Social inclusion of migrant workers in a pandemic: employing consumer vulnerability lens to internal Indian migrant experience

PurposeThe purpose of this paper is to expand the theoretical understanding of social inclusion of vulnerable populations. Employing cross disciplinary literature from marketing and social policy, this paper examines the factors shaping internal migrant workers experience of inclusion and vulnerability in the context of COVID-19 pandemic.Design/methodology/approachThe authors conducted a review of social inclusion and consumer vulnerability literature to develop a new and innovative conceptual framework which operationalises social inclusion. This framework was then examined using an illustrative case study of internal migrant worker crisis in India. Data for the case were collected from various national and international media, government and non-government reports published in English on the pandemic related migrant crisis in India.FindingsAccess and control over food was fraught with barriers for migrant workers. As the lockdown progressed, access to and control over work opportunities was precarious. Furthermore, the resource-control constraints faced by migrant workers in terms of food, work and transport had a direct impact on their experience of social inclusion. Lastly, the stranded migrant workers found themselves unable to fully participate in economic activities.Originality/valueTo the authors’ knowledge this is the first paper that integrates consumer vulnerability concept, originating in marketing scholarship into the social inclusion framework. This allowed for anchoring the “aspirational goals” of social inclusion into the concrete context of consumers and marketplaces.

Non-communicable disease risk factors and management among internal migrant in China: systematic review and meta-analysis

BackgroundIn 2019, there are more than 290 million people who have ever migrated from rural to urban areas in China. These rural-to-urban internal migrants account for more than one-fifth of China’s population and is the largest internal migrant group globally. We present the first systematic review that examines whether internal migrants are more likely to exhibit non-communicable diseases (NCDs) risk factors and have worse NCD management outcomes than non-migrant counterparts in China.MethodsA systematic review was conducted via medical, public health, and economic databases including Scopus, MEDLINE, JSTOR, WHO Library Database and World Bank e-Library from 2000 to 2020. Study quality was assessed using the National Institute of Health Quality Assessment tool. We conducted a narrative review and synthesised differences for all studies included, stratified by different types of outcomes. We also conducted random-effects meta-analysis where we had a minimum of two studies with 95% CIs reported. The study protocol has been registered with PROSPERO: CRD42019139407.ResultsFor most NCD risk factors and care cascade management, comparisons between internal migrants and other populations were either statistically insignificant or inconclusive. While most studies found migrants have a higher prevalence of tobacco use than urban residents, these differences were not statistically significant in the meta-analysis. Although three out four studies suggested that migrants may have worse access to NCD treatment and both studies suggested migrants have lower blood pressure control rates than non-migrants, these findings were not statistically significant.ConclusionFindings from this systematic review demonstrate that there is currently insufficient evidence on migrant and non-migrant differences in NCD risk factors and management in China. Further research is expected to investigate access to healthcare among internal and its effect on both their NCD outcomes and long-term healthcare costs in China.

The relationship between internal migration and the likelihood of high-risk pregnancy: Hukou system and high-risk pregnancies in China

Background China has one of the world’s largest internal migrant populations. The Chinese Hukou system is a unique household registration system that limits internal migrants in their access to basic urban public services, such as public health insurance and social assistance of their host city. In the case of female internal migrants, this may lead to high-risk pregnancies. The objective of this study is to assess the relationship between internal migrant status (Hukou) and the likelihood of high-risk pregnancies that occur in one large municipal-level obstetrics hospital in Shanghai, China. Methods Medical records data from the Shanghai First Maternity and Infant Hospital from January 1, 2013, to May 31, 2018, were used to analyze 133,358 live births for Shanghai natives (n = 83,872) and internal migrant women (n = 49,486). A propensity score matching approach was used in conjunction with logistic regression analysis to identify the role of internal migrant status (Hukou) on the likelihood of high-risk pregnancies. Results A greater likelihood of high-risk pregnancies were found among internal migrant women who moved from other parts of China to Shanghai. This effect was more obvious for women who gave birth for the first time and internal migrant women who were employed. Conclusion The results show the effects of internal migrant status (Hukou) and the elevated likelihood of high-risk pregnancies among internal migrant women relative to their urban counterparts in Shanghai even after accounting for self-selection by employing the propensity score matching method. China’s unique Hukou household registration system limits access to public services for internal migrant women and accordingly may account for the elevated likelihood of high-risk pregnancies.

Major Stressors and Coping Strategies of Internal Migrant Workers During the COVID-19 Pandemic: A Qualitative Exploration

COVID-19 forced lockdown in India, leading to the loss of job, crisis of food, and other financial catastrophes that led to the exodus migration of internal migrant workers, operating in the private sector, back to their homes. Unavailability of transport facilities led to an inflicted need to walk back to homes barefooted without lack of any other crucial resources on the way. The woeful state of internal migrant workers walking back, with all their stuff on their back, holding their children, was trending on social media worldwide. Their problem continued even after reaching home, including misbehavior of villagers, indifferent mannerism of family members toward them, inability to fulfill family responsibility, and financial crisis, which led to stress, fear, and trauma for these internal migrant workers. The present paper aimed to assess the idiosyncratic stressors of internal migrant workers throughout the pandemic era and their responses toward those problems, which helped them cope with it. In-depth semistructured telephonic interviews were conducted with 25 internal migrant workers who were working in different cities in India before lockdown. The analyses revealed that multiple stressors include financial crisis, unavailability of food, inability to continue education, inability to pay house rent, lack of support from neighbors and family, and other psychological stressors that affected them. However, they also tried multiple strategies to deal with the problems, including a cognitive appraisal of the problem and making oneself psychologically competent to deal with the situation. Social support of family and friends played a vital role in enhancing hardiness and increasing the level of happiness at scarce times. At the same time, some of them could not deal with stressors and opted for psychiatric help to manage the physical symptoms of stress.