Inequality in health service utilization among migrant and local children: a cross-sectional survey of children aged 0–14 years in Shenzhen, China

Background: Shenzhen has the largest number of migrant children of all cities in China. Unequal access to basic health services among migrant and local children greatly affects health equity and has a profound impact on the quality of human capital. This study aimed to investigate differences in child health management service utilization between local and migrant children in the Futian District of Shenzhen and to identify factors influencing these differences.Methods: This study extracted the data on child health management in the Futian District of Shenzhen from the 2018 Survey of Health Service Needs of Chinese Residents in the New Era. The chi-square test was used to analyze differences between local and migrant children, and specific factors affecting child health management service utilization were analyzed with binary logistic regression.Results: In this study, 1512 families in 12 communities in Futian District, Shenzhen were investigated. Among this families, 936 participants were aged 0-14 years, and the final effective sample size was 508. The greatest difference between migrant and local children was in the utilization of development guidance services (59% vs. 77.5%, P < 0.001). The main factors influencing physical examination, development guidance, disease prevention guidance, injury prevention guidance, oral health guidance and mental health guidance service utilization were mother’s educational level, household registration, father’s educational level, father’s occupation and annual family income, household registration, the child’s sex and father’s occupation, respectively. The odds of having used disease prevention guidance were 2.257 times higher among children whose fathers had an undergraduate education or above compared with children whose fathers had a junior high school education or below (95% CI: 1.417–3.595). The odds of having used injury prevention guidance were 46.3% lower for children whose fathers were mixed white-/blue-collar workers compared with children whose fathers were white-collar workers (OR = 0.537, 95% CI: 0.361–0.799). The odds of having used mental health guidance were 52.2% lower among children whose fathers were mixed white-/blue-collar workers compared with those whose fathers were white-collar workers (OR = 0.478, 95% CI: 0.293–0.777).Conclusions: In the Futian District of Shenzhen, health management service utilization is significantly lower among migrant children than among local children. Father’s educational level and occupation limit the utilization of child health management services for migrant children. Fathers have a stronger influence on children’s health service utilization than do mothers. The potential influence of fathers in promoting children’s health maintenance should be carefully considered, and fathers’ attention to children’s health should be increased.