Migration has become a defining phenomenon of the twenty-first century, of global proportion. Yet, the effects of migration are increasingly becoming multifaceted, both at places of origin and at destinations1. The impact of emigration (out migration) appears to be framed by two extremes. In some sending areas, migration has set in motion a development force, as remittances loosen various kinds of investment and production constraints that typically confront households. This includes direct and indirect investment in health and health care activities, including better access to essential treatment. In some cases, emigration has however, drained local economies and societies of their human and financial capital 1. Very little, if any attention, has been placed on the relationship between emigration and health at the place of origin2.
Zimbabwe endures a very high migrant stock. UNDP estimates the population of Zimbabweans living in the diaspora to be around 3.5 million3. Ratha et. al, place the net migration for Zimbabwe at 11.1 migrants per 1000 population, translating to a migrant stock of over 4 million4. This means a quarter of the Zimbabwean population is in the diaspora. The high level of emigration is associated with crippling skills losses in the health and other sectors. This notion however, overlooks the direct and indirect role of remittances in funding health and healthcare as well as other sectors. Skeldon contends that remittances have a positive impact on the place of origin5. Recruitment and Returns are also key dimensions of migration with impact on health. Recruitment deals with employment status (employed, unemployed or underemployed) of migrants on departure and at destination. Returns refers to migrants who come back to their countries of origin – the commonly asked questions are; ‘do returning migrants bring back new technologies and ideas and stay, do they circulate between home and abroad, or do they return to rest and retire?’6. The 3Rs (Recruitment, Remittances and Returns) of migration can therefore collectively either result in a vicious or a virtuous circle6. We therefore, assume that households exposed to emigration have better health, including through improved access to healthcare.
The current economic situation in Zimbabwe is forcing people to migrate in the hope of securing employment in countries with better economies than Zimbabwe such as South Africa, Botswana, United Kingdom and Australia8. Zimbabwe is faced with serious economic challenges characterised by high unemployment rates, inflation and low productivity. The assumption when migrating is that such migrants will be better off in their destination countries than they were in Zimbabwe, this includes improved access to health and health care. Those who migrate however may not get a job in their destination countries as soon as they would have anticipated. They may also find it difficult to have their qualifications recognized in countries of destination. Sometimes they have to take up 3D (dirty, dangerous and degrading) jobs with meagre salaries9. As a result, they end up in a worse economic situation than they were before they migrated. Considering that those with a high tendency to migrate tend to be bread winners in their families, the situation may be worse for those they leave behind. When this happens, the health situation of the families left behind is also affected.
This study explores the impact of emigration on health by comparing access to health and healthcare among emigration exposed and non-exposed households in urban Zimbabwe. It also explores the impact of emigration on other key determinants of health.