Self-reported physical and emotional health among left behind children in Lithuania. A pilot study

Background

Left behind children (LBC) are children living with caregivers, while their parents work abroad. In recent decades Lithuania had lost ¼ of its population due to emigration, but the prevalence of LBC and their health needs are not sufficiently studied. The aim of study was to evaluate the association between self-reported health, emotional and behavioural difficulties between LBC and non-LBC.

Methods

The cross-sectional study was approved by the Biomedical Research Ethics Committee, No. 2021/11-1378-861. In March 2022, this pilot study collected data from adolescents aged 12-17 years at three randomly selected schools from the migration affected regions. Parents and children provided informed consent to participate in pilot study. Self-reported measures collected from the participants: Strengths, and Difficulties Questionnaire (Goodman, 2005) and a questionnaire on demographics and on the health situation. Chi² tests and logistic regression were calculated by using Stata (version 15.1).

Results

The sample consisted of 127 children (mean age 15.2, SD 1.27; 54 boys, 72 girls) including 39 LBC. Mostly fathers left to work abroad (n = 36), but majority of children (n = 36) regularly communicated remotely with their migrated parents. Binary logistic regression results show that LBC children tend to evaluate their health as ‘poor, ‘bad', or ‘very bad’ (OR 2,33; 95CI [1,02-5,33]). There were no differences for emotional and behavioural problems. Preliminary results from multiple regression model showed that children with self-reported emotional/behavioural difficulties (OR 3,06; 95CI [1,12-7,84]), females (OR 4,99;95CI [1,55-16,13]) and LBC (OR 2,44; 95CI 0,95-6,25]) more likely evaluate their health as ‘poor', ‘bad’ or ‘very bad’ (likelihood-ratio test=23,72; model p < 0.001).

Conclusions

This pilot study found negative association between parental migration and children’s self-reported health. However, a more comprehensive study with a larger sample size is needed.

Key messages

• Pilot study suggests negative association between parents migration and children’s self-reported health.

• More comprehensive study in bigger sample for the emotional/behavioural/communication difficulties between left behind children needs to be done.

Parent emigration and physical health of children left behind: a systematic review of literature

Background

The aim of our study was to systematically review the literature on physical health and related consequences of internal and international parental migration on left-behind children (LBC).

Methods

This study followed the PRISMA guidelines. We searched relevant databases for studies published up to 15 May 2020. The quality of the studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results

We included 34 studies out of 6061 in the final analysis. Results from internal migration shows that compared with children of non-migrant parents, LBC were more susceptible to illness and had a higher prevalence of acute and chronic diseases, have a higher risk of getting injured, were more likely to engage risky behaviours such as unhealthy diet, physical inactivity, sedentary lifestyle, smoking, and drinking. Studies included in this review found a lower coverage of vaccination among LBC. Results from international migration found that left-behind adolescents reported poorer physical health than non-LBC. It was found that the prevalence of stunting (11.5% vs. 14.8%), wasting (18.1% vs. 21.5%), and underweight (24.3% vs. 26.2%) was lower among LBC as compared with non-LBC, respectively. Physical activity among LBC was lower than non-LBC. We provided comparative analysis of the outcomes of the internal and international migration. We found that, despite the type of migration/region, LBC suffer from poor general health, are at a higher risk of developing poor nutrition, overweight or obesity, addictive behaviours, physical inactivity, lower vaccination coverage, and more frequent injuries than non-LBC.

Conclusions

This study found that both internal and international parental migration is mostly negatively associated with LBC general health, nutrition, weight and height, injuries, and immunization. However, in low- and middle-income countries parental migration might also prevent LBC from undernutrition.

Key messages

Internal and international migration parental migration is negatively associated with child physical health outcomes. Issue is well addressed in China, but there are substantial research gap from other migration affected regions of the world.

Impacts of international labor migration on the mental health and well-being of left-behind children

Background

Labor migration is a challenge for the globalised world due to its long-term effects such as the formation of transnational families with the particularly vulnerable groups of left-behind children (LBC). These families, where family members of migrant workers are 'left-behind' are becoming common practice in many developing countries. In this systematic literature review, we aimed to investigate the impacts of parental labor migration on the mental health and well-being of their LBC.

Methods

Following the PRISMA guidelines, we performed a systematic literature search in English using PubMed, PsychINFO, Web of Science, Cochrane Library and Google Scholar for studies, investigating mental health and well-being among LBC who live in transnational families. Case-reports, qualitative studies as well as opinion papers were excluded. We summarized the evidence and additionally compared quantitative results.

Results

25 studies were selected for the final analysis. We found that mental health and well-being outcomes of LBC differ across regions and sometimes even within regions. Only studies conducted in South America and South Asia observed purely negative effects. Overall, LBC show abnormal SDQ (Strengths and Difficulties Questionnaire) scores and report higher levels of depression and loneliness, than children who do not live in transnational families. Evidence suggests that gender of migrant parent, culture and other transnational family characteristics such as family arrangement, the role of the mother and the role of the father contribute to the well-being and psychological health of LBC.

Conclusions

International migration of parents has more negative than positive effects (e.g. through remittances) on the mental health and well-being of LBC. However, the effects strongly depend on family arrangements and care giving practices in migrants' sending countries.

Key messages

Further research utilizing longitudinal data is needed to better explore the complex and long-term effects of parental migration on LBC. Multidimensional family characteristics are crucial and should be better explored when examining the impacts of migratory separation on left-behind children.