Shelters and clinics: sites where care and violence are mutually constitutive for migrant workers in Singapore

The social determinants of migrant domestic worker (MDW) health and well-being in the Western Pacific Region: A Scoping Review

“…A total of 33 sources from the peer-reviewed (n = 14) and gray literature (n = 19) focused on working conditions, limits on healthcare coverage, and policy restrictions as barriers to accessing formal healthcare services. Studies in Hong Kong and Singapore described access to care as largely determined by employers’ willingness to allow their workers to seek care [ 76 , 151 ]. A mixed-methods study of 30 MDWs in Hong Kong found that healthcare access was associated with MDWs’ technology and internet access, especially via up-to-date health information and telemedicine appointments during the COVID-19 pandemic, and support from employers and friends [ 175 ].…”

“…Some studies discussed discrimination within healthcare settings and distrust of providers as a barrier to health care. MDW participants in Singapore described care providers’ negative judgments and seeming unwillingness to treat MDWs [ 76 ]. Filipino MDWs in a Macau-based study referenced language barriers and a lack of trust [ 34 ].…”

“…The findings of MDWs’ perceived discrimination, distrust, and language barriers in healthcare settings were also supported by global data on barriers to health for migrants [ 208 , 209 ]. However, given the finding that access to care for MDWs was mostly determined by employers, a prominent gap in the literature was an exploration of employers’ decision-making regarding their workers’ healthcare needs and coverage [ 76 , 141 ].…”

“…Studies conducted in Singapore were comprised of participants from the Philippines, Indonesia, India, Sri Lanka, Cambodia, and Myanmar. Physical health problems identified among Singapore-based studies included unintentional injuries, back pain, breathing problems, thyroid illness, digestive issues, and HPV [73][74][75][76][77][78]. Two studies described physical deterioration, pains, and chronic conditions like diabetes among older MDWs from the Philippines, Indonesia, India, and Sri Lanka who had worked overseas for 20 to 30 years [74,75].…”

“…A PLOS GLOBAL PUBLIC HEALTH study on HPV found that 22.2% of participants (n = 226), primarily comprised of Filipino MDWs, tested positive for HPV, although 70% of the positive results were for non-16 and non-18 HPV strains [73]. In terms of mental health and well-being, the main outcomes among samples in Singapore included emotional pain, stress, trauma, and anxiety from caregiving burdens, poor relationships with employers, and separation from children and family [31,[74][75][76][78][79][80][81][82]. One study conducted on MDWs (n = 100) engaged in eldercare found that 4% of the study sample met criteria for clinically elevated anxiety [79].…”