Understanding the Experiences of Health Care–Seeking Migrants in Delhi: Trajectories and Challenges

2020 ◽  
Vol 30 (11) ◽  
pp. 1710-1722
Author(s):  
Bincy Mathew ◽  
Devaki Nambiar

Many studies have reported on issues of accessibility and quality of health care among the different vulnerable subgroups in urban locations. To date, no study has been done on the challenges faced by health care–seeking migrants (those traveling to cities for health reasons). This qualitative study used in-depth interviews and nonparticipant observation to examine the health problems, health care–seeking trajectories, and challenges faced by health care–seeking migrants in Delhi, India. Participants described long courses of health care seeking, typically from the district to the state capital to the national capital. There were variegated paths to health care seeking characterized by delays in service utilization, progression of disease, and cost escalation. The challenge relating to the delay in receiving health care was exacerbated by the residency status of health care–seeking migrants. In conclusion, health-related migration is associated with shared but also unique barriers to health care seeking. India’s urban health care reform agenda needs to cater to the needs of this population.

2006 ◽  
Vol 50 (4) ◽  
pp. 818-825 ◽  
Author(s):  
Isabelle Gasquet ◽  
Stéphanie Tcherny-Lessenot ◽  
Pierre Gaudebout ◽  
Brigitte Bosio Le Goux ◽  
Patrick Klein ◽  
...  

2008 ◽  
Vol 85 (5) ◽  
pp. 693-706 ◽  
Author(s):  
Jessica M. Gill ◽  
Gayle G. Page ◽  
Phyllis Sharps ◽  
Jacquelyn C. Campbell

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nadine Kalenda Kayiba ◽  
Doudou Malekita Yobi ◽  
Brecht Devleesschauwer ◽  
Dieudonné Makaba Mvumbi ◽  
Pius Zakayi Kabututu ◽  
...  

Abstract Background This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Methods In 2017, a cross-sectional survey included patients with uncomplicated malaria in 64 healthcare facilities from 10 sentinel sites of the National Malaria Control Programme (NMCP) in the DRC. A standard questionnaire was used to assess health care-seeking behaviours of patients. Health-related quality of life (HRQL) and disutility weights (DW) of illness were evaluated by using the EuroQol Group’s descriptive system (EQ-5D-3L) and its visual analogue scale (EQ VAS). Malaria costs were estimated from a patient’s perspective. Probabilistic sensitivity analyses (PSA) evaluated the uncertainty around the cost estimates. Generalized regression models were fitted to assess the effect of potential predictive factors on the time lost and the DW during illness. Results In total, 1080 patients (age: 13.1 ± 14 years; M/F ratio: 1.1) were included. The average total costs amounted to US$ 36.3 [95% CI 35.5–37.2] per malaria episode, including US$ 16.7 [95% CI 16.3–17.1] as direct costs and US$ 19.6 [95% CI 18.9–20.3] indirect costs. During care seeking, economically active patients and their relatives lost respectively 3.3 ± 1.8 and 3.4 ± 2.1 working days. This time loss occurred mostly at the pre-hospital stage and was the parameter associated the most with the uncertainty around malaria cost estimates. Patients self-rated an average 0.36 ± 0.2 DW and an average 0.62 ± 0.3 EQ-5D index score per episode. A lack of health insurance coverage (896 out of 1080; 82.9%) incurred substantially higher costs, lower quality of life, and heavier DW while leading to longer time lost during illness. Residing in rural areas incurred a disproportionally higher socioeconomic burden of uncomplicated malaria with longer time lost due to illness and limited access to health insurance mechanisms. Conclusion Uncomplicated malaria is associated with high economic costs of care in the DRC. Efforts to reduce the cost-of-illness should target time lost at the pre-hospital stage and social disparities in the population, while reinforcing measures for malaria control in the country.


2001 ◽  
Vol 120 (5) ◽  
pp. A634-A635
Author(s):  
P PARE ◽  
S FERRAZZI ◽  
W THOMPSON ◽  
E IRVINE ◽  
L RANCE

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