The Impact of Micro and Macro Level Factors on the Working and Living Conditions of Migrant Care Workers in Italy and Israel—A Scoping Review

Abstract

Background: The provision of home-based care for frail older adults in Italy and Israel is predominately provided by live-in migrant care workers (MCWs). However, despite the important role that they play in filling the demand for home care, MCWs often experience labor rights violations. This not only impacts the well-being of MCWs but also leads to lower-quality care being provided to people in need of support. Method: This scoping review used Arksey and O’Malley’s methodological framework to map literature. This article aims to analyze the scope, main topics, themes and gaps in the existing academic literature on how micro and macro level indicators impact the working and living conditions of live-in MCWs in Italy and Israel. Scopus, Pubmed, and Web of Science Core Collection were searched for peer-reviewed articles. Search terms were adapted from the Multilevel Framework of Transnational Care Migration (MFTCM). Themes were developed using Braun and Clarke’s method for conducting reflexive thematic analysis. Articles were included if they focused on Italy and/or Israel, included analysis on the working and living conditions of live-in MCWs at the macro and/or micro levels, were written in English, and were published between 2015 and 2020. Results: Out of the 1088 articles retrieved, 33 met the inclusion criteria. A total of 18 articles focused on Italy and 14 on Israel, and one focused on both Italy and Israel. The majority of articles in Italy (84 per cent) and Israel (53 per cent) included analysis on care regimes. Only 37 per cent of articles in Italy and 20 per cent in Israel included analysis on gender regimes. At the micro level, 80 per cent of articles in Israel discussed Power/Class Asymmetry, compared to 37 per cent in Italy. In total, six themes were developed. At the macro level, these themes included funding care work, MCWs as a pragmatic approach, care in the home, and valuing care work. At the micro level, the themes included being part of the family, and perceptions on class asymmetries. The findings presented in this review show that MCWs in both Italy and Israel face many of the same challenges in accessing decent work opportunities, despite contrasting employment and migration policies in each country. This can be partially attributed to the undervaluing of care work because of racialized and gendered notions of care. At the macro level, this has contributed to a lack of political will to develop long-term sustainable solutions to create or monitor decent work standards for MCWs. At the micro level, this has led to power imbalances between MCWs and people in need of care and their family members, resulting in MCWs being expected to work hours beyond those contractually allowed, having little to no time off, and experiencing emotional, physical, and sexual abuse. Conclusion: This study provides a review of the most recent contributions to the fields of labor migration and health concerning the MCW markets in Italy and Israel. While there have been many studies in each country that detail the labor rights violations experienced by MCWs, this is the first review that develops themes around the underlying causes of these violations. By thematically analyzing the findings of recent studies and current gaps in existing knowledge, this scoping review assists in building the groundwork for the development and implementation of policy, strategies, practice and research to improve the rights and migration experiences of MCWs.

Role and Characteristics of Personal Care Assistants of Frail Older People with Functional Limitations Ageing in Place in Italy

“…DOMINA [ 34 ] puts in evidence data partially different for Italy, with a minority of living-in care workers (34%), and a greater 66% hired on hourly basis, with cohabitation requiring a greater number of working hours, on average 38 h, against 20 for non-cohabitants. Other authors indicate that families hiring PCAs expect them to care around the clock, i.e., 24 h each day [ 67 ], whereas they officially (by regular employment contract) should work up to 54 h per week and up to 10 h per day [ 61 , 68 ]. Our findings further stressed the existence of combination of daily/nightly assistance, and the importance in particular of a supervision during the sleep.…”

“…In six situations respondents report indeed serious difficulties for paying the current PCA, with consequent waivers. Thus, in Italy, on the one side a widespread availability of “economic benefits” favors the use of the private care assistance market, but on the other side these financial allowances do not cover the whole costs of PCAs [ 67 ].…”

“…In particular ethnicity of PCAs sometimes impacts willingness to hire them for caring older relatives, who in some cases accept help only from certain nationalities. Thus, the relationship between PCA and older people cared for is extremely important for making this care worker being part of the family [ 67 ], and recruitment and skill requirements of PCAs are aspects requiring particular attention [ 81 ].…”

Low-Wage Agricultural Migrant Workers in Apulian Ghettos, Italy: General Health Conditions Assessment and HIV Screening

“…Few data are available on the health status of migrant workers in Europe, but previous studies in Nepal, Tanzania and Ethiopia have documented a low prevalence of HIV in migrant farm workers, low condom use, high risk of risky sex and high prevalence of malnutrition, and reinforce the need for screening for diseases related to a poor quality of work and life, which is strongly correlated with tuberculosis and non-communicable diseases, such as hypertension and diabetes, and overwork illnesses, such as rickets, asthenia, muscle/fatigue pain and mental health illnesses [ 11 , 12 , 13 , 14 ].…”

Special Issue on “Advances in Socio-Economic Research on Ageing”

“…Last but not least, in the background of the observation that long-term care provision to community dwelling frail older adults in many countries is partly provided by live-in migrant care workers, the study of Oliver Fisher et al [ 19 ] provides a scoping review of recent contributions in this field with regard to Italy and Israel; the two of the countries in which this phenomenon is most widespread. The novelty of this piece of research lies in the fact that, while there have been many studies that detail the labour rights violations experienced by migrant care workers, this is the first review that develops themes around the underlying causes of these violations.…”