Differentials in self-reported health status and healthcare utilization among homeless women during the antenatal period in urban settings: Does migration status matter?

Abstract

Background: Limited studies have covered the nexus between homelessness, migration, and maternal health. However, most homeless women are migrants and have high-risk fertility behaviors. Therefore, the present study examines the variation in antenatal health and healthcare behavior among homeless women, focusing on migration status. Methods: The present study employed a mixed-methods approach. A cross-sectional quantitative survey using Time and Location sampling (TLS) and face-to-face interviews was carried out for the quantitative component. Further, qualitative data was gathered through in-depth interviews using purposive sampling. Descriptive statistics, bivariate analysis with the Pearson chi-square test, and multivariate logistic models estimated qualitative results. Further, the thematic analysis presented qualitative findings. Results: Out of 400 respondents, 76 % were migrants, and 57 % reported poor SRH. The likelihood of poor SRH was 1.07 times higher among migrants than non-migrants. A higher likelihood of poor SRH was found among beggars and ragpickers. Similarly, it was prevalent among the respondents who lived alone, mainly migrants. Almost 80 % of migrants reported experiencing depression. The unmet need for health visits was substantial among the study population (41 %), and it was found to be noteworthy among migrants (51 %). Several individual, socioeconomic, and structural factors were identified as barriers to healthcare utilization. Conclusion: Poor antenatal health was substantial among homeless women, mainly migrants. Public and private healthcare visits were inadequate among homeless women who were migrants. Several individual, socioeconomic, and structural factors affected healthcare utilization. The study highlights the urgent need to introduce population-centric programs and policies to promote reproductive health among homeless women.

Keywords

• Homelessness
• Migrants
• Antenatal health
• Self-rated health
• Health-seeking behaviors