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Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

Women on the move: Migration, care work and health
World Health Organization
2017 : 102 pages
ISBN: 978-92-4-151314-2
PDFs:    Women on the move: Full report
Women on the move: Policy brief
Executive Summary [Excerpt; text bolding from original]
Ageing in late industrial and middle-income economies, combined with rising demographic dependency ratios and female labour force participation, has led to emerging care deficits in many developed and developing countries. Around the world, more women are entering the labour force, thus taking them away from traditional unpaid caring roles.

This report focuses largely on one population group: women migrant care workers who provide home-based personal care. However, many of the issues, and the next steps suggested here, also apply to other migrants and refugees – particularly women and girls – as well as to other socially excluded and marginalized groups engaged in paid and unpaid care work across the world.

Without a doubt, women migrant care workers play an increasingly prominent role in securing and protecting the health status of others and are contributing both to health in the broadest sense and to health systems. Yet relatively little is known about their own health status, the health implications to their families of their out-migration, and the extent of their important contributions to health systems. Around the world, care workers are overwhelmingly female, and many are migrants. This report documents how, despite making a large contribution to global public health, they are exposed to many health risks themselves, while enjoying few labour market and health protections. The report also underscores that paid and unpaid care work is central to the broad health and well-being of individuals, their families and communities, as well as society at large.

The care paradox: global public health and the role of migrant women care workers
Increasingly, immigrant women are being imported into receiving country economies to care, often in informal settings, and are frequently engaged by private households, without full access to social protection and labour rights. Yet this group of migrants provides essential care services and, increasingly, health-care services, thus contributing to health systems and to health and well-being worldwide.

As the leading normative agency on health, the World Health Organization (WHO) calls attention to the paradox that migrant women care workers buttress health systems in countries with shortfalls in health-care provision, while their own rights to health may be eroded and their health-care needs are unfulfilled. Migrant women care workers act as a cushion for states that lack adequate public provision for long-term care, child care and care for the sick.
 
Unmet needs and growing demand for care
Home-based personal care – whether for older persons, children, or those with chronic diseases or disabilities – constitutes an important component of modern health systems. This applies to both high-income countries, where formal health-care institutions and services are struggling to meet the growing demand for such care, as well as to middle- and lower-income countries and regions where home-based care relieves the demand for, and expense of, institutional care. In all societies there is a cultural preference for care “in the family” or for “ageing in place”.

One area in which the care deficit in receiving countries is particularly pronounced is long-term care for older persons. Critical shortages of long-term care workers make quality services  unavailable for large parts of the global population aged 65 years and over. The extent of the unmet need varies worldwide, but in Europe alone the shortage is estimated at around 2.3 million formal long-term care workers.

The policy architecture related to care work, migration and women
The unique status of migrant women care workers as both providers and consumers of health and social care requires that both sending and receiving countries reflect on this paradox and work urgently, and much more collaboratively, to overcome challenges, contradictions, gaps and inconsistencies in international, regional, national and subnational policies, laws and programmes across all relevant sectors. This report proposes the integration of policy actions – and of gender, equity and human rights approaches – to mediate concerns about care deficits and decent and safe work in the care sector as a crucial component of maintaining global and national public health.

Why this report?
WHO initiated this report in response to growing global political interest in population health and development, particularly noting discussions at the 42nd G7 meeting in Japan in May 2016 which called for more attention to migrants and their role in paid and unpaid care work. It is hoped that this report, and its reflection on potential next steps, will foster further debate about approaches to ensure that the global community meets its obligations to leave no one behind in securing long-term equitable and sustainable development. The analysis is also shaped by commitments to the principles of human rights, the Tanahashi Framework on health service coverage and evaluation, the United Nations Migration Governance Framework,i the Framework of priorities and guiding principles for a World Health Assembly Resolution on the health of migrants and refugees, the concept of progressive universalism towards achieving universal health coverage (UHC), and the 2030 Agenda for Sustainable Developmentii with its overarching goal of leaving no one behind…

[See also full-text of Lancet editorial “Caring for migrant health-care workers” in Journal Watch below]