Irregular Migrant Workers and Health: A Qualitative Study of Health Status and Access to Healthcare of the Filipino Domestic Workers in Mainland China
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ABSTRACT:
SUBMITTER: Chen H
PROVIDER: S-EPMC9324804 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The number of migrant workers in Taiwan increases annually. The majority is from Indonesia and most of them are female caregivers. This study aims to determine the access to health services and the associated factors among Indonesian female domestic workers in Taiwan. In this cross-sectional study, data were collected from February to May 2019, using a structured questionnaire. Subsequently, multiple logistic regression was used to examine the association between socio-demographic factors and health service access. Two hundred and eighty-four domestic migrant workers were interviewed. Eighty-five percent of the respondents declared sickness at work, but only 48.8% seek health care services. Factors associated with health service access were marital status, income, and the availability of an attendant to accompany the migrant workers to the healthcare facilities. Language barrier and time flexibility were the main obstacles. Further research and an effective health service policy are needed for the domestic migrant workers to better access health care services.
| S-EPMC8038466 | biostudies-literature
Project description:BACKGROUND:Malaysia is widely credited to have achieved universal health coverage for citizens. However, the accessibility of healthcare services to migrant workers is questionable. Recently, medical fees for foreigners at public facilities were substantially increased. Mandatory health insurance only covers public hospital admissions and excludes undocumented migrants. This study explores barriers to healthcare access faced by documented and undocumented migrant workers in Malaysia. METHODS:We use qualitative data from 17 in-depth interviews conducted with key informants from civil society organisations, trade unions, academia, medical professionals, as well as migrant workers and their representatives. We interviewed doctors working in public hospitals and private clinics frequented by migrants. Data were analysed using thematic analysis. RESULTS:We found that healthcare services in Malaysia are often inaccessible to migrant workers. Complex access barriers were identified, many beyond the control of the health sector. Major themes include affordability and financial constraints, the need for legal documents like valid passports and work permits, language barriers, discrimination and xenophobia, physical inaccessibility and employer-related barriers. Our study suggests that government mandated insurance for migrant workers is insufficient in view of the recent increase in medical fees. The perceived close working relationship between the ministries of health and immigration effectively excludes undocumented migrants from access to public healthcare facilities. Language barriers may affect the quality of care received by migrant workers, by inadvertently resulting in medical errors, while preventing them from giving truly informed consent. CONCLUSIONS:We propose instituting migrant-friendly health services at public facilities. We also suggest implementing a comprehensive health insurance to enable healthcare access and financial risk protection for all migrant workers. Non-health sector solutions include the formation of a multi-stakeholder migration management body towards a comprehensive national policy on labour migration which includes health.
| S-EPMC6608924 | biostudies-literature
Project description:The effectiveness of peer support in improving mental health and well-being has been well documented for vulnerable populations. However, how peer support is delivered to migrant domestic workers (MDWs) to support their mental health is still unknown. This scoping review aimed to synthesize evidence on existing peer support services for improving mental health among MDWs. We systematically searched eight electronic databases, as well as grey literature. Two reviewers independently performed title/abstract and full-text screening, and data extraction. Twelve articles were finally included. Two types of peer support were identified from the included studies, i.e., mutual aid and para-professional trained peer support. MDWs mainly seek support from peers through mutual aid for emotional comfort. The study's findings suggest that the para-professional peer support training program was highly feasible and culturally appropriate for MDWs. However, several barriers were identified to affect the successful implementation of peer support, such as concerns about emotion contagion among peers, worries about disclosure of personal information, and lack of support from health professionals. Culture-specific peer support programs should be developed in the future to overcome these barriers to promote more effective mental health practices.
| S-EPMC9265321 | biostudies-literature
Project description:ObjectivesIn 2018, Spain adopted a national law that significantly expanded healthcare access to all residents, including undocumented migrants. This was a substantial shift from a more restrictive system of coverage in previous years. However, irregular migrants continue to experience challenges accessing healthcare in Spain. This study aimed to describe the legislative and administrative barriers to implementation of this law from the perspective of providers and administrators of the healthcare system.DesignWe interviewed 12 individuals using a semistructured format.SettingSpain.Participants12 participants were interviewed; 7 males, 5 females. Participants included Spanish healthcare workers, government officials, hospital administrators, individuals working with non-governmental organisations focused on the provision of healthcare, and experts studying healthcare for underserved populations.Primary and secondary outcome measuresInterviews delved into personal experiences and knowledge of the entitlements and barriers of providing or trying to access care for undocumented migrants.ResultsThe interviews yielded eight key themes: (1) context of universal healthcare in Spain pre-2012; (2) erosion of trust as rationale for more restrictive policies of 2012; (3) challenges of the 3-month residency requirement; (4) areas of ambiguity: exceptions in the 2012 Royal Decree Law not discussed in the 2018 Royal Decree Law; (5) jurisdictional authority and conflicts between national and AC government; (6) near impossibility of obtaining documentation for exportation of healthcare; (7) difficulties obtaining necessary paperwork to register residency; and (8) rise of NGOs to provide support to irregular migrants.ConclusionWhile there has been a general political movement to expand healthcare access for undocumented migrants in Spain, there remains a fundamental need to clarify the legal entitlements for undocumented migrants nationally and create administrative consistency across autonomous communities for providing health cards for undocumented migrants. Other countries may be able to draw lessons from the Spanish experience about the legislative frameworks surrounding access to healthcare for undocumented migrants.
| S-EPMC8395358 | biostudies-literature
Project description:Objectives: This paper explores policies addressing migrant worker's health and barriers to healthcare access in two middle-income, destination countries in Asia with cross-border migration to Yunnan province, China and international migration to Malaysia.Design: Qualitative interviews were conducted in Rui Li City and Tenchong County in Yunnan Province, China (n=23) and Kuala Lumpur, Malaysia (n=44), along with review of policy documents. Data were thematically analysed.Participants: Participants were migrant workers and key stakeholders with expertise in migrant issues including representatives from international organisations, local civil society organisations, government agencies, medical professionals, academia and trade unions.Results: Migrant health policies at destination countries were predominantly protectionist, concerned with preventing transmission of communicable disease and the excessive burden on health systems. In China, foreign wives were entitled to state-provided maternal health services while female migrant workers had to pay out-of-pocket and often returned to Myanmar for deliveries. In Malaysia, immigration policies prohibit migrant workers from pregnancy, however, women do deliver at healthcare facilities. Mandatory HIV testing was imposed on migrants in both countries, where it was unclear whether and how informed consent was obtained from migrants. Migrants who did not pass mandatory health screenings in Malaysia would runaway rather than be deported and become undocumented in the process. Excessive attention on migrant workers with communicable disease control campaigns in China resulted in inadvertent stigmatisation. Language and financial barriers frustrated access to care in both countries. Reported conditions of overcrowding and inadequate healthcare access at immigration detention centres raise public health concern.Conclusions: This study's findings inform suggestions to mainstream the protection of migrant workers' health within national health policies in two middle-income destination countries, to ensure that health systems are responsive to migrants' needs as well as to strengthen bilateral and regional cooperation towards ensuring better migration management.
| S-EPMC7713184 | biostudies-literature
Project description:There is a global increase in migrant workers. In Singapore, there are over 230,000 migrant domestic workers (MDWs). Female MDWs may experience high levels of stress and social isolation, which may negatively impact on their health and quality of life. There have also been documented cases of abuse and exploitation. However, there is a lack of empirical research with this population. This study aimed to investigate factors impacting on the health and quality of life of female MDWs in Singapore, including socio-demographic and job related characteristics, stress, social isolation, and working management style.A cross-sectional survey was carried out with 182 female MDWs in Singapore. The survey examined health and quality of life (WHOQoL-Bréf), social connectedness (the Friendship Scale), and preferred and experienced working management style (the Theory X and Theory Y Questionnaire). Descriptive analyses were carried out in addition to ANOVA, t-tests, and chi-square tests, followed by a multivariate analysis using linear regression.Participants were found to have good overall quality of life and satisfaction with health. Age and working experience were found to be significantly (p < 0.05) associated with overall quality of life and three domains (psychological, social, and environmental health). Agreement between experienced and preferred working management style was also found to be associated with higher quality of life scores (with the exception of the social relationships domain). Though women reported relatively good overall quality of life, more than half of participants reported feeling stressed. In addition, nearly 20% of participants reported being isolated or very isolated. Stress was identified to be associated with isolation. In the multivariate analysis, stress was found to contribute to worse quality of life in all domains except social relationships, after adjusting for confounders. Social connectedness was positively associated with all domains of quality of life, and agreement of working management style was positively associated with physical health, psychological health and environmental quality of life.The findings serve as an evidence-base pointing to the need for policies aimed at decreasing stress and social isolation among female MDWs in order to improve their health and quality of life.
| S-EPMC5634837 | biostudies-other
Project description:Objectives: Evaluate the psychometric properties and structural validity of the Filipino version of the Pittsburgh Sleep Quality Index (PSQI) among Filipino domestic workers (FDWs). Methods: In Study 1, 131 FDWs completed PSQI and other scales, along with 10-day actigraphic assessment with accompanying electronic daily sleep dairy. A subsample of 61 participants completed follow-up assessment after 10 days. In Study 2, 1363 FDWs were recruited and randomized into two halves. Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used in the two halves, respectively. Results: In Study 1, the Cronbach's alpha of the PSQI was 0.63 at baseline and 0.67 at follow-up. Test-retest reliability for the PSQI global score based on intraclass correlation was 0.63. Convergent validity was supported by the significant associations between the PSQI global score, PSQI components scores, sleep patterns from the daily sleep diary, and measures of depression, anxiety, and rumination. Small correlations between the PSQI global score and measures of daytime sleepiness, social support, and self-reported height, supported discriminant validity. In Study 2, EFA yielded two PSQI factors with acceptable factor loadings. CFA established that this two-factor model, comprised of perceived sleep quality and sleep efficiency, evidenced better model fit than alternative models tested. The Cronbach's alpha of two factors was 0.70 and 0.81, respectively. Conclusions: The PSQI demonstrated good internal consistency of two factors, and good convergent, and divergent validity. Results can be referenced in future studies to measure and screen sleep dysfunction among clinical and non-clinical populations in the Philippines.
| S-EPMC7400329 | biostudies-literature
Project description:Cervical cancer screening (CCS) has been proven to reducing mortality of cervical cancer; yet migrant women show a lower participation in screening compared to non-migrants. This study explores the perspectives of healthcare workers and community workers on the factors influencing the CCS participation of migrant women living in Portugal. A qualitative study with online focus groups was conducted. Healthcare workers experienced in CCS and community workers working with migrant communities were purposively sampled. A semi-structured guide was used covering the participation of migrant women in CCS, barriers, and strategies to overcome them. Data were analyzed using content analysis. Participants considered that migrant women have low participation in CCS related to insufficient knowledge, low risk perception, and lack of interest on preventive care. Other barriers such as difficulties in accessing the healthcare services, relationship with healthcare workers, language, and cultural differences were highlighted. Promoting continuity of care, disseminating culturally tailored information, and use of self-sampling methods were suggested to improve participation in CCS. Inequalities in access to CCS among migrant women are mostly caused by information gaps and healthcare system-related barriers. Building a migrant-friendly healthcare system that creates opportunities for healthcare workers to establish relationships with their patients and delivering culturally and linguistically adapted information may contribute to overcoming those barriers and increasing the participation of migrant women in screening.
| S-EPMC8305801 | biostudies-literature
Project description:Discrimination based on ethnicity and the lack of translation services in healthcare have been identified as main barriers to healthcare access. However, the actual experiences of migrant patients in Europe are rarely present in the literature. The aim of this study was to assess healthcare discrimination as perceived by migrants themselves and the availability of translation services in the healthcare systems of Europe. A total of 1407 migrants in 10 European Union countries (consortium members of the Mig-HealthCare project) were surveyed concerning healthcare discrimination, access to healthcare services, and need of translation services using an interviewer-administered questionnaire. Migrants in three countries were excluded from the analysis, due to small sample size, and the new sample consisted of N = 1294 migrants. Descriptive statistics and multivariable regression analyses were conducted to investigate the risk factors on perceived healthcare discrimination for migrants and refugees in the EU. Mean age was 32 (±11) years and 816 (63.26%) participants were males. The majority came from Syria, Afghanistan, Iraq, Nigeria, and Iran. Older migrants reported better treatment experience. Migrants in Italy (0.191; 95% CI [0.029, 0.352]) and Austria (0.167; 95% CI [0.012, 0.323]) scored higher in the Discrimination Scale to Medical Settings (DMS) compared with Spain. Additionally, migrants with better mental health scored lower in the DMS scale (0.994; 95% CI [0.993, 0.996]), while those with no legal permission in Greece tended to perceive more healthcare discrimination compared with migrants with some kind of permission (1.384; 95% CI [1.189, 1.611]), as opposed to Austria (0.763; 95% CI [0.632, 0.922]). Female migrants had higher odds of needing healthcare assistance but not being able to access them compared with males (1.613; 95% CI [1.183, 2.199]). Finally, migrants with chronic problems had the highest odds of needing and not having access to healthcare services compared with migrants who had other health problems (3.292; 95% CI [1.585, 6.837]). Development of culturally sensitive and linguistically diverse healthcare services should be one of the main aims of relevant health policies and strategies at the European level in order to respond to the unmet needs of the migrant population.
| S-EPMC8345338 | biostudies-literature
Project description:BackgroundFemale migrant domestic workers (MDW), approximately 8.5 million globally, often live in their employer's home under vulnerable conditions. In Hong Kong, MDWs currently comprise 5% of the population. This study was conducted to assess the association between employment conditions and mental health, and the mediating roles stress and job satisfaction have, among female MDWs in Hong Kong.MethodsParticipants completed an online cross-sectional survey. A total of 1,965 survey were collected between August 2020 and August 2021. Questions in the survey were related to MDWs background information, employment conditions, stress, job satisfaction, and two mental health outcomes: anxiety and depression. An employment conditions score was created to assess the cumulative effect poor employment conditions had on mental health. A multicategorical parallel mediation analysis was used to assess the direct effect employment conditions have on mental health and the indirect effects through stress and job satisfaction.ResultsOverall, 17.7% of MDWs were reported to be suffering from anxiety and 30.8% from depression. An increase in poor employment conditions was statistically associated with an increase in both outcomes, while stress levels and job satisfaction mediated this association.ConclusionsThe findings call for increased scrutiny of employment conditions and mental well-being of MDWs.
| S-EPMC10792881 | biostudies-literature