Health Disparities: A Perspective on Internal Migration and Health Behavior in Sudan

Cluster	Variable/Indicator	Expression/Coding	Measurement
	Age in years		Discrete
	Years of work		Discrete
	Income/month Sudanese Pound (SDG)		Discrete
	Education	Illiterate (1)	Nominal
		Informal (2)
		Primary (3)
Secondary (4)
University (5)
Mental health	Experiencing stress	No (0)	Nominal
Yes (1)
Physical health	Having chronic disease	No (0)	Nominal
Yes (1)
Access to healthcare	-Distance to the nearest health facility	>5 km (0)	Nominal
Access to healthcare	<5 km (1)
-Means of transportation to a health facility	On foot/Public transport (0)	Nominal
Taxi/renting a car/Own vehicle (1)
Healthcare-seeking behavior	-Medical care received in the previous six months	No (0)	Nominal
	Yes (1)
	-Health care sought in a health facility	No (0)	Nominal
Yes (1)
-Health care sought in the nearest health facility	No (0)	Nominal
Yes (1)
Access to water, sanitation, and hygiene (WASH) services	-Drinking water source	Well/Surface water/Very poor (1)	Likert scale
	-Drinking water source	Tanker truck/Poor (2)	Likert scale
	Water Tank/Moderate (3)
	Piped/Bottled water/Good (4)
	-Sanitation/latrine	Bucket/Bush/Field/Very poor (1)	Likert scale
	-Sanitation/latrine	Pit without slab/Poor (2)	Likert scale
Pit with slab/Moderate (3)
Flush to septic/Good (4)
-Shower location	Open area/Very poor (1)	Likert scale
-Shower location	Inside tent/dwelling/Poor (2)	Likert scale
Inside toilet/Moderate (3)
Inside private shower/Good (4)
Perception	-Perception of mining-related risks	Very low (1)	Likert scale
		Low (2)
		Moderate (3)
High (4)
Very high (5)
	-Self-rated nutritional status	Very low (1)	Likert Scale
		Low (2)
		Moderate (3)
	High (4)
	Very high (5)
	-Perceived adherence to safety measures	Very low (1)	Likert scale
		Low (2)
		Moderate (3)
	High (4)
	Very high (5)
-Perceived quality of healthcare services	Very low (1)	Likert scale
	Low (2)
	Moderate (3)
High (4)
Very high (5)
-Perceived satisfaction regarding accessing necessities	Very low (1)	Likert scale
	Low (2)
	Moderate (3)
High (4)
Very high (5)
Knowledge	-Health hazards		Discrete
Knowledge	- Traditional gold mining-associated diseases/health outcomes		Discrete
- Methods of diarrhea prevention		Discrete
Health behavior	-Water treatment practices	No (0)	Nominal
	Yes (1)
	-Garbage disposal practices	No/Throw it outside (0)	Nominal
	Yes/In a public bin/In a bin inside/In a sack or carton outside (1)
	-Shower habits (personal hygiene)	No/Every two days or more (0)	Nominal
Yes/Every day/Every other day (1)
-Handwashing habits(personal hygiene)	Inadequate/Twice or less (0)	Nominal
Adequate/Three times or more (1)
-Having health insurance	No (0)	Nominal
Yes (1)

Table 2

Respondents’ sociodemographic characteristics, N = 211 (Local: 63, Migrant: 148).

Characteristic	Local			Immigrant			Test of difference	Sig.
Characteristic	Min-Max	Median	Mean (SD)	Min-Max	Median	Mean (SD)	Test of difference	Sig.
Age (years)	18–60	27	28.76 (8.17)	18–61	29.0	30.18 (9.32)	Mann-Whitney U test	0.271
Years of work	1.0–20.0	4.0	4.89 (3.67)	1.0–20	4.0	5.83 (3.75)	Mann-Whitney U test	0.034*
Monthly income (SDG)	1,000–15,000	5,000	5142.86 (2517.34)	2,000–15,000	5,000	5341.22 (2417.36)	Mann-Whitney U test	0.703
Marital status:	Freq. (%)			Freq. (%)
Unmarried	31 (49.2)			59 (39.9)			Pearson Chi-Square	0.209
Married	32 (50.8)			89 (60.1)
Education:
Illiterate	7 (11.1)			25 (16.9)			Pearson Chi-Square	0.001**
Informal	0 (0.0)			1 (0.7)
Primary	7 (11.1)			50 (33.8)
Secondary	16 (25.4)			33 (22.3)
University	33 (52.4)			39 (26.3)
Having health insurance
No	57 (90.5)			147 (99.3)			Pearson Chi-Square	0.001**
Yes	6 (9.5)			1 (0.7)

[i] * Denotes significance at 0.05.

Table 3

Results of principal component analysis with varimax rotation.

Cluster	Kaiser-Meyer-Olkin	Total Variance Explained (%)
Access to healthcare	0.50	67.778
Healthcare-seeking behavior	0.52	50.310
Access to WASH services	0.50	77.652
Perception	0.50	52.127
Knowledge/awareness	0.53	60.342
Health behavior	0.56	62.856

[i] * P < 0.001.

Table 4

Tests of difference by immigration status across composite and individual variables.

Variable	Test	P-value
Age	Mann-Whitney U test	0.271
Years of work	Mann-Whitney U test	0.034*
Income	Mann-Whitney U test	0.703
Education	Chi-Square (18.765)	0.001*
Experiencing stress	Chi-Square (4.104)	0.043*
Having chronic disease	Chi-Square (0.036)	0.850
Access to healthcare	Mann-Whitney U test	0.927
Healthcare-seeking behavior	Mann-Whitney U test	0.001*
Access to WASH	Mann-Whitney U test	0.755
Perception of risk	Mann-Whitney U test	0.140
Knowledge related to health hazards, health outcomes, and methods of diarrhea prevention	Mann-Whitney U test	0.001*
Health behavior	Mann-Whitney U test	0.050*

[i] * The significance level is 0.05.

Table 5

Stepwise multiple linear regression for immigrants.

Model	R		R²	Adjusted R²	Std. Error of the Estimate
a) Model summary
Model	Immigration status = Immigrant (Selected)	Immigration status ~ = Immigrant (Unselected)	R²	Adjusted R²	Std. Error of the Estimate
1	0.895		0.802	0.801	0.16469
2	0.903	1.000	0.815	0.812	0.15976

Model		B	Std. Error	Beta	t	Sig. (P-value)	Lower Bound	Upper Bound
b) Coefficients
Model		Unstandardized Coefficients		Standardized Coefficients	t	Sig. (P-value)	95% ConfidenceInterval for B
1	Access to WASH	0.123	0.005	0.895	24.390	0.000	0.113	0.133
2	-Access to WASH	0.115	0.005	0.838	21.017	0.000	0.104	0.126
-Secondary	0.100	0.031	0.127	3.195	0.002	0.038	0.161

Table 6

Stepwise multiple linear regression for non-immigrants.

a) Model summary
Model	R		R²	Adjusted R²	Std. Error of the Estimate
Model	Immigration status = non-immigrant (Selected)	Immigration status ~ = non-immigrant (Unselected)	R²	Adjusted R²	Std. Error of the Estimate
1	0.931		0.866	0.864	0.14341
2	0.939		0.882	0.878	0.13562
3	0.944	1.000	0.891	0.885	0.13177

b) Coefficients
Model		Unstandardized Coefficients		Standardized Coefficients	t	Sig.(P -value)	95% Confidence Interval for B
Model		B	Std. Error	Beta	t	Sig.(P -value)	Lower Bound	Upper Bound
1	Access to WASH	0.132	0.007	0.931	20.034	0.000	0.119	0.146
2	-Access to WASH	0.127	0.007	0.893	19.485	0.000	0.114	0.140
-Knowledge	0.066	0.023	0.132	2.886	0.005	0.020	0.112
3	-Access to WASH	0.082	0.022	0.575	3.728	0.000	0.038	0.126
3	-Knowledge	0.053	0.023	0.106	2.300	0.025	0.007	0.099
-Perception	0.041	0.019	0.339	2.148	0.036	0.003	0.080

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DOI: https://doi.org/10.5334/aogh.2589 | Journal eISSN: 2214-9996

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Language: English

Published on: May 5, 2020

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

© 2020 Mahmoud Ali Fadlallah, Indrajit Pal, Joyee S. Chatterjee, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 86 (2020): Issue 1

Health Disparities: A Perspective on Internal Migration and Health Behavior in Sudan

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