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Epidemiology
Cohort profile
Cohort profile: internal migration in sub-Saharan Africa—The Migration and Health in Malawi (MHM) study
  1. Philip Anglewicz1,
  2. Mark VanLandingham1,
  3. Lucinda Manda-Taylor2,
  4. Hans-Peter Kohler3
  1. 1 Department of Global Community Health and Behavioral Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
  2. 2 Malawi College of Medicine, University of Malawi, Zomba, Malawi
  3. 3 Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Philip Anglewicz; panglewi{at}tulane.edu

Abstract

Purpose The Migration and Health in Malawi (MHM) study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. The MHM study uses a longitudinal panel premigration and postmigration study design (with a non-migrant comparison group) to measure and/or control for important characteristics that affect both migration and health outcomes.

Participants Data are available for two waves. The MHM interviewed 398 of 715 migrants in 2007 (55.7%) and 722 of 1013 in 2013 (71.3%); as well as 604 of 751 (80.4%) for a non-migrant reference group in 2013. The total interviewed sample size for the MHM in both waves is 1809. These data include extensive information on lifetime migration, socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, social networks and social capital, HIV/AIDS biomarkers and other dimensions of health.

Findings to date Our result for the relationship between migration and health differs by health measure and analytic approach. Migrants in Malawi have a significantly higher HIV prevalence than non-migrants, which is primarily due to the selection of HIV-positive individuals into migration. We find evidence for health selection; physically healthier men and women are more likely to move, partly because migration selects younger individuals. However, we do not find differences in physical or mental health between migrants and non-migrants after moving.

Future plans We are preparing a third round of data collection for these (and any new) migrants, which will take place in 2018. This cohort will be used to examine the effect of migration on various health measures and behaviours, including general mental and physical health, smoking and alcohol use, access to and use of health services and use of antiretroviral therapy.

  • epidemiology
  • HIV & AIDS
  • public health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014799

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    Footnotes

    • Acknowledgements The MHM has been conducted in collaboration with the College of Medicine at the University of Malawi and Invest in Knowledge (IKI) in Zomba, Malawi.

    • Contributors HPK and PA initially conceived the manuscript. PA conducted the statistical analysis and wrote the first draft of the paper. HPK, LMT and MV reviewed the paper before submission and provided comments and edits.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Information about the MHM is available on the MLSFHproject website at https://malawi.pop.upenn.edu/. Researchers interested in using MHM data that have not yet been made publicly available on the MLSFH websitecan submit a two-page description of their proposed analysis plan to the MHMPrincipal Investigator (mail to: panglewi@tulane.edu). If approved, researchers willthen be asked to sign a Data Use Agreement to access and utilize the data. Forcomparisons of migrants and non-migrants, MHM data can be linked to the publicuseMLSFH data that can be requested at https://malawi.pop.upenn.edu/malawidata-mlsfh.All analyses of the restricted MHM data are conducted in collaborationwith members of the MHM study team.

    • Author note The data collection and research conducted by MLSFH and MHM was approved by the Institutional Review Boards at the University of Pennsylvania and Tulane School of Public Health and Tropical Medicine, respectively. Both studies were approved in Malawi by the College of Medicine Research Ethics Committee or the National Health Sciences Research Committee.

    • Author note The MHM was funded by two sources: the original 2007 cohort of migrants was funded by a grant from the NIA (P30 AG12836, Beth Soldo P.I.); the second wave in 2012 was funded by NICHD R21HD071471-01 (Anglewicz and Kohler, PIs). The MLSFH, on which the MHM was built, was funded by NICHD grants R03 HD05 8976, R21 HD050652, R01 HD044228, R01HD053781, as well as funding through R24 HD-044964.