Migration and its influence on the knowledge and usage of birth control methods among Afghan women who stay behind

Husband's migration status and contraceptive behaviors of women: evidence from Middle-Ganga Plain of India

BACKGROUND

Male out-migration is negatively associated with contraceptive use in developing countries. This study aimed to examine the effect of male out-migration on the contraceptive behaviour of women in the Middle-Ganga Plain (MGP) region.

METHODS

The data has been collected from the Middle-Ganga Plain survey (2018-19), which was conducted by the International Institute for Population Sciences (IIPS). The overall sample size was 1314 wives left behind and 1402 non-migrant wives. Multivariate logistic regression analysis was used to examine the relationship between the variables. Statistical analyses were done using SPSS version 25.

RESULT

The result shows that female sterilization was the most common method used by both left behind wives (30.9%) and non-migrant wives (34.6%). Most of the left-behind women didn't use contraception because their husbands were away from home (30.86%). The result also shows that left behind wives were less likely to use any methods of contraception than the non-migrant wives. Left behind women were more tended to use the modern methods (OR-0.71, 95%CI = 0.57-0.88) than any traditional methods (OR-0.61, 95% CI = 0.46-0.80). Age, religion, family type, working status, and marital duration were strongly associated with women's contraceptive use.

CONCLUSION

These results strengthen the existing literature that explains how migration affects women's health. Therefore, there is an important need to develop and implement comprehensive education programs and policy on contraception use.

Economic Drivers of Voluntary Return among Conflict-Induced Internally Displaced Persons in Nigeria

North-East Nigeria is recovering from a decade of terrorism by Boko Haram during which the region collapsed socioeconomically and millions were displaced. The displaced live in various camps in Adamawa, Borno, and Yobe States, and serve as the primary source of data for this research. The Nigerian government has expressed their desire for the displaced to return home following peace restoration to the region. Their unwillingness to return despite the perceived gains of reintegration prompted this research to examine economic determinants of willingness for reintegration. Logistics regression results show a strong positive influence of having an assurance of finding employment back home on the willingness for reintegration. The results further suggest that displaced persons are 14 times more willing to return home when the government guarantees employment. To encourage willingness for reintegration, the authors recommend that displaced persons be empowered economically through the provision of jobs upon their return to their various home communities. Recommendations for the Nigerian government and interested parties are presented with suggestions to expand social institutions and their collaboration with the government.

Effects of spousal migration on access to healthcare for women left behind: A cross-sectional follow-up study

Background

Women left behind by migration represent a unique and growing population yet remain understudied as key players in the context of migration and development. Using a unique longitudinal survey of life in Bangladesh, the Matlab Health and Socioeconomic Surveys, we examined the role of spousal migration in healthcare utilization for women. The objective of this study was to assess realized access to care (do women actually get healthcare when it is needed) and consider specific macrostructural, predisposing, and resource barriers to care that are related to migration.

Methods and findings

In a sample of 3,187 currently married women, we estimated multivariate logistic and multinomial regression models controlling for a wide range of baseline sociodemographic factors measured as far back as 1982. Our analyses also controlled for selection effects and explored two mechanisms through which spousal migration can affect healthcare utilization for women, remittances and frequent contact with spouses. We found that women with migrant spouses were approximately half as likely to lack needed healthcare compared to women whose spouses remained in Bangladesh (predicted probability of not getting needed healthcare 11.7% vs. 21.8%, p<0.001). The improvements in access (logistic regression coefficient for lacking care for left-behind women -0.761 p<0.01) primarily occurred through a reduction in financial barriers to care for women whose spouses were abroad.

Conclusions

Wives of international migrants showed significantly better access to healthcare even when accounting for selection into a migrant family. While the overall story is one of positive migration effects on healthcare access due to reductions in financial barriers to care, results also showed an increase in family-related barriers such as not being permitted to get care by a family member or travel alone to a facility, indicating that some of the benefits of migration for women left behind may be diluted by gendered family structures.

Transnational social networks, health, and care: a systematic narrative literature review

While transnational social ties and exchanges are a core concern within migration studies, health researchers have often overlooked their importance. Continuous and circular exchanges of information within transnational networks, also defined as social remittances, facilitate the diffusion of innovations, potentially driving contemporary social and cultural change. Influences on health, wellbeing, and care-seeking are important, but under-researched, dimensions for consideration. We undertook a systematic narrative evidence synthesis to describe the current state of knowledge in this area and to identify gaps and future directions for health researchers to take. Between April 2017 and May 2019, an iterative series of searches in Medline, Embase, PsycINFO and PubMed, plus backward and forward citation searches identified 1173 potential papers. Screening resulted in 36 included papers, eighteen focused on migrant populations and eighteen on those who remain behind. The top three health topics were health-seeking strategies, sexual and reproductive health issues, and healthcare support. And, while not always explicitly identified, mental health and wellbeing was a further prominent, cross-cutting theme. Articles on migrant populations were all conducted in the global North and 13 out of 18 used qualitative methods. Five main themes were identified: therapeutic effect of the continuing social relationships, disrupted social relationships, hybridisation of healthcare, facilitation of connections to healthcare providers, and factors encouraging or undermining transnational social exchanges. Papers concerned with those who remain behind were mainly focused on the global South and used a mix of qualitative and quantitative approaches. Four main themes were identified: transnational transfer of health-related advice, norms, and support; associations between migrant linkages and health behaviours/outcomes; transnational collective transfer of health knowledge; and power and resistance in exchanges. Findings suggest that transnational social exchanges can both support and undermine the health of migrants and those who remain behind. This review confirms that the volume and quality of research in this area must be increased so that health policy and practice can be informed by a better understanding of these important influences on the health of both migrants and those who remain behind.

Why women do not use contraceptives: Exploring the role of male out-migration

Introduction

Contextual understanding of reasons for non-use of contraceptives is key to devising family planning (FP) strategies. This study aimed to understand the reasons for non-use of contraceptives among women in the context of male out-migration.

Methods

Focus Group Discussions (FGDs) were conducted in two high male out-migration districts in Bihar, namely Nawada and Gopalganj. Twenty-five FGDs were conducted with currently married women with migrant husbands, currently married men and Accredited Social Health Activists (ASHAs) during April-June 2019. Data were analysed by using a thematic approach through Atlas.ti-6.2.

Results

The reasons for contraceptive non-use in areas with high male out-migration were complex, as this included barriers to contraceptive use unique to high-migration areas and reasons commonly found in other rural settings. Non-use of contraceptives among women with migrant husbands was mostly driven by lack of contraceptive preparedness before husband’s arrival, inability to procure contraceptives due to inaccessibility to health facilities and stigma to procure when husband was away. Other migration environment related factors included low ASHA outreach, myths and side effects of contraceptives, community fertility norms and poor spousal communications around FP.

Conclusion

The reasons for non-use of contraceptives are multifaceted, complex and interlinked. Exploration of these reasons in migration context suggest that FP programs in migration affected areas need to address a range of barriers to contraceptive use at multiple levels.