Male out-migration and the health of left-behind wives in India: The roles of remittances, household responsibilities, and autonomy

Abstract

In developing countries, labor out-migration has led to millions of married couples living apart from each other. Male out-migration brings economic benefits to the families in places of origin, but also leads to profound changes in the lives of the left-behind wives. It is unclear how the husband's out-migration influences the health of wives, let alone the mechanisms through which any effects are transmitted. Using data from the Indian Human Development Survey (2004–2005 and 2011–2012), we estimated lagged dependent variable models (N = 19,737) to assess the health impact of husbands' out-migration for women in India. The results showed that left-behind wives had lower self-rated health than wives of non-migrants. Part of this negative health impact was driven by the low remittances sent by the migrant husbands. For both women in nuclear families and women in extended families, the negative health impact was partially attributable to women's added responsibilities, such as animal care and managing a bank account. For women in nuclear families, the negative health effect of husbands' migration has been partially suppressed by women's increased autonomy.

Do Remittances Enhance Elderly Adults’ Healthy Social and Physical Functioning? A Cross-Sectional Study in Nigeria

“…Conversely, the remittance recipients in our study have significantly lower PF probabilities than non-recipients. Though this result is counterintuitive since we expect additional resources to afford better health outcomes, a recent study found remittance recipients with poorer PF odds than non-recipients [ 18 ]. There are plausible explanations for this.…”

“…Though 60–80% of the Nigeria’s population of elderly adults require regular medical attention [ 16 ], it is surprising that only 4.7% of the received remittances go to medical expenses. There are several possible reasons for this: firstly, remittances may not be large enough to sustain a living; hence, they do not provide much to spare in terms of medical expenses [ 18 ]. Next, elderly adults might deliberately spend less on medical expenses because they prefer the cheaper and widespread traditional treatments that are available in Nigeria [ 68 , 69 ] or downplay their health challenges because of their “unrealistic optimism” in life [ 70 , 71 ].…”

“…Consequently, most Nigerian elderly adults have insufficient finances to seek medical redress, though 60–80% have multimorbidity challenges requiring regular medical attention, posing a substantial challenge to healthy aging [ 16 ]. Therefore, non-conventional financing sources such as remittances are growing more relevant as an alternative source of health-financing income [ 17 , 18 , 19 ].…”

“…Hence, there is a need for a national strategy to promote a sustainable alternative source of income in the short term. The authors of [ 17 , 18 , 19 ] have argued that remittances can be this alternative source of income.…”

“…In fact, studies highlighting the nonlinear relationship between remittances and other indicators suggest that healthy aging could also depend on the amount of remittances received [ 50 , 51 , 52 ]. For instance, [ 18 ] found that receiving more than INR 35,000 improved the self-reported health status of left-behind Indian wives. Hence, ignoring this nonlinear association possibility would deny us valuable information about the true nature of the relationship between remittances and healthy aging in Nigeria.…”