Building a better understanding of labour exploitation's impact on migrant health: An operational framework

Abstract

Background There is limited evidence on labour exploitation’s impact on migrant health. This population is, however, often employed in manual low-skilled jobs known for poor labour conditions and exploitation risks. The lack of a common conceptualisation of labour exploitation in health research impedes the development of research measuring its effects on migrant health and, ultimately, our understanding of migrants’ health needs. Aim To develop an operational conceptual framework of labour exploitation focusing on migrant workers in manual low-skilled jobs. Methods Non-probabilistic sampling was used to recruit multidisciplinary experts on labour exploitation. An online Group Concept Mapping (GCM) was conducted. Experts: 1) generated statements describing the concept ‘labour exploitation’ focusing on migrants working in manual low-skilled jobs; 2) sorted generated statements into groups reflecting common themes; and 3) rated them according to their importance in characterising a situation as migrant labour exploitation. Multidimensional Scaling and Cluster Analysis were used to produce an operational framework detailing the concept content (dimensions, statements, and corresponding averaged rating). Findings Thirty-two experts sorted and rated 96 statements according to their relative importance (1 “relatively unimportant” to 5 “extremely important”). The operational framework consists of four key dimensions of migrant labour exploitation, distributed along a continuum of severity revealed by the rating: ‘Shelter and personal security’ (rating: 4.47); ‘Finance and migration’ (4.15); ‘Health and safety’ (3.96); and ‘Social and legal protection’ (3.71). Conclusion This study is the first to both generate an empirical operational framework of migrant labour exploitation, and demonstrate the existence of a "continuum from decent work to forced labour". The framework content can be operationalised to measure labour exploitation. It paves the way to better understand how different levels of exploitation affect migrant workers’ health for global policymakers, health researchers, and professionals working in the field of migrant exploitation.

‘They treat us like machines’: migrant workers’ conceptual framework of labour exploitation for health research and policy

“…The dimensions ‘poor employment conditions and protection’ and ‘health and safety’ echo what we found in the ‘expert skeleton’ framework with professional experts 13. However, by following recommendations to better engage communities in research,64–66 our research revealed the content of the dimension of ‘disposability and abuse of power’ which reflects a widespread view in qualitative research and activism that migrant workers are treated like machines and not as humans 67.…”

“…This list was then reduced and synthesised until a final list of less than 100 statements was reached, as recommended by GCM developers 52. Following the example of Boufkhed et al ,13 duplicates and statements deemed to be outside the study scope were deleted. Given the high number of raw statements, the statements were reduced further by combining those that were very specific or comparable experiences to create a more general, encompassing statement 61.…”

“…However, the dearth of research on migrant workers’ exploitation and health has been highlighted in the past few years,10 11 and the lack of a standard conceptualisation has hindered the development of quantitative assessment of labour exploitation’s impacts on migrant workers’ health. Issues of labour exploitation in the health field have been mostly explored conceptually and in practice through two schools of thought 12 13. The Human Rights School focuses on severe and criminal forms of migrant worker exploitation such as modern slavery and human trafficking, and emphasises exposure to violence and physical harms 14.…”

“…Boufkhed et al proposed a standardisable conceptual framework of migrant worker exploitation in low-paid jobs for health, bringing together the two schools of thought based on professional experts’ perspectives 13. They argue that their framework could be culturally and contextually adapted.…”

Accidental traffickers: Qualitative findings on labour recruitment in Ethiopia

“…Among an estimated 169 million migrant labourers globally (9), the number who nd themselves in "dirty, dangerous and demeaning work" (10) remains unknowable, although its negative implications for health are clear (11,12). Taking a public health approach to the harm caused by human tra cking and labour exploitation suggests the need to intervene "upstream" to address their structural determinants (13,14). Yet despite decades (even centuries (15)) of efforts to curb tra cking, there have been few insights into effectiveness of most approaches (16-18) and, conversely, there has been evidence of damage caused by heavy-handed anti-tra cking measures, often motivated by political and social concerns related to migration and/or sex work, more broadly (19)(20)(21)(22)(23).…”