BMJ Global Health
Volume 2, Issue 2, 2017

Healthcare-seeking behaviour, barriers and mental health of non-domestic migrant workers in Singapore (Article) (Open Access)

Ang J.W. , Chia C. , Koh C.J. , Chua B.W.B. , Narayanaswamy S. , Wijaya L. , Chan L.G. , Goh W.L. , Vasoo S.*
  • a Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  • b HealthServe Community Clinic, Singapore
  • c Division of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore
  • d Department of Pharmacy, KK Women’s and Children’s Hospital, Singapore
  • e Department of Pharmacy, Singapore General Hospital, Singapore
  • f Department of Infectious Diseases, Singapore General Hospital, Singapore
  • g Department of Psychiatry, Tan Tock Seng Hospital, Singapore
  • h HealthServe Community Clinic, Singapore
  • i Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore

Abstract

Background: Low-wage migrant workers are vulnerable to healthcare inequities. We sought to identify potential barriers to healthcare and risk factors for mental health issues in non-domestic migrant workers in Singapore, and identify high-risk subgroups. Methods: A cross-sectional, interviewer-administered survey of 433 non-domestic migrant workers was conducted at subsidised clinics and a foreign worker dormitory from July to August 2016. Questions assessed healthcare usage patterns, affordability issues, barriers to care and psychological distress using a validated screening scale (Kessler-6). Findings: Bangladeshi workers surveyed were more likely to be single, have more financial dependents, a lower level of education and salary and pay higher agent fees (p<0.01). 61.4% of workers reported that they had insurance, but had poor understanding of whether it covered inpatient/outpatient expenses. The majority of workers had not, or were not sure if they had, received information about company-bought insurance (72.4%). Among those who had, most reported that information was not in their native language (67.7%). Non-specific psychological distress was found in 21.9%, as estimated by the Kessler-6 scale. Multivariate analysis found that psychological distress was independently associated with Bangladeshi nationals (OR 2.98, 95% CI 1.58 to 5.62; p=0.001) and previous experience of financial barriers to healthcare (OR 3.86, 95% CI 2.25 to 6.62; p<0.0001). Interpretation: We identified gaps in non-domestic migrant workers’ knowledge of healthcare coverage, and substantial financial barriers to healthcare. The Bangladeshi population in our study was at higher risk of such barriers and psychological distress. These represent areas for further research and intervention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.

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Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85052131749&doi=10.1136%2fbmjgh-2016-000213&partnerID=40&md5=3355e13025e8cf86000c943e807d44cc
DOI: 10.1136/bmjgh-2016-000213
ISSN: 20597908
Cited by: 7
Original Language: English