PLoS ONE
Volume 13, Issue 9, 2018

Nepalese migrants in Japan: What is holding them back in getting access to healthcare? (Article) (Open Access)

Shakya P. , Tanaka M. , Shibanuma A. , Jimba M.*
  • a Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  • b Faculty of Global Studies, Sophia University, Tokyo, Japan
  • c Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  • d Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

Abstract

Introduction Migrants are one of the most deprived and vulnerable groups who receive the least health services in the society. Only a few studies have been conducted on access to healthcare among migrants in Asia, despite hosting 75 million migrants. In Japan, Nepalese migrants constitute the largest South Asian community. Their number increased by three folds from 2011 to 2016. However, little is known about their access to health care in Japan. Based on Andersen’s model, we examined the factors associated with access to healthcare among Nepalese migrants in Japan. Methods We conducted a cross-sectional study among 642 Nepalese migrants residing in 10 prefectures of Japan. We used multivariable logistic regression model to explore the key predisposing, enabling, and need factors associated with access to healthcare among the migrants. Results The migrants who had stayed in Japan longer were more likely to perceive better access to a doctor/health worker (AOR = 1.11, 95% CI 1.03–1.19).The migrants were more likely to perceive better access to a doctor/health worker (AOR = 1.79, 95% CI 1.17–2.73) when they did not need Japanese language interpreter during visit to health facilities. They were also less likely not to see a doctor/health worker when needed (AOR = 0.34, 95% CI 0.21–0.56). The migrants were less likely to perceive better access to a doctor/health worker when they had not paid the health insurance premium regularly (AOR = 0.21, 95% CI 0.13–0.33).Their low perception of better access to a doctor/health worker was also associated with self-rated health status as poor or fair (AOR = 0.60, 95% CI 0.41–0.89). Conclusion Nepalese migrants have poor access to health care in Japan. The key factors associated with their access to health care are the length of stay (predisposing factor), Japanese language skill and health insurance (enabling factors) and self-rated health status (need factor). © 2018 Shakya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

perception health care personnel health insurance human middle aged statistics and numerical data health service controlled study health status social support length of stay language Health Services Needs and Demand Cross-Sectional Studies cross-sectional study migrant psychology Humans Adolescent male Japan female Article adult human experiment migration Analysis of Variance skill Transients and Migrants health care facility Nepal Health Services Accessibility health care delivery

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85053134537&doi=10.1371%2fjournal.pone.0203645&partnerID=40&md5=169de0dbb702d7ad62d060c4351403a8

DOI: 10.1371/journal.pone.0203645
ISSN: 19326203
Cited by: 1
Original Language: English