Internal migration and child health in Malawi

Soc Sci Med. 2019 Aug:235:112389. doi: 10.1016/j.socscimed.2019.112389. Epub 2019 Jul 2.

Abstract

A strong and consistent association between migration and health has been found in many settings, but the overwhelming focus of this research has been on adults. In addition, identifying the effect of migration on health largely remains an unresolved challenge, due in part to the inability to distinguish between the effect of migration on health and the selection of children of differing health status into migration streams. In this research we examine the relationship between internal migration and child health in Malawi. We use longitudinal panel data with pre- and post-migration health measures for children and their mothers, which permits us to measure both migration health selection and the effect of migration on health. We also examine if child health changes over time in post-migration destinations. We do not find evidence of migration health selection: children who move have similar pre-migration health status to non-migrant children. We find that the impact of migration on child health is mediated by mothers' characteristics. Before controlling for mothers' health status, we find a strong negative impact of migration on health, particularly for children moving to rural areas or cities, and children moving due to changes in mothers' marital status. After controlling for mothers' health status, however, the negative impact of migration on child health disappears. We also find that child health is worse with longer durations spent in post-migration residence, compared to children who don't move.

Keywords: Child health; Migration; Selection.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Child
  • Child Health Services
  • Child, Preschool
  • Emigration and Immigration / trends*
  • Female
  • Humans
  • Longitudinal Studies
  • Malawi
  • Male
  • Population Dynamics / trends*
  • Regression Analysis
  • Socioeconomic Factors*