Responding to the Public Health Burden of Births to Mainland Migrant Mothers in Hong Kong: Policy Implications for Maternal and Child Health Care After the Repatriation of 1997

The repatriation of Hong Kong to The People’s Republic of China in 1997 alongside the designation of Shenzhen in 1980 as a Special Economic Zone in China has led to a migration boom in the Hong Kong-Shenzhen border region. Migration policy and law under the fundamental principle of “One Country, Two Systems” has changed how populations utilize health care on either side of the border. In Hong Kong (HK), a birth “loophole” in The Basic Law has led to a surge in mainland mothers giving birth in HK in order to gain HK citizenship for their children. In 2010 alone, nearly half of all HK births were to a mainland mother. There are implications for HK health services.

Using immunization as a marker, we will describe the socio-political situation of mainland mothers visiting HK to give birth, and discuss the public health response and policy implications of recent migration. A retrospective clinic audit of child immunization records at 31 HK Maternal and Child Health Clinics (MCHC) studied the effect of migrant status on immunization timeliness and up-to-date status for 155,774 children. As a supplement, 393 caregivers were interviewed at two migrant-populated MCHC’s on attitudes, access, and barriers towards child immunization.

Results found that parents of cross border migrant children were relatively more affluent and better educated than those of local children. They were highly motivated towards using MCHC immunization services. However, maternal mainland status was significant factor in delayed immunization uptake for children and in caregivers seeking immunization knowledge from informal sources. Stronger public health responses and strategy from Hong Kong health policy makers are needed to properly plan for the increasing number of births to mainland mothers and to address future demand on the Hong Kong system by cross border migrant children.  

Word count: 293