Internal migration of young peasants: from a contemporary source of health inequality to a new challenge for urban public health and social welfare

Set in the context of health inequality and limited welfare availability in fragile societies, this paper seeks to examine whether current migration pattern of young rural peasants exacerbate health inequality, undermines welfare and social determinants of health. It identifies the challenges associated with the internal out-migration of young people between the ages of 5 and 24 years from rural areas to urban destinations in Ghana. The paper also examines the nature and impact of the migration process (including issues of health risks, social welfare and inequality); the implications for both local and national health development policy. Questionnaire surveys, interviews and focus group discussions were triangulated to elicit the views and experience of young rural out-migrants from two districts in Southern Ghana (Akuapem North and Dangme West districts) presently working in urban food markets in southern Ghana. Individual migrants and their households was the unit of analysis for the study. The study reveals that rural out-migration involves both genders with evidence of vulnerability of young migrants in relation to the weak and fragile social welfare support for young migrants undermines their personal well-being and social determinants of health. Whilst the productive capacity of young migrants can be enhanced by low cost labour opportunities in the urban informal sector, this tends to perpetuate a cycle health inequality. The paper recommends the introduction of skill development programmes in peripheral rural districts in southern Ghana to improve the employability and economic potential of young people and thereby reduce health inequality, reduce the pressure on public health and social welfare systems whilst enhancing the accessibility of health care in urban destinations.