1. ‘Behind Closed Doors’ Global Seminar on the Human Rights of Migrant Domestic Workers in an Irregular Situation
A call to action:
ensuring equitable access to
a continuum of health care
and services for migrant
domestic workers
Dr. Maria Nenette Motus
International Organization for Migration (IOM)
Regional Office for Asia and Pacific, Bangkok 1

2. Migration Mega-trend: 1 in 7 on the move
7 billion Population
1 billion Migrants
247 million International
>740 million Internal
Urbanization: 50% Feminization: ca. 50%
Irregular : 15-20% – 25 million women in domestic services (83%)
Six Drivers of Migration
1. DEMOGRAPHY
2. DEMAND
3. DISTANCE
4. DIGITAL REVOLUTION
5. DISPARITY
6. DISASTERS 2

3. Why focus on health of migrant domestic workers?
They are human beings, and have a right to health
Migrant-inclusive health systems improves global health outcomes and health security
(origin/transit/ destination)
Healthy migrants contribute to positive sustainable development outcomes.
The right to health is a human right, i.e. a birthright of every human being. Especially groups of vulnerable migrants (women, children, undocumented and low skilled migrant workers, etc.) are at higher risk of not having those rights realized.
From a public health perspective, realizing migrants’ right to health makes practical sense – it is cost-effective and improves public health outcomes. Promoting the usage of primary health care and early treatment, as opposed to leaving migrants’ health to be managed by costly emergency care, avoids high costs for the health system and reduces the risk of transmission of communicable diseases.
From a global economic, social and human development perspective, migrants’ health is a prerequisite for migrants to be able to contribute to development and enhance their personal well-being, as well as that of their families, and countries of origin and destination. Indicators that monitor the equitable access of migrants to healthcare, and that inform evidence-based, relevant policy coherence across sectors, should be included within the post-2015 development framework.
A shared responsibility!

4. ‘Healthy Migrant Effect’ & Spaces of Vulnerability
Destination
Pre-departure
Return
Travel
Cross-cutting factors
When migrating , people bridge disparate health environments. people bring their epidemiological profiles ,culture, values, health beliefs and vulnerabilities. Health of migrants can be better as compared to the host community for some conditions, or worse. Migrants may introduce conditions and acquire conditions while migrating or residing in host communities and introduce acquired conditions when returning home. This is not only of relevance in the context of infectious problems , but as evidence proves, also NC conditions.
A WHO WHO Secretariat report on the health of migrants clarified that most migrants are healthy , young people - the ‘Healthy Migrant Effect’ - but conditions surrounding the migration process can increase vulnerability to ill health. This is most obvious for those who migrate involuntarily, fleeing natural or man-made disasters and human rights violations, or those who migrate clandestinely or fall in the hands of traffickers

5. Domestic Service - a space of vulnerability

6. Trafficked Migrant Domestic Workers
(IOM Indonesia Recovery Center )
Number of positive Chlamydia test results based on type of exploitation.
Percentage of positive STI results among VOTs assisted in year 2006

7. Trafficked Migrant Domestic Workers
(IOM Indonesia Recovery Center )

8. Stranded Domestic Workers in Conflict Situations
Libya Crisis

9. Stranded Domestic Workers in Irregular Situation in Conflict Situations
Syria Crisis
Yemen Crisis

10. IOM Migration Crisis Operational Framework
15 Sectors of Assistance
Emergency Evacuations
Health Care
Assistance
Travel Health Assistance
Psychosocial
Support
Return and Reintegration

11. Challenges in promoting health & well being of migrant domestic workers
National level: health of migrants not often safeguarded:
Migrants still seen as burden on health system and carriers of disease
‘Generous’ social rights seen as a potential pull factor
Migrants too often remain invisible, marginalized and excluded (empowerment?)
Lack of policy coherence, and multi-sectoral collaboration
International level: health of migrants absent in global debates:
Often absent in global health debates (SDH, NCD, Disease Control programmes, etc.)
Often absent in debates on migration & development (HLD M&D, GFMD, GMG, Post-2015, etc.)

12. Operational Framework on Migrants’ Health:
WHO & IOM Global Consultation
on WHA Resolution on Health
of Migrants (2010)
Operational Framework on Migrants’ Health:
Monitoring Migrant Health
Partnerships, Networks and Multi country Frameworks
Policy and Legal Frameworks
Migrant-Sensitive Health Systems

13. Opportunities for Advocacy Efforts
Global Forum on Migration
and Development (GFMD)
Colombo Process

14. A shared responsibility : to promote equitable access to continuity of health care services
Conceptual framework
STAKEHOLDERS
Action Pillars
Critical Domains
Gov’ts
(origin/transit
& destination)
_____
Regional Government Structures
Migrant Workers & Families
Labor Migration & Development
Health Services Capacity Buiding
Migration Health
Research & Data Sharing
Social Welfare
Advocacy for Policy Changes
Research
Donor Community
Multi-Sector Partnerships
Civil Society
Primary Heath Care & Referral
Sustainable Development Goals
Rights &
Protection
Social Determinants of Health
Media & Public Info 14