ACHIEVE Conducts Research on Sexual and Reproductive Health of Women Migrant Domestic Workers

In May 2009, Action for Health Initiatives (ACHIEVE), Inc. began the conduct of a study on access of women migrant domestic workers to sexual and reproductive health (SRH) services and information at the country of destination. This study was conducted in three countries, namely: Hong Kong, Singapore and Qatar. It employed qualitative data-gathering methods, mainly focus group discussions, in-depth interviews and key informant interviews. These interviews were supplemented by a review of existing laws and policies in these countries that pertain to labor and health-related policies for migrant workers.
A total of 147 women migrant domestic workers and 32 key informants were interviewed for this study. Among the key informants were Embassy officials, NGO workers, community leaders, healthcare providers, employers of domestic workers and government officials in the Philippines.
ACHIEVE worked closely with its NGO partners onsite in the conduct of this study: St. John’s Cathedral HIV Education Center in Hong Kong and Humanitarian Organization for Migration Economics (H.O.M.E.) in Singapore. In Qatar, ACHIEVE worked directly with the Philippines Embassy and with individuals from the Filipino community who were engaged in activities that included women migrant domestic workers.
Upon completion of the data gathering and analysis, ACHIEVE conducted a validation workshop in August of this year. This was participated in by women migrant domestic workers, representatives from the Department of Labor and Employment (DOLE), Philippine Overseas Employment Administration (POEA), Overseas Workers Welfare Administration (OWWA), Philippine Health Insurance Corporation, and various NGOs working on migration and health issues.
The initial findings of the study indicate that the level of access of women migrant domestic workers to SRH services is more often a function of their relationship with their employers. When employers are concerned about the well-being of their domestic workers, then access to health services, in general, is easy for the workers. In Hong Kong and Singapore, having a medical insurance or simply presenting a work permit, can gain them access to hospital services, including emergency care, which can even be free of charge. The most common barriers resulting from the attitude of employers and the nature of relationship they have with their workers, include: disallowing regular days off; non-payment of wages; disallowing the use of telephones and cell phones; and refusal to pay for medical costs.
However, utilization of SRH services in general, is also highly dependent on the attitudes and perceptions of domestic workers, themselves. Even in situations where these services are available and accessible, there are domestic workers who refuse to utilize them for various reasons, such as: fear of knowing what illness they may have, refusal to have a doctor check their private parts, and fear of possible termination if an SRH condition is confirmed, to name a few. There is also a strong aversion to being confined in a hospital in a foreign land, where there are no loved-ones to care for them.
The reliance of a domestic worker on the good graces of her employer in order to access health care in general, is very notable in Qatar. Although employers are encouraged to process a health card for their domestic workers that allows the latter to access medical services in government hospitals in Qatar, many of the domestic workers who were interviewed either did not have health cards or were totally unaware that they should have health cards. If a domestic worker who does not have a health card gets sick and needs to go to the hospital, it will be up to the employer whether to take her or not.
The study recommends for measures both at the pre-departure and onsite phases. These include: community-based awareness-raising on SRH issues to supplement the information given to migrant workers in their pre-employment or pre-departure orientation seminars; awareness-raising on the PhilHealth benefit package for OFWs to encourage membership and utilization; and the strengthened protection for women migrant domestic workers, including the strict implementation of the Reform Package for Household Service Workers issued by the POEA in 2006. The full report will be launched in December 2010. 
This research project is supported by the International Development Research Center (IDRC) in Canada.