AccScience Publishing / IJPS / Online First / DOI: 10.36922/ijps.2314
REVIEW

Accessibility and utilization of health-care services among rural–urban migrants in Ghana: A scoping review

Godfred Otchere1 Samuel Egyakwa Ankomah2* Adam Fusheini1,3 Emmanuel Kumah4 Samuel Kofi Agyei5
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1 Department of Preventive and Social Medicine, Faculty of Medicine, University of Otago, Dunedin, Otago, New Zealand
2 Obstetrics and Gynaecology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ashanti Region, Ghana
3 Public Service Department of New Zealand, Ministry of Social Development, Wellington, New Zealand
4 Department of Health Administration and Education, Faculty of Health, Allied Sciences and Home Economics Education, University of Education, Winneba, Central Region, Ghana
5 Department of Physician Assistant, Faculty of Health and Medical Sciences, Presbyterian University, Agogo, Ashanti Region, Ghana
Submitted: 26 November 2023 | Accepted: 13 March 2024 | Published: 10 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Since the second half of the 20th century, internal migration patterns in Ghana have been dominated by movements from rural (or northern) to urban (or southern) areas. Numerous studies report wide socioeconomic gaps between the geographical north and south of Ghana, explaining the unidirectional movement in search of better opportunities. Differences in personal health profiles, values, and beliefs mean that internal migrants face a higher risk of ill health than urban natives. Compounding this issue is the barriers that impede their access to and utilization of health-care services. We synthesized evidence from existing literature to understand internal migrants’ access to and utilization of healthcare in Ghana, as well as their coping strategies. This review followed Arksey and O’Malley’s guidelines for conducting scoping reviews. We searched PubMed, EconLit, CINAHL, PsychINFO, and Medline (Ovid) electronic databases for studies published from January 2012 to June 2022. In addition, a manual literature search was conducted on Google by examining the reference lists of selected articles to identify other relevant studies. The majority of the studies (n = 12 [75%]) focused on female migrants, while 4 (25%) included both male and female migrants. This review identified several factors affecting access to health-care services for internal migrants in Ghana. These factors included infrastructural, financial, and language barriers, as well as long patient waiting times. Significantly, these barriers resulted in increased self-medication and self-diagnosis among internal migrants, leading to overall poor health outcomes. Based on the study findings, we propose a multidimensional approach to bridging the health access gap for internal migrants. This approach involves improving health system factors such as health service delivery, health workforce, availability of essential medicines, and health finance reforms to provide quality health-care services at affordable or no cost, while considering the socioeconomic and cultural conditions of the internal migrants.

Keywords
Internal migrants
Access
Healthcare
Utilization
Ghana
Health system
Funding
None.
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Conflict of interest
The authors declare that there are no conflicts of interest regarding the publication of this paper.
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