ArticleAfrican journal of primary health care & family medicine2025
Exploring barriers to healthcare among internal and international female migrants in The Gambia.
Article in African journal of primary health care & family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundExisting research on female migration and healthcare in sub-Saharan Africa has predominantly focused on internal migration and maternal and child health, often overlooking broader healthcare access issues for (international) migrant women.
aimThis study aimed to quantitatively assess healthcare barriers faced by internal and international migrants relative to non-migrant women.
settingThe setting of this study was The Gambia.
methodsUsing the 2019-2020 Gambia Demographic and Health Survey and overlap weighting, we compare healthcare access - based on reported usage and key barriers - between non-migrants and internal or international migrants. We distinguish between recent and settled migrants according to the duration of residence at the destination.
resultsFinancial barriers are reported by 26.46% - 28.09% of women, geographic barriers by 21.47% - 26.02% and safety barriers by 11.85% - 15.37%. Internal female migrants encounter significantly more geographic (odds ratio [OR] = 1.32, 95% confidence interval [CI] [1.19, 1.45]), permission (OR = 1.43, 95% CI [1.16, 1.76]), safety (OR = 1.16, 95% CI [1.03, 1.30]) and financial (OR = 1.21, 95% CI [1.10, 1.33]) barriers than non-migrants - differences that persist for settled migrants. Conversely, international migrants do not experience more barriers than non-migrants. In addition, migrants who have moved in the past 3 years used health services more than non-migrants, both for internal migrants (OR = 1.14, 95% CI [1.00, 1.31]) and for international migrants (OR = 1.42, 95% CI [1.02, 1.98]), but these differences disappear for settled migrants.
conclusionPolicy interventions should address disparities between internal migrants and non-migrants and improve healthcare access for all women.Contribution: This study highlights internal migration as a key factor shaping healthcare access.
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