The Migration Experience and Differential Risks to Sexual and Reproductive Health in Ghana

Abstract

Background. Though internal migration in Ghana has become increasingly common in recent years, research has not focused on the gendered experiences and perceptions of migration and the association with sexual and reproductive health risks for male and female migrants. Method. A qualitative study using semistructured interviews among migrant market workers and market leaders working in Agbogbloshie in Accra, Ghana, was completed in April 2018. Interview domains for the migrant interviews included the following: expectations of migration, current working and living conditions, sexual and reproductive health, access to health care, and self-reported health status. Qualitative data were analyzed using a combination of inductive and deductive coding in MAXQDA. Results. Data indicate that migrant workers have a variety of perceptions surrounding their migration experience. In the urban destination, migrants face a number of challenges that negatively affect their health, including poor accommodation, safety concerns, and low levels of social support. Reported risks to sexual and reproductive health were unsafe sexual encounters, such as low condom use and sexual assault. Discussion. The negative sexual and reproductive health outcomes among migrant populations in urban poor settings are a result of a confluence of factors, including perceptions of destination locations, working and living conditions, social support, and gender norms. A complex systems approach to understanding the sexual health of migrants is warranted. Conclusion. Findings from this research illustrate the complexity of health risks among migrants in Agbogbloshie. Further research is needed to explore the increased vulnerability of migrants compared with nonmigrants in urban poverty and the long-term implications of sexual and reproductive health risks in vulnerable migrant communities.

Keywords: gender; global health; qualitative methods; sexual health; social determinants of health; urban health.