Rural-urban migrants have huge difficulties in accessing health care in Hanoi
Urban poverty is an emerging trend in Asia. Millions of rural-urban migrants leave their traditional livelihoods to seek a new fortune in the city. Vietnam is a good example of this global trend recording some of the highest urbanisation rates in Southeast Asia. It has already 755 urban towns and cities which are home to approximately 30 million people. Estimates predict that by 2020, Vietnam’s cities will be populated by more than 46 million people.
The Asian Trends Monitoring team conducted a survey among Hanoi’s poor between May 18 and May 24. We collected a total of 351 responses from four different neighbourhoods with the help of 12 field interviewers from the Center for Studies and Applied Sciences in Gender in Hanoi.
The survey had a “perception of difficulties” section comprising ten categories, each to be rated on a 5-point scale (from “easy” to “impossible/unable to do”). In four out of ten categories more than 40% of respondents answered with very difficult or unable to do. ‘Accessing modern health treatments’ came up on top with more than 50% of respondents rating it as very difficult or unable to access health treatments.
The next Asian Trends Monitoring Bulletin will be published next week and it will contain a more detailed analysis on the challenges faced by Hanoi’s urban poor. In this blog post I will focus on the differences between rural-urban migrants and established residents in Hanoi (lived in Hanoi 10 or more years).
After looking at the answers from both groups you can see a clear trend where migrants report higher difficulties in accessing health treatments as compared to residents. Almost two thirds (58%) of migrants answer with ‘very difficult’ or ‘unable’ compared to “only” 44% among the resident group. A group comparison in Stata shows that the differences are significant on the 5% level (p=.0114).
We also asked them ‘where do you usually seek treatment when you are sick’ and the results point to some potential reasons why migrants find it more difficult to get access to health treatments.
The most frequent institutions for health services for both groups are hospitals, followed by private pharmacies and self-treatment. The devil is in the details: Among the resident group hospitals are the primary choice for 64% of respondents, followed by 15% for private pharmacies and 6% indicated that they use self-treatment. This compares to 42% of migrants who answered hospitals, 31% private pharmacies and 12% self-treatments.
More than twice as many migrants in our sample turn to private pharmacies and self-treatment than Hanoi’s residents. One possible explanation could be lower incomes among the migrant group which would explain the higher share of self-treaters. However, another explanation could be linked to the eligibility criteria for free health care. Poor residents are eligible for free health care treatments if their income is low enough to be on the ‘poor list’ (income <32 USD/month). Whereas migrants are not eligible at all, due to their official registration in their native village. These results illustrate that
- Hanoi’s urban have enormous difficulties in accessing health treatments (>40% of all respondents)
- Rural-urban migrants seem to be worse off than residents who have lived in Hanoi 10 years or longer
Read more about Hanoi’s Poor in ATM Bulletin 18…
[...] http://www.asiantrendsmonitoring.com/2012/09/26/rural-urban-migrants-health-hanoi/ [...]
Interesting findings guys, consistent with the literature on health seeking behaviour of low-income groups (more self-medication and pharmacy visits than wealthier groups). But whether migrants themselves are poorer..Are migrants substantively worse off in education and water and sanitation access? Look forward to reading the issue!
Dear Nicola,
Our data shows significant differences between migrants and residents in the areas of access to clean water, access to toilets as well as access to good schools for children.
While all group comparisons are statistically significant, the most pronounced differences were found in the water category.
your feedback motivates me to write more blog posts on those subtopics.
best Johannes
[...] in the infographic are a combination of secondary data from the World Bank, primary data from the ATM poverty profile survey, as well as information from interviews the team conducted in the [...]