Nepalese migrants in Japan: What is holding them back in getting access to healthcare?

Migrants are one of the most deprived and vulnerable groups who receive the least health services in the society. Only a few studies have been conducted on access to healthcare among migrants in Asia, despite hosting 75 million migrants. In Japan, Nepalese migrants constitute the largest South Asian community. Their number increased by three folds from 2011 to 2016. However, little is known about their access to health care in Japan. Based on Andersen's model, we examined the factors associated with access to healthcare among Nepalese migrants in Japan.We conducted a cross-sectional study among 642 Nepalese migrants residing in 10 prefectures of Japan. We used multivariable logistic regression model to explore the key predisposing, enabling, and need factors associated with access to healthcare among the migrants.The migrants who had stayed in Japan longer were more likely to perceive better access to a doctor/health worker (AOR = 1.11, 95% CI 1.03-1.19).The migrants were more likely to perceive better access to a doctor/health worker (AOR = 1.79, 95% CI 1.17-2.73) when they did not need Japanese language interpreter during visit to health facilities. They were also less likely not to see a doctor/health worker when needed (AOR = 0.34, 95% CI 0.21-0.56). The migrants were less likely to perceive better access to a doctor/health worker when they had not paid the health insurance premium regularly (AOR = 0.21, 95% CI 0.13-0.33).Their low perception of better access to a doctor/health worker was also associated with self-rated health status as poor or fair (AOR = 0.60, 95% CI 0.41-0.89).Nepalese migrants have poor access to health care in Japan. The key factors associated with their access to health care are the length of stay (predisposing factor), Japanese language skill and health insurance (enabling factors) and self-rated health status (need factor).