Healthcare-seeking behaviour, barriers and mental health of non-domestic migrant workers in Singapore
Open accessAbstract
Background: Low-wage migrant workers are vulnerable to healthcare inequities. We sought to identify potential barriers to healthcare and risk factors for mental health issues in non-domestic migrant workers in Singapore, and identify high-risk subgroups. Methods: A cross-sectional, interviewer-administered survey of 433 non-domestic migrant workers was conducted at subsidised clinics and a foreign worker dormitory from July to August 2016. Questions assessed healthcare usage patterns, affordability issues, barriers to care and psychological distress using a validated screening scale (Kessler-6). Findings: Bangladeshi workers surveyed were more likely to be single, have more financial dependents, a lower level of education and salary and pay higher agent fees (p<0.01). 61.4% of workers reported that they had insurance, but had poor understanding of whether it covered inpatient/outpatient expenses. The majority of workers had not, or were not sure if they had, received information about company-bought insurance (72.4%). Among those who had, most reported that information was not in their native language (67.7%). Non-specific psychological distress was found in 21.9%, as estimated by the Kessler-6 scale. Multivariate analysis found that psychological distress was independently associated with Bangladeshi nationals (OR 2.98, 95% CI 1.58 to 5.62; p=0.001) and previous experience of financial barriers to healthcare (OR 3.86, 95% CI 2.25 to 6.62; p<0.0001). Interpretation: We identified gaps in non-domestic migrant workers' knowledge of healthcare coverage, and substantial financial barriers to healthcare. The Bangladeshi population in our study was at higher risk of such barriers and psychological distress. These represent areas for further research and intervention.
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Despite the mental health burden, access to specialist health care is limited for international migrant workers.
“Despite this mental health burden, access to specialist health care is limited [10, 13].”
From Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial (2023) · cites this paper as [13]
The Discussion reports financial barriers to seeking care among low-wage migrant workers in Singapore, alongside an association between those barriers and psychological distress. It does not establish that access to specialist health care specifically is limited, and its findings do not cover international migrant workers generally. (LLM, conf=0.86)
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“Despite this mental health burden, access to specialist health care is limited [10, 13].”
Background
- Authors
- Ang, J. W., Chia, C., Koh, C. J., Chua, B. W. B., Narayanaswamy, S., Wijaya, L., Chan, L. G., Goh, W. L., & Vasoo, S.
- Affiliations
- Nanyang Technological University (SG)
- HealthServe Community Clinic, Singapore
- National University Hospital (SG)
- KK Women's and Children's Hospital (SG)
- Singapore General Hospital (SG)
- Tan Tock Seng Hospital (SG)
- Corresponding author
- Vasoo, Shawn
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2017-03
- Volume
- 2
- Issue
- 2
- Pages
- e000213
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC5435267
- OpenAlex
- W2592647417
- Cited by
- 84
- References
- 15
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 12 · 2023: 8 · 2022: 12 · 2021: 13 · 2020: 14 · 2019: 7 · 2018: 3
- FWCI
- 16.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DR-NTU (Nanyang Technological University) (submittedVersion, cc-by-nc)
- National University of Singapore (submittedVersion)
- Funders
- Lee Kong Chian School of Medicine, Nanyang Technological University
- Topics
- Social Sciences › Sociology and Political Science › Migration, Identity, and Health
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- health-seeking behavior, barriers to care, mental health, psychological distress, Bangladeshi migrant workers, health insurance knowledge, financial barriers to care, health care affordability, language barriers, health care inequities, Singapore
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