Department of Health Promotion and Education, Faculty of Health Medicine and Life Sciences, Maastricht University Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands.
Department of Social Work and Social Administration, School of Social Sciences, Makerere University College of Humanities and Social Sciences, Kampala, Uganda.
BMC Health Serv Res. 2021 Feb 23;21(1):169. doi: 10.1186/s12913-021-06173-1.
While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on the use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-urban migration on the use of SRH services, while controlling for confounding, and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults.
Data were collected from 513 street children and young adults aged 12-24 years, using venue-based time-space sampling (VBTS). We performed multivariate logistic regression analysis using Stata 16.0 to identify factors associated with SRH services use, with rural-urban migration status as the main predictor. Participants were further classified as new migrants (≤ 2 years of stay in city), established migrants (> 2 years of stay in city) or non-migrants (lifelong native street children) with no rural-urban migration history.
Overall, 18.13% of the street children and young adults had used contraception/family planning, 58.67% had tested for human immunodeficiency virus (HIV) and knew their status and 34.70% had been screened for sexually transmitted infections (STIs). Non-migrants were 2.70 times more likely to use SRH services (HIV testing, STI screening and family planning) compared to the migrants (aOR = 2.70, 95% CI 1.23-5.97). Other factors associated with SRH services use among street children and young adults include age (aOR = 4.70, 95% CI 2.87-7.68), schooling status (aOR = 0.33, 95% CI 0.15-0.76), knowledge of place of care (aOR = 2.71, 95% CI 1.64-4.46) and access to SRH information (aOR = 3.23, 95% CI 2.00-5.24).
SRH services utilisation among migrant street children and young adults is low compared to their non-migrant counterparts and is independently associated with migration status, age, schooling status, knowledge of place of care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase the use of SRH services among street children and young adults, while taking into consideration their migration patterns.
尽管移民与健康结果之间的联系已得到充分认识，但农村到城市移民对性健康和生殖健康（SRH）服务的利用影响却较少受到关注。我们评估了农村到城市移民对 SRH 服务利用的影响，同时控制了混杂因素，并探讨了移民和非移民街头儿童和青年之间在 SRH 服务利用方面是否存在差异。
我们使用基于场所的时空抽样（VBTS）从 513 名 12-24 岁的街头儿童和青年那里收集数据。我们使用 Stata 16.0 进行多变量逻辑回归分析，以确定与 SRH 服务利用相关的因素，将农村到城市的迁移状况作为主要预测因素。参与者进一步分为新移民（≤2 年城市居住史）、老移民（>2 年城市居住史）或非移民（无农村到城市迁移史的本地街头儿童）。
总体而言，18.13%的街头儿童和青年使用了避孕/计划生育措施，58.67%接受了艾滋病毒（HIV）检测并知晓其检测结果，34.70%接受了性传播感染（STI）筛查。与移民相比，非移民使用 SRH 服务（HIV 检测、STI 筛查和计划生育）的可能性高 2.70 倍（调整后的优势比[aOR]=2.70，95%置信区间[CI]为 1.23-5.97）。街头儿童和青年使用 SRH 服务的其他相关因素包括年龄（aOR=4.70，95%CI 2.87-7.68）、受教育程度（aOR=0.33，95%CI 0.15-0.76）、对护理地点的了解（aOR=2.71，95%CI 1.64-4.46）和获得 SRH 信息的途径（aOR=3.23，95%CI 2.00-5.24）。
与非移民街头儿童和青年相比，移民街头儿童和青年的 SRH 服务利用率较低，且独立于移民状况、年龄、受教育程度、对护理地点的了解和获得 SRH 信息的途径等因素。我们的研究结果表明，需要设计和实施多维度干预措施，以提高街头儿童和青年对 SRH 服务的利用，同时考虑到他们的移民模式。
