They are both providers and consumers of health and social care. Countries must work urgently and collaboratively to overcome the challenges, contradictions, gaps, and inconsistencies in international, national, and subnational policies, laws, and programmes across all relevant sectors to combat the negative experiences of the care paradox for women migrant care workers. Integrating a gendered lens into policy actions will help mediate concerns on the growing demand for care and is a crucial component of maintaining global and national public health.
The care paradox refers to the fact that immigrant women are increasingly being imported into receiving country economies to provide care, and yet lack access to social protection and labour rights.
Migrant women care workers can face health challenges as a result of their work and migration status; they may also be excluded from and underserved by the health systems to which they contribute due to race, ethnicity, language, type of work (informal/formal, irregular/regular) and their migrant status (undocumented).
Migrant care workers have poorer reproductive and sexual health and health care than native born women, and there is ample evidence that these women are subject to physical violence including sexual harassment/assault and regular beatings.
Governments should respect the contributions of migrant women care workers – in all their diversity – to the care economy. They should acknowledge migration as a social determinant of health and, in turn, modify policies to ensure migrant women are not left behind in the development process and can access basic services to safeguard their health needs, well-being, and rights.
Overall, more collaboration between different stakeholders is needed to understand and overcome the intersecting complexities of migrant women care workers and their relationship to global public health. This would involve a process of redesigning service delivery to account for the multitude of factors that affect migrant (women) care workers’ health.
Importantly, we must improve access to UHC through specific measures to address non-discrimination and promote the inclusion and social participation of migrant women and other care workers.
A “whole-of-government” approach is recommended; developing and strengthening bilateral agreements between labour-sending and labour-receiving countries is necessary to protect the rights of migrant care workers. Beyond this, policymakers must ratify and apply relevant international labour standards, as well as adopt unilateral measures to enhance migrant workers’ access to social protection.
