Characteristics and reproductive health needs of female 'Rural to Urban' migrants in Zambia

Abstract

Background Rural-to-urban migration has been a powerful trend in developing countries. When people migrate from rural to urban areas, they face problems of dislocation and need to adapt to new, often difficult surroundings. Consequently, they face many risks to their health, including their reproductive health. Few published analyses of DHS data have examined how migrants from rural areas differ from other residents in urban areas in their demographic and socioeconomic characteristics and reproductive health needs. In Zambia, little is known of the reproductive intentions, knowledge regarding contraceptive use, and access to and use of existing reproductive health services of rural-to-urban migrants. We undertook this study to examine these issues.

Methods Use was made of data from a sample of 8021 women aged 15-49 who were interviewed in the 1996 ZDHS. 1050 urban non-migrants and 247 recent rural-to-urban migrants were distinguished, from among the 3001 urban residents, by a standard answer regarding length of time spent in the current residence. Data on these migrants had not previously been published. Recent rural-to-urban migrants were those who had migrated to the urban area less than 4 years ago. Information regarding personal characteristics, reproductive history, knowledge and use of family planning methods, antenatal and delivery care and fertility preferences was extracted from the 1996 ZDHS data set, analyzed and compared between the two groups: urban non-migrants and recent rural-to-urban migrants. Analysis utilised standard descriptive and comparative statistical methods (Student's t test and the Z statistic to show differences between groups).

Results The two groups differed in their personal characteristics and reproductive health behaviour. There were more illiterate women (42% vs 32%; p< 0.01) and fewer women with secondary or higher education (26% vs 47%; p<0.01) among recent rural-to-urban migrants. Knowledge of individual contraceptive methods (4.6% vs 5.3%; p=0.001), contraceptive prevalence rate (17% vs 22%; p<0.05) and the percentage of women who approved of family planning use were significantly lower among recent rural-to-urban migrants compared to urban non-migrants. Recent migrants were more likely than urban non-migrants to deliver at home without assistance from medically trained personnel (42% vs 23%; p<0.01). On average, recent migrant women considered a larger family size ideal compared to non-migrant urban women (4.84 vs 4.44; p<0.05).

Conclusion This study highlights the need to consider recent rural-to-urban migrants as a distinctly disadvantaged group that need to be targeted when planning appropriate improvements in reproductive health services of urban areas.