The paradox of free access to maternal health: The twofold narrative of pregnant migrant women in Johannesburg

Abstract

Maternal health is a key issue in any health discourse, in any country. Access to healthcare for pregnant women is a concern of governments the world over. However, in South Africa, a binary system separates migrant and non-migrant women, favouring non-migrant women’s access to maternal healthcare. The paradox of pregnant migrant women’s access to healthcare has therefore become topical among researchers, in a bid to understand the issue, and consequently, influence policy. The present study was designed to explore the concerns of migrant women accessing maternal healthcare in Johannesburg. Through a qualitative design, a non-representative sample of 15 migrant women and healthcare providers were interviewed, and the findings were coded and analysed according to thematic content. The findings show the context in which free access to maternal healthcare has created a paradox within the system. This is especially the case in terms of access, consultation time and the dissemination of drugs for migrant women, and also at an administrative level, where lack of access to and shortages of drugs are now considered a result of abuse, overuse and misuse of free access to healthcare services by migrant women. The punitive approach of denying migrant women access to maternal healthcare creates a binary of contradictions where on the one hand, access is supposedly free to all, while on the other, some are excluded, or receive healthcare only partially.