Emigration as a social and economic determinant of health in low-income urban Zimbabwe

BACKGROUND: The negative consequences of medical professionals’ emigration on the health systems of nations are well documented in the literature. However, there is a dearth of evidence on the impact of emigration in general, on sending households’ welfare, health in particular. This study compared socio-economic characteristics, including health, of emigrants’ households with those of non-emigrants’ households in an urban setting in Harare, Zimbabwe. METHODS: A cross-sectional survey and focus group discussions were used to collect quantitative and qualitative data, respectively. Concurrent and retrospective data were collected using an interviewer-administered questionnaire. The target population were households, both emigrants' households and non-emigrants' households, and the interviewees were de facto heads of the respective households. RESULTS: A sample of 279 households was determined; however, 268 heads of households, a response rate of 96%, were achieved. The majority of the respondents were females (52%). Emigrants’ households were more likely to access private compared to government health care facilities, than non-emigrants’ households [P = 0.001]. Emigrants' households were also more likely to report higher incomes than non-emigrants’ households [P < 0.05] and were having more meals per day and better access to education. Emigrants' households were also more likely to report positive lifestyles than non-emigrants’ households. Only 13.8% of emigrants' households reported a negative shift in lifestyle, compared to 25.2% non-emigrants' households. CONCLUSIONS: Emigration was found to have a positive relationship with health seeking, income, education, and number of meals a household had. It is clear from the findings that emigration during the hard economic times in Zimbabwe is beneficial; it cushions households from the ravages of poverty. Yet emigration robs the nation of its professional able-bodied people. It is, therefore, recommended that the government optimises the reported positive effects, whilst expeditiously working on improving the economy with the view of reversing the observed migration streams.