Access to malaria health care among seasonal migrants in rural communities in Surkhet district, Nepal

Abstract

Background: In Nepal, malaria is prevalent, detected most especially in rural areas where large numbers of seasonal migrants travel to malaria infected zones of India, particularly through the open border. Seasonal migrants constitute the majority of imported cases of malaria but are less likely to use health care services despite its being a free service. This study aims to examine the reasons why seasonal migrants in rural communities of Surkhet district do not utilize the free malaria healthcare services provided by the government. Methods: Data was collected from a total of 367 seasonal migrants, selected by non-probability multiple cluster sampling method, using structured questionnaires. Multinomial logistic regression was used as the main statistical analysis. Results: The statistical result show that females, married people, elderly people, female headed households, and educated people were more likely to utilize healthcare services compared to their counterparts. Similarly, gender and household income have a significant effect on health seeking behaviors of sessional migrants. The result shows that male seasonal migrants were more likely to utilize private health care services whereas females prefer to seek services from traditional healers. On the other hand, low income people have less tendency to utilize healthcare service compared to middle or high-income seasonal migrant. The main reasons for non-utilization of health care services were as follows: unavailability, inaccessibility and unacceptability, uncertainty of service hours, long distance to travel in poorly constructed roads and inadequate services which demotivated the migrants to access the health services. Recommendations: To improve availability, accessibility, and acceptability of government health care services for the seasonal migrants, strategies should be created that ensure availability of services at accessible locations through malaria mobile clinics, conduct awareness, research offer and counselling to increase acceptability