likely to use any type of maternal healthcare services when compared against the urban non-migrants.

Addressing the effects of migration in designing and implementing maternal healthcare service delivery programs may address the needs and challenges faced by migrants.