Parent emigration and physical health of children left behind: a systematic review of literature

Abstract

Abstract Background The aim of our study was to systematically review the literature on physical health and related consequences of internal and international parental migration on left-behind children (LBC). Methods This study followed the PRISMA guidelines. We searched relevant databases for studies published up to 15 May 2020. The quality of the studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results We included 34 studies out of 6061 in the final analysis. Results from internal migration shows that compared with children of non-migrant parents, LBC were more susceptible to illness and had a higher prevalence of acute and chronic diseases, have a higher risk of getting injured, were more likely to engage risky behaviours such as unhealthy diet, physical inactivity, sedentary lifestyle, smoking, and drinking. Studies included in this review found a lower coverage of vaccination among LBC. Results from international migration found that left-behind adolescents reported poorer physical health than non-LBC. It was found that the prevalence of stunting (11.5% vs. 14.8%), wasting (18.1% vs. 21.5%), and underweight (24.3% vs. 26.2%) was lower among LBC as compared with non-LBC, respectively. Physical activity among LBC was lower than non-LBC. We provided comparative analysis of the outcomes of the internal and international migration. We found that, despite the type of migration/region, LBC suffer from poor general health, are at a higher risk of developing poor nutrition, overweight or obesity, addictive behaviours, physical inactivity, lower vaccination coverage, and more frequent injuries than non-LBC. Conclusions This study found that both internal and international parental migration is mostly negatively associated with LBC general health, nutrition, weight and height, injuries, and immunization. However, in low- and middle-income countries parental migration might also prevent LBC from undernutrition. Key messages Internal and international migration parental migration is negatively associated with child physical health outcomes. Issue is well addressed in China, but there are substantial research gap from other migration affected regions of the world.