Study on sexual and reproductive health behaviors of unmarried female migrants in China

Barriers to sexual health-seeking behaviors for Chinese women

PURPOSE

Cognitive barriers to Chinese women's sexual health-seeking behaviours remained unclear. Therefore, we conducted this study to investigate the characteristics of the sexual health beliefs of Chinese women to clarify why they were reluctant to seek help for sexual issues.

METHODS

An online survey was undertaken from April to July 2020.

RESULTS

A total of 3443 valid responses were gleaned (the effective rate was 82.6%), the participants of which were mainly Chinese urban women of childbearing age. Up to 66.0% (n=2271, the standardized rate was 66.8%~73.4%) felt ashamed of sexual health-related disorders. Most women (49.4%, n=1700) were strongly motivated to seek help for sexual issues but also had a great psychological impediment. Women with low motivation and a great psychological impediment were rare (6.4%, n= 219).

CONCLUSIONS

The shame of sexual health-related disorders was the main barrier to sexual health-seeking behaviours for Chinese women, which should be given enough attention in related health services and sexual education.

Characteristics of Chinese women in need of enhanced sexual health attention and at risk of hypoactive sexual desire disorder

BACKGROUND

The target population for women's sexual health services in China was unclear. To identify high-risk individuals with psychological barriers to sexual health-seeking behaviors and those at high risk of hypoactive sexual desire disorder (HSDD), we investigated correlates of Chinese women's unwillingness to communicate sexual health, the shame of sexual health-related disorders, sexual distress, and HSDD.

METHODS

An online survey was conducted from April to July 2020.

RESULTS

We received 3443 valid responses online (effective rate 82.6%). Participants were mainly Chinese urban women of childbearing age (median 26 years old, Q1-Q3 23-30). Women who knew little about sexual health knowledge (aOR 0.42, 95%CI 0.28-0.63) and were ashamed (aOR 0.32-0.57) of sexual health-related disorders were less willing to communicate sexual health. Age (aOR 4.29, 95%CI 2.26-8.17), low income (aOR 1.52-2.11), family burden (aOR 1.34-1.43), and living with friends (aOR 1.39, 95%CI 1.02-1.91) were independent correlates of women's shame about sexual health-related disorders while living with a spouse (aOR 0.66, 95%CI 0.51-0.86) or children (aOR 0.77, 95%CI 0.62-0.96) were correlated with less shame. Age (aOR 0.98, 95%CI 0.96-0.99) and a postgraduate degree (aOR 0.45, 95%CI 0.28-0.71) were linked with less sexual distress of low sexual desire while having children (aOR 1.38-2.10), intense work pressure (aOR 1.32, 95%CI 1.10-1.60) and heavy family burden (aOR 1.43, 95%CI 1.07-1.92) increased women's odds of having distress. Women with a postgraduate degree (aOR 0.42, 95%CI 0.19-0.90), more knowledge about sexual health (aOR 0.53-0.67), and decreased sexual desire caused by pregnancy, recent childbirth, or menopausal symptoms (aOR 0.60, 95%CI 0.41-0.85) were less likely to have HSDD, while they were more likely to have HSDD when their decreased sexual desire was due to other sexual issues (aOR 2.56, 95%CI 1.84-3.57) and partners' sexual problems (aOR 1.72, 95%CI 1.23-2.39).

CONCLUSION

Sexual health education and related services need to focus on psychological barriers of women with older age, insufficient knowledge of sexual health, intense work pressure, and poor economic conditions. The medical staff need to pay attention to the sexual health of women with intense work or life pressure and a history of gynecological disease. Low sexual desire is not equal to the sexual desire problem, which should be noticed in the future.

"Every Medicine Is Somewhat Poisonous": Understanding the reluctance to use oral contraceptives among unmarried women seeking abortion in China

OBJECTIVES

In this study, I examined the low uptake of oral contraceptives (OCs) in China and the factors affecting the reluctance among unmarried Chinese women seeking abortion to use OCs to prevent unintended pregnancies.

STUDY DESIGN

I conducted ethnographic and participant observation in multiple medical facilities and interviewed 62 women who were seeking or had had an abortion between 2013 and 2017 in a coastal city in east China. I analyzed data regarding the women's perceptions and experiences of using OCs through a thematic analysis approach.

RESULTS

The women reported fear of side effects, including infertility, weight gain, and mental health issues and their view on traditional Chinese medicine further validated their skepticism toward Western medicine. Discouragement from male partners and a lack of sexual and reproductive education also caused their hesitancy and misunderstandings of OCs.

CONCLUSIONS

This study contributes to a more nuanced understanding of the barriers to OC use in China. It resonates with existing studies that associate the reluctance to use OCs with the fear of side effects and highlights the influence of sociocultural specificities and couple interactions in shaping contraceptive use.

IMPLICATIONS

Tackling premarital abortions is one of the priorities of the Chinese government in the face of the population crisis. Service providers and educators should understand unmarried women's reluctance to use OCs and provide comprehensive sexuality education and postabortion counseling services to women and men to dispel culturally specific misconceptions.

A structural equation modeling of reproductive health promoting behaviors among female adolescents in the Philippines

AIMS

Integrated reproductive health promoting behaviors, including safe sexual intercourse, preventing sexually transmitted diseases, sexual responsibility, and genital health management, are essential for adolescents in developing countries. The Philippines is currently facing several reproductive health threats. The aim of this study was to identify factors affecting reproductive health promoting behaviors based on a theoretical model using structural equation modeling.

METHODS

In this cross-sectional study and a structural equation modeling, a total of 227 female adolescents in the Philippines participated in a self-reported questionnaire survey.

RESULTS

The results indicated that reproductive health knowledge (β = .14, p = .033), attitudes regarding reproductive health behaviors (β = .31, p = .027), and reproductive health self-efficacy (β = .31, p = .002) influenced participants' reproductive health promoting behaviors. Social norms (β = .31, p = .021) influenced reproductive health self-efficacy and indirectly influenced reproductive health promoting behaviors. Attitude toward gender roles (β = .20, p = .020) was associated with reproductive health knowledge.

CONCLUSIONS

This study confirmed the direct effect of reproductive health knowledge, attitudes regarding reproductive behaviors, and reproductive health self-efficacy, as well as the indirect effect of social norms, on reproductive health promoting behaviors using structural equation modeling.

A review of the literature on sexual and reproductive health of African migrant and refugee children

Background

Migration and involuntary displacement of children and young people have recently become common features of many African countries due to widespread poverty, rapid urbanization, joblessness, and instability that motivate them to seek livelihoods away from their places of origin. With limited education and skills, children become vulnerable socioeconomically, thereby exposing themselves to sexual and reproductive health (SRH) risks.

Methods

Against this background, the authors undertook a scoping review of the existing literature between January and June 2019 to highlight current knowledge on SRH of African migrant and refugee children. Twenty-two studies that met the inclusion criteria were reviewed.

Results

The results identified overcrowding and sexual exploitation of children within refugee camps where reproductive health services are often limited and underutilized. They also reveal language barriers as key obstacles towards young migrants’ access to SRH information and services because local languages used to deliver these services are alien to the migrants. Further, cultural practices like genital cutting, which survived migration could have serious reproductive health implications for young migrants. A major gap identified is about SRH risk factors of unaccompanied migrant minors, which have received limited study, and calls for more quantitative and qualitative SRH studies on unaccompanied child migrants. Studies should also focus on the different dimensions of SRH challenges among child migrants differentiated by gender, documented or undocumented, within or across national borders, and within or outside refugee camps to properly inform and situate policies, keeping in mind the economic motive and spatial displacement of children as major considerations.

Conclusion

The conditions that necessitate economic-driven migration of children will continue to exist in sub-Saharan Africa. This will provide fertile grounds for child migration to continue to thrive, with diverse sexual and reproductive health risks among the child migrants. There is need for further quantitative and qualitative research on child migrants’ sexual and reproductive health experiences paying special attention to their differentiation by gender, documented or undocumented, within or across national borders and within or outside refugee camps.

Child migration is increasingly becoming a common feature of many African countries as children migrate within and away from their countries of origin in search of better livelihoods due to widespread poverty, instability and rapid urbanisation. Many of the migrating children have little or no education and limited employable skills, thereby exposing themselves to sexual and reproductive health (SRH) risks. This paper is a scoping review of existing literature from 2000 to 2019 to document relevant findings on SRH of African migrant and refugee children.

The review identified migrant children within refugee camps to experience overcrowding and sexual exploitation amidst limited and underutilized reproductive health services. Language barriers are also key obstacles against young migrants’ access to SRH information and services as these services are delivered in local languages unfamiliar to them. Child migrants continue to suffer from cultural practices including genital cutting with serious reproductive health implications. SRH risk factors of unaccompanied migrant minors remain as a gap in the review and, therefore, more SRH studies on unaccompanied child migrants are needed. Attention should also be paid to the different dimensions of SRH challenges among child migrants to reflect gender differences, whether documented or undocumented, within or across national borders, and within or outside refugee camps for better understanding.

In conclusion, child migration in Africa will continue to be economic-driven and will expose the actors to diverse sexual and reproductive health risks. Further in-depth quantitative and qualitative research is required to inform relevant policies on child migrants’ SRH.

Understanding condom use among unmarried female migrants: a psychological and personality factors modified information-motivation-behavioral skills model

BACKGROUND

In China, unmarried female migrants are vulnerable to sexual and reproductive health risks. One effective protection strategy is promoting consistent condom use (CCU).

METHODS

We conducted a cross-sectional study to apply the information-motivation-behavioral skills (IMB) model and modified it by addition of psychological and personal factors to examine the related factors of CCU and provide suggestions for intervention among unmarried female migrants.

RESULTS

Of all 903 eligible participants, only 13.8% of participants reported CCU in the past six months. Both the IMB model and the modified IMB model provided acceptable fit to the data. In both models, information had no direct or indirect influence on CCU (p > 0.05). However, behavioral skills had a positive effect on CCU (β = 0.344, p < 0.001 and β = 0.330, p < 0.001). Moreover, motivation contributed to CCU indirectly by affecting behavioral skills (β = 0.800, p < 0.001) and had no direct influence (p > 0.05). In the modified model, psychological and personality factors influenced CCU directly (β = - 0.100, p = 0.005).

CONCLUSIONS

Our results highlight the importance of conducting CCU promotion among unmarried female migrants. Future intervention strategies should focus on both the traditional IMB model constructs and the added psychological and personality factors.

Contraceptive practices among unmarried women in China, 1982-2017: systematic review and meta-analysis

OBJECTIVE

Premarital sexual practices and contraceptive prevalence rate (CPR) among unmarried women in China remain unclear. We conducted a systematic review and meta-analysis to estimate CPR and analyse contraceptive methods used by unmarried women between 1982 and 2017.

METHODS

Wanfang, The China National Knowledge Infrastructure Database, MEDLINE, PubMed and Web of Science were systematically searched. Data on CPR and use of major contraceptive methods were extracted and pooled using a DerSimonian-Laird random effects model.

RESULTS

Of 188 articles retrieved from five databases, 22 studies met our inclusion criteria. Overall CPR based on a random effects meta-analysis was 32.2% (95% confidence interval [CI] 24.7%, 39.8%). Pooled rates of contraceptive use were 61.4% (95% CI 47.9%, 74.9%) for condoms, 25.9% (95% CI 14.5%, 37.4%) for pills, 19.8% (95% CI 8.9%, 30.8%) for the rhythm method and 25.4% (95% CI 14.2%, 36.7%) for the withdrawal method.

CONCLUSIONS

The sexual and reproductive health situation of unmarried women in China seems to have improved little since the 1990s. Our findings may help to optimise reproductive health care programmes and thereby reduce the alarming rates of unplanned pregnancies and abortions among unmarried women in China.

Association between induced abortion and suicidal ideation among unmarried female migrant workers in three metropolitan cities in China: a cross-sectional study

Background

Despite reports of mental health issues, suicidality has not been closely examined among the migrant population. The association between induced abortion and suicidal ideation is unknown among unmarried female migrant workers of reproductive age in China. This study aims to examine induced abortion and suicidality among the Chinese migrant population.

Methods

We recruited 5115 unmarried female migrant workers during 2015 to 2016 from Shanghai, Beijing and Guangzhou, and collected demographic, psychosocial, reproductive and mental health information using structured questionnaires. We used logistic regression models to examine the association between lifetime induced abortion and suicidal ideation during the past year among the subjects.

Results

Overall, 8.2% of the subjects had suicidal ideation during the past year, and 15.5% of the subjects experienced induced abortion. Induced abortion was associated with nearly twice the odds of having past-year suicidal ideation (Odds ratio, OR = 1.89; 95% confidence interval, CI: 1.46, 2.44) after adjusting for age, education, years in the working place, tobacco use, alcohol consumption, daily internet use, attitude towards premarital pregnancy, multiple induced abortion, self-esteem, loneliness, depression, and anxiety disorders. The association was stronger in those aged > 25 (OR = 3.37, 95% CI = 2.16, 5.28), with > 5 years of stay in the working place (OR = 2.98, 95% CI = 2.02, 4.39), the non-anxiety group (OR = 2.28, 95% CI = 1.74, 3.00), and the non-depression group (OR = 2.94, 95% CI = 2.08, 4.15).

Conclusions

Induced abortion was associated with increased odds for suicidal ideation among the unmarried female migrant workers in urban cities in China. More attention should be paid to the mental health of the population.

A qualitative exploration of perceptions and experiences of contraceptive use, abortion and post-abortion family planning services (PAFP) in three provinces in China

BACKGROUND

The INPAC project aims to evaluate the effectiveness of integrated post-abortion family planning (PAFP) services into existing hospital based abortion services in China. A qualitative study was conducted in three provinces to contribute to developing effective PAFP services through understanding influences on contraceptive use, experiences of abortion and existing PAFP, and their effect on future contraceptive practices from the perspective of users, in the context of social and institutional change.

METHODS

Twenty-nine in-depth interviews (IDIs) were undertaken with women who had experienced abortion between 1 and 6 months prior to interview, recruited from three urban and two rural facilities in each province. Thirteen IDIs were also conducted with male partners. Six focus group discussions (FGDs) were carried out with community members from different social groups, including unmarried and married women and men, urban residents and rural-to-urban migrants.

RESULTS

Social networks and norms are important in shaping attitudes and behaviour towards abortion and contraception. Widespread concerns were expressed about side-effects, reliability and effects on future fertility of some modern contraceptives. The combination of limited information and choices and a lack of person-centred counselling in PAFP with anxieties about side effects underlies the widespread use of unreliable methods. Gendered power relations significantly influence contraceptive (non)use, with several examples illustrating women's relative lack of power to decide on a method, particularly in the case of condoms. Although the availability of contraceptive information from respected providers can offer impetus for individual behaviour change, social distance from providers reduces opportunities for clients to discuss their difficulties regarding contraceptive use; particularly, but not exclusively for young, unmarried clients.

CONCLUSIONS

Increased access to non-commercial, reliable information on contraceptive methods is needed. PAFP services must go beyond simple information provision to ensure that providers take a more person-centred approach, which considers the most appropriate method for individual clients and probes for the underlying influences on contraceptive (non)use. More sensitive reflection on gender norms and relationships is required during counselling and, where women choose this, efforts should be made to include their male partners. Specific attention to provider positionality and skills for counselling young, unmarried clients is needed.

Contraceptive practices and induced abortions status among internal migrant women in Guangzhou, China: a cross-sectional study

BACKGROUND

China is facing the unprecedented challenges of internal migration. Migrants tend to have poorer utilization of health and family planning services as compared to the local residents. Migrant women are at greater risk of induced abortions due to their poor contraceptive knowledge and attitude. This study aims to understand the contraceptive practices and history of induced abortions, explore the potential factors influencing induced abortions, and evaluate the utilization of family planning services among migrant women in Guangzhou, China.

METHODS

An anonymous, self-administered questionnaire survey was conducted with 1003 migrant women aged 18-49 in Guangzhou, China in 2013. A multi-stage sampling method was employed. Binary logistic regression model was used for analyzing risk factors of induced abortions.

RESULTS

Among the 1003 participants, 810 (80.8 %) reported having sex in the past 6 months, including 715 (88.3 %) married and 95 (11.7 %) unmarried. The most reported contraceptive method was male condom (44.9 %), while 8.1 % never used any contraceptive methods. Only 10.4 % reported having attained free condoms from family planning service stations (FPSSs) and 39.3 % reported having acquired contraceptive knowledge from family planning workers. Of all the participants, 417 (41.6 %) had a history of induced abortion. Of married and unmarried women, 389 (49.1 %) and 28 (14.0 %) had induced abortion respectively. Of these, 152 (36.5 %) had repeated abortions. The most reported reason for having induced abortion was failure of contraception (31.9 %), followed by nonuse of any contraceptives (21.1 %). Migrants who had induced abortion tended to be older, have household registration outside Guangdong province, receive no annual health checkup, have lower education, have urban household registration, have lived longer in Guangzhou and have children (P < 0.05).

CONCLUSIONS

The prevalence rate of induced abortion, especially repeated abortions among migrant women was high in Guangzhou, China. There is an urgent need to improve the awareness of regular and appropriate use of contraceptives. The utilization of FPSSs among migrant women was reportedly low. Family planning system should be improved to provide better access for migrants and better integrated with the general health services.

HIV risk and sexual health among female migrants in China

Sexual behavior is the dominant mode of HIV transmission in China, and young female migrants are among the populations at highest risk. This article examines how HIV-related risk behaviors among female migrants might vary according to workplace settings. Participants were young female migrants recruited from three workplace settings-factories, restaurants and entertainment venues. In a cross-sectional survey, we assessed 457 participants' sociodemographic characteristics, HIV/AIDS-related knowledge, condom use knowledge, sexual behaviors, condom use behavior and reproductive health factors. Participants working in entertainment venues were significantly more likely than those working in factories and restaurants to report sexual behavior, unprotected sex, multiple pregnancy terminations and sexually transmitted infections (STI). However, participants working in factories and restaurants reported significantly lower levels of HIV/AIDS knowledge, condom use knowledge, condom use self-efficacy and history of HIV/AIDS counseling and testing. Independent correlates of unprotected sex included employment in an entertainment venue, abortion history and sexual self-efficacy. Independent correlates of STI or genitourinary tract infection included employment in an entertainment venue, abortion history, recent migration and recent unprotected sex. These findings indicate a need for sexual and reproductive health interventions prioritizing young female migrants, and call for programs that can be incorporated into different workplace settings.

[Development of reproductive health program and identification of effect for married women immigrants]

PURPOSE

This study was done to develop a reproductive health program to improve reproductive health of women immigrants.

METHODS

The participants in the study were 58 immigrant women who lived in Vietnam, China, Philippines, or Cambodia before marriage. They were assigned to the experiment group (n=29) or the control group (n=29). The reproductive health program for this study consisted of reproductive health education, health counseling, phone monitoring, and emotional support based on Cox (1982)'s Interaction Model of Client Health Behavior and was implemented for four weeks.

RESULTS

There were significant differences in reproductive health knowledge (t=9.78, p<.001), reproductive health attitude (t=6.59, p<.001), and reproductive health behavior (t=5.11, p<.001) within and between groups after the reproductive health program. But there were no significant differences in clinical indicators between the two groups.

CONCLUSION

The results of this study indicate the that reproductive health program for the women immigrants is effective in terms of reproductive health knowledge, reproductive health attitude and reproductive health behaviors. Therefore, nurses in public and private facilities, such as multicultural centers and public health centers in each community, should develop strategies to expand and provide reproductive health programs for women immigrants.

HIV-related risk among female migrants working in entertainment venues in China

China has experienced a surge in internal migration during the past decade, and migrant populations have been identified as a high-risk group for HIV and other sexually transmitted infections (STIs). Young female migrants often find employment in entertainment venues (bars, karaoke parlors, and massage parlors) located in metropolitan cities, and sex work transactions frequently occur in these venues. We examined factors associated with risk for HIV, other STIs, and reproductive health challenges in a cross-sectional study of 358 young female migrants, ages 18-29, working in entertainment venues in a rapidly growing urban city in China. Results indicate high levels of behavioral risk for HIV and other STIs, low rates of HIV testing, and high prevalence of problem drinking and mental health problems, including recent depression symptoms and suicidal ideation. Factors associated with increased STIs and genitourinary tract infections included commercial sex work, early sexual debut, abortion history, illicit drug use, and anxiety. Factors associated with increased HIV testing included employment in an affluent entertainment venue, education level, knowledge about where to obtain free HIV tests, condom use, and general HIV/AIDS knowledge. Findings of this study highlight the insufficient coverage of current public health services to female migrants working in entertainment venues and call for more assertive prevention interventions to mitigate risk for sexual, reproductive, behavioral, and mental health problems in this mobile population.

Effect of improving the knowledge, attitude and practice of reproductive health among female migrant workers: a worksite-based intervention in Guangzhou, China

Background The sexual and reproductive health (SRH) knowledge and attitudes of female migrant workers are far from optimum in China. A worksite-based intervention program on SRH-related knowledge, attitude and practice (SRH KAP) modification may be an effective approach to improve the SRH status among migrant workers. This study aimed to identify better intervention approaches via the implementation and evaluation of two intervention packages.

METHODS

A worksite-based cluster-randomised intervention study was conducted from June to December 2008 in eight factories in Guangzhou, China. There were 1346 female migrant workers who participated in this study. Factories were randomly allocated to the standard package of interventions group (SPIG) or the intensive package of interventions group (IPIG). Questionnaires were administered to evaluate the effect of two interventions.

RESULTS

SRH knowledge scores were higher at follow up than at baseline for all participants of the SPIG; the knowledge scores increased from 6.50 (standard deviation (s.d.) 3.673) to 8.69 (s.d. 4.085), and from 5.98 (s.d. 3.581) to 11.14 (s.d. 3.855) for IPIG; SRH attitude scores increased among unmarried women: the attitude scores changed from 4.25 (s.d. 1.577) to 4.46 (s.d. 1.455) for SPIG, and from 3.99 (s.d. 1.620) to 4.64 (s.d. 1.690) for IPIG; most SRH-related practice was also modified (P<0.05). In addition, after intervention, the IPIG had a higher knowledge level than the SPIG; the scores were 11.14 (s.d. 3.855) versus 8.69 (s.d. 4.085), and unmarried women in the IPIG had higher condom use rate than the SPIG (86.4% versus 57.1%).

CONCLUSIONS

The interventions had positive influences on improvements in SRH knowledge, attitudes and behaviours. Additionally, IPIs were more effective than SPIs, indicating that a comprehensive intervention may achieve better results.

Sexual and reproductive health among unmarried rural-urban female migrants in Shanghai China: a comparative analysis

We compared sexual and reproductive health (SRH)-related knowledge, attitude and behavior among unmarried rural-urban female migrants in Shanghai coming from different regions of China. A total of 944 unmarried rural-urban female migrants were recruited from three districts of Shanghai. We used an interviewer-administered structured questionnaire to collect information from each participant and a multivariate logistic regression to examine the association between premarital sex and risk factors. We found the rates of premarital sex, pregnancy and abortion among unmarried rural-urban female migrants were 28.2%, 5.2% and 5.0%, respectively. Participants from the east of China were more likely to engage in premarital sex than those from the mid-west (p < 0.001). The analysis showed premarital sex was associated with age, hometown, education, current residential type, knowledge of sexual physiology and safe sex, attitude to SRH and safe sex, and permissive attitude to sex. Unmarried rural-urban female migrants lack SRH related knowledge and the data suggests high levels of occurrence of premarital sex. The results indicate that programs to promote safe sex, especially to those migrants coming from eastern China, should be a priority.

Association between history of abortion and nonalcoholic fatty liver disease in middle-aged and elderly Chinese women

PURPOSE

To evaluate the possible relationship between self-reported history of abortion and nonalcoholic fatty liver disease (NAFLD) in middle-aged and elderly Chinese women.

METHODS

A cross-sectional study was performed in 5911 women aged 40 years or older in Jiading District, Shanghai, China. Reproductive histories, including miscarriage and induced abortion, were collected using a validated questionnaire by trained physicians. Abdominal B-mode ultrasound evaluation and serum liver enzymes levels were used in the diagnosis of NAFLD.

RESULTS

The percentage reporting history of abortion in women with NAFLD was higher than in those without NAFLD (72.4% vs. 69.3%, age-adjusted P = .001). Compared with women without a history of abortion, the fully adjusted odds ratio (OR) for NAFLD in those with a history of abortion was increased by 28% (OR, 1.28 and 95% confidence interval [CI], 1.06-1.55). Histories of miscarriage and induced abortion were also associated with increased risk of prevalent NAFLD in fully adjusted models (OR, 1.84 and 95% CI, 1.24-2.72; OR, 1.23 and 95% CI, 1.02-1.50, respectively).

CONCLUSIONS

Both miscarriage and induced abortion are associated with prevalent NAFLD in middle-aged and elderly Chinese women.

Health of China's rural-urban migrants and their families: a review of literature from 2000 to 2012

BACKGROUND

Socioeconomic transformation in China at the beginning of the twenty-first century has led to rapid urbanization and accelerated rural-urban migration. As a result, the concerns about public health problems triggered by increasing internal population mobility have been more widely studied in recent years.

SOURCES OF DATA

Published data in Chinese and English on health of migrants and their families in mainland China from 2000 to 2012.

AREAS OF AGREEMENT

The shifting patterns of disease distribution due to rural-urban migration, health equity and health reform strategies that cater for this specific yet substantial subpopulation are outstanding concerns. Infectious diseases, mental health, occupational health and women's health are emerging public health priorities related to migration.

AREAS OF CONTROVERSY

The high mobility and large numbers of Chinese rural-urban migrants pose challenges to research methods and the reliability of evidence gained.

GROWING POINTS

While the theme of working migrants is common in the literature, there have also been some studies of health of those left behind but who often remain unregistered. Migration within China is not a single entity and understanding the dynamics of new and emerging societies will need further study.

AREAS TIMELY FOR DEVELOPING RESEARCH

Social, economic, emotional, environmental and behavioural risk factors that impact on health of migrants and their families call for more attention from health policy-makers and researchers in contemporary China.