Department of Economics Sciences, University of Lomé (Togo), Lome, Togo.
Public Health. 2018 Sep;162:16-24. doi: 10.1016/j.puhe.2018.05.010. Epub 2018 Jun 20.
Togo is experiencing a growing phenomenon of migration and consequently receives remittances from international migrants back to their relatives. Remittances represent about 9.4% of the gross domestic product (GDP), placing Togo in the top 10 recipients of remittances in the world in 2014. Despite the importance of remittances, information on their health outcomes is inadequate, particularly if remittances have a positive impact on the utilisation of maternal and child health services. The aim of this article is to evaluate the impacts of migration on maternal and child health services utilisation.
Cross-sectional data analysis of mothers aged 15-49 years who have recently given birth.
We used propensity score matching to compare the utilisation of health services by mothers and children from households with migrants to those without migrants. We simulated a potential confounder to assess the robustness of the effects of the estimated treatment (i.e. migration). We also addressed the problem of hidden biases with the bounding approach.
Deliveries attended by skilled health personnel were found to be 10.3% higher in migrant households than in households without migrants. The antenatal visits of mothers in migrant households were 3.5%-9.5% higher than those of matched control groups. Compared to the non-migrant households, the migrant households had a positive welfare (postnatal checks at the hospital) impact of 11.9%-12.5% percentage points. Furthermore, through access to health insurance, mothers in migrant families enjoy more financial protection with regard to delivery, prenatal and postnatal care. We also found that children in migrant households benefit from more preventive health inputs such as postnatal checks and vaccinations.
Our results suggest that migration contributes greatly to improving births at hospitals, skilled birth assistance, and utilisation of antenatal and postnatal care through the return flow of financial resources. Efforts in health care reforms in Togo should take into account the scope of the positive impacts of migration on the utilisation of maternal and child health services.
多哥正经历着移民现象的增长，因此从国际移民那里收到了汇款，寄回给亲属。这些汇款占国内生产总值（GDP）的 9.4%左右，使多哥在 2014 年成为世界上接受汇款最多的 10 个国家之一。尽管汇款很重要，但有关其健康结果的信息却不足，特别是如果汇款对利用母婴健康服务有积极影响的话。本文旨在评估移民对母婴健康服务利用的影响。
对最近分娩的 15-49 岁母亲进行横断面数据分析。
我们使用倾向评分匹配来比较有移民和没有移民的家庭的母亲和儿童对卫生服务的利用情况。我们模拟了一个潜在的混杂因素，以评估估计治疗（即移民）效果的稳健性。我们还通过边界方法解决了隐藏偏差的问题。
与没有移民的家庭相比，移民家庭中由熟练卫生人员接生的比例高出 10.3%。移民家庭中母亲的产前检查比匹配对照组高出 3.5%-9.5%。与非移民家庭相比，移民家庭的产妇福利（医院产后检查）影响有 11.9%-12.5%的正点。此外，通过获得医疗保险，移民家庭的母亲在分娩、产前和产后护理方面享有更多的经济保护。我们还发现，移民家庭的儿童受益于更多的预防保健投入，如产后检查和疫苗接种。
我们的结果表明，移民通过资金回流，极大地促进了改善医院分娩、熟练接生以及产前和产后护理的利用。多哥的医疗改革努力应该考虑到移民对母婴健康服务利用的积极影响的范围。
