International Journal for Equity in Health
Volume 16, Issue 1, 2017

Health is my capital: A qualitative study of access to healthcare by Chinese migrants in Singapore (Article) (Open Access)

Tam W.J. , Goh W.L. , Chua J. , Legido-Quigley H.*
  • a Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
  • b HealthServe Pte Ltd, Singapore, Singapore
  • c HealthServe Pte Ltd, Singapore, Singapore
  • d Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, London School of Hygiene and Tropical Medicine, London, United Kingdom

Abstract

Background Since the 1970s, Singapore has turned into one of the major receiving countries of foreign workers in Southeast Asia. Over the years, challenges surrounding access to healthcare by Chinese migrant workers have surfaced globally. This study aims to explore the experiences of Chinese migrants accessing primary and secondary/tertiary healthcare in Singapore, and the opportunities for overcoming these barriers. Methods We conducted 25 in-depth interviews of 20 Chinese migrants and five staff from HealthServe, a non-governmental organization serving Chinese migrants in Singapore from October 2015 to January 2016. Interviews were transcribed and analysed inductively adopting thematic analysis. Results Chinese migrants in Singapore who were interviewed are mainly middle-aged breadwinners with multiple dependents. Their concept of health is encapsulated in a Chinese proverb, meaning "health is my capital". Health is defined by them as a personal asset, needed to provide for their families. From their health-seeking behaviors, six pathways were identified, highlighting different routes chosen and resulting outcomes depending on whether their illness was perceived as major or minor, and if they sought help from the private or public sector private or public sector. Key barriers were identified relating to vulnerabilities during the migration process, during their illness, when consulting with healthcare providers, and during repatriation. A transactional doctor-patient culture in China contrasts with the trust migrants place in Singaporean's public health system, perceived as equitable and personable. However, challenges remain for injured migrants who sought help from the private sector and those with chronic diseases. Conclusions Policy recommendations to increase patient autonomy enabling choice of healthcare provider and provide for non-work related illnesses are suggested. Partnerships between migrant advocacy organizations and various stakeholders such as hospitals, government agencies and employers can be strengthened. © 2017 The Author(s).

Author Keywords

China Migrants Singapore healthcare access

Index Keywords

tertiary health care cultural anthropology China Chinese questionnaire survey health care personnel human middle aged statistics and numerical data Singapore [Southeast Asia] priority journal ethnology family support qualitative research Humans migrant psychology information consultation male Diseases social problem migratory population hospital sector family counseling Article nongovernmental organization health care help seeking behavior private sector adult migration health care access Singapore government Transients and Migrants secondary health care disease incidence public sector attitude to health repatriation public health Health Services Accessibility primary health care finance health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85027852296&doi=10.1186%2fs12939-017-0567-1&partnerID=40&md5=0cce2ce14fbf363a2861306a215aae08

DOI: 10.1186/s12939-017-0567-1
ISSN: 14759276
Cited by: 1
Original Language: English