Knowledge, attitudes and practices of migrant workers and doctors towards migrant health in Singapore
Ang, Jia Wei
Date of Issue2017
Lee Kong Chian School of Medicine (LKCMedicine)
Background: Low-wage non-domestic migrant workers are a large but vulnerable population in Singapore. This study describes potential healthcare barriers and mental health issues faced, and identifies subgroups of workers at higher risk. Methods: A cross-sectional, interviewer-administered survey of 433 migrant workers was conducted at subsidized clinics and a foreign worker dormitory in July to August 2016. Questions assessed healthcare usage patterns, affordability issues, barriers to care and psychological distress using a validated scale (Kessler-6). Results: Bangladeshi workers surveyed were significantly more likely to be single, have more financial dependents, a lower level of education and salary, and pay higher agent fees. 61.4% of workers reported that they had insurance, but had poor understanding of whether it covered inpatient expenses. The majority of workers did not receive any information about their company-bought insurance. Among those who did, most were not in their native language. Many had misconceptions that insurance cannot be used for hospitalizations not related to work injuries, and that they had to self-pay in such instances. 63% of workers were unsure and 10% said that their insurance excluded outpatient costs. 12.5% of workers reported that only sick leave from company doctors were accepted, and 25.6% of workers said that their daily wage would be held even with approved sick leave. 21.9% had non-specific psychological distress estimated by the Kessler-6 scale. On multivariate logistic regression, psychological distress was independently associated with Bangladeshi nationality (OR 2.98, 95%CI 1.58, 5.62) and previous experience of financial barriers to healthcare (OR 3.86, 95%CI 2.25, 6.62). Conclusion: We identified knowledge gaps among migrant workers in Singapore and identified the Bangladeshi population in our study to be at higher risk of psychological distress and barriers to healthcare. These may represent areas for further work and intervention.
Final Year Project (FYP)