A survey of health problems of Nepalese female migrants workers in the Middle-East and Malaysia

Work-related challenges and their associated coping mechanisms among female head porters (Kayayei) in Ghana

Background

While internal migrants (Kayayei) in Ghana have been perceived as a vulnerable group facing various health-related challenges, there has not been enough research on the impact of their work on their health and well-being. This study investigated the lived experiences of the Kayayei to identify the health-related challenges associated with their work and the coping mechanisms they adopt in dealing with these challenges.

Methods

We interviewed 21 participants purposely selected and conducted two focus group discussions (FGD) of five participants each at the Agbogbloshie market. Interpretive Phenomenology Analysis Approach was used to identify themes and sub-themes. Statements from participants were presented as quotes to corroborate their views.

Results

The work-related challenges identified in the study were physical health, mental health, accommodation, and social challenges. Religion, recreation, social support, hope, resilience, and self-medication were the coping strategies adopted by the study participants.

Conclusion

The government of Ghana should be encouraged to work with stakeholders like social welfare to raise awareness about women's rights, build their skills to increase their employment opportunities, enhance their safety, health, and overall well-being. It is also important to ensure the networking of relevant stakeholders to work with women in the informal sector to foster agency and provide support when needed.

A Qualitative Insight into Pre-Departure Orientation Training for Aspiring Nepalese Migrant Workers

Pre-departure orientation training (PDOT) can help equip aspiring migrant workers with skills and knowledge to mitigate vulnerabilities throughout their migration journey, including health. In Nepal, PDOT has been mandatory since 2004 for migrant workers awaiting labour permits. The current PDOT programme includes country-specific information as well as health and well-being advice. However, the views of trainees and trainers on PDOT are largely unknown. This qualitative study aims to explore perceptions of migrant workers and relevant stakeholders on the content and delivery of PDOT. Six focus group discussions and six in-depth interviews were conducted with migrants, and eight interviews with key stakeholders were conducted. Thematic analysis resulted in five themes: (a) PDOT structure, accessibility, and implementation; (b) role of stakeholders in labour migration process; (c) coordination and governance; (d) curriculum development and relevance; and (e) capacity of trainers and effectiveness of training. Our findings emphasise the need for a more tailored curriculum with relevant information, education, and communication resources, possibly with input from former migrant workers. Regular updates of training topics and resources, as well as continued engagement with migrants after their employment, are essential for meeting the dynamic demands of the global employment market.

Migrant workers' health-related research in Nepal: A bibliometric study

Background

In recent years, the health of migrants has become an important global public health issue. However, less is known about the current status of research activity among Nepalese migrants' health. This study aimed to assess the current status of research activity by analysing published peer review literature on Nepalese migrants' health.

Methods

A systematic search of published literature on Nepalese migrant workers' health was conducted in Scopus, Medline, CINAHL, Embase, PsycINFO and Web of Science, and a bibliometric analysis methodology was used. The search of databases retrieved 520 records, and a total of 161 papers were included in the analysis. Bibliometric analyses were performed in R and VoSViewer to create visualisation maps.

Results

The retrieved documents were published in the last three decades, and a total of 533 researchers originating from 24 countries contributed to the literature. A large proportion of papers (n=22) were published in a single year, in 2019, and the number of authors per journal ranged from one to 14. The topmost preferred journals for publications in Nepalese migrants' health were PLoS One (n=9), followed by the Journal of Immigration and Minority Health (n=6). The retrieved articles received 2425 citations, with an average of 15.1 citations per article. The study identified nine overlapping research domains (thematic areas) - infectious disease, non-communicable diseases, health and lifestyle, sexual and reproductive health, access to health services, workplace safety, maternal health, gender-based violence, and health system and policy.

Conclusion

The present bibliometric study fills an analytical gap in the field of migrat's health research in Nepal and provides evidence and insights to advocate the formulation of strategies to promote the migrants' health vulnerabilities often associated with individual-related hazards such as working in 'difficult, dirty, and dangerous (3Ds) working conditions.

Psychological morbidities among Nepalese migrant workers to Gulf and Malaysia

BACKGROUND

One of the important aftereffects of rapid global development is international mobility, which has placed the health of migrant workers as a key public health issue. A less-developed country, Nepal, with political instability and a significant lack of employment, could not remain untouched by this phenomenon of migration. Our goal was to identify and determine the predictors of anxiety, depression, and psychological wellbeing among Nepalese migrant workers in Gulf countries (United Arab Emirates, Saudi Arabia, Qatar, Oman, Kuwait, Bahrain) and Malaysia.

METHODS

A descriptive cross-sectional study was used to collect information from 502 Nepalese migrant workers in the arrival section of Tribhuvan International Airport from May to June 2019 using purposive sampling. Workers with a minimum work experience of 6 months and above were included in the study. A structured questionnaire with socio-demographic items was used along with the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and WHO (five) wellbeing scale for measuring the subjective psychological wellbeing and screening for depression.

RESULTS

The mean age of the respondents was 32.97 years. Majority (41.8%) of the respondents had work experience in Qatar and 63.7% had work experience of 1-5 years. The results suggested that 14.4% had mild to severe depression while 4.4% had a moderate level of anxiety. The WHO5 wellbeing index score suggested that 14.1% of the respondents had a score below 13, which is suggestive of poor psychological wellbeing. Further, the country of work (p = 0.043), sleeping hours (p = 0.001), occupation (p = 0.044), working hours (p = 0.000), water intake (p = 0.010) and anxiety level (p = 0.000) were found to be significantly associated with depression score. Similarly, sleeping hours (p = 0.022), occupation (p = 0.016), working hours (p = 0.000), water intake (p = 0.010), and anxiety level (0.000) were significantly associated with the WHO5 wellbeing score.

CONCLUSIONS

Nepalese migrant workers in the Gulf countries (United Arab Emirates, Saudi Arabia, Qatar, Oman, Kuwait, Bahrain) and Malaysia bear an important burden of psychological morbidities. This highlights the need to prioritize the migrant worker's mental health by Nepal as well as Gulf countries and Malaysia.

The burden of mental disorders in Nepal between 1990 and 2019: Findings from the Global Burden of Disease Study 2019

Mental disorders are the leading cause of disease burden, affecting 13% of all people globally in 2019. However, there is scarce evidence on the burden of mental disorders in Nepal. This study used the Global Burden of Disease Study 2019 data to assess the prevalence and disability-adjusted life-years (DALYs) of mental disorders in Nepal between 1990 and 2019. In 2019, there were 3.9 million (95% UI: 3.6-4.3) people with mental disorders in Nepal. Major depressive disorders (1.1 million; 95% UI: 0.9-1.2 million) and anxiety disorders (0.9 million; 95% UI: 0.8-1.2 million) were the most prevalent mental disorders in 2019. Attention deficit hyperactive disorder, conduct disorder, and autism spectrum disorders were present twice as high in males than in females. The proportional contribution of mental disorders to the total disease burden has tripled between 1990 (1.79% of all DALYs) and 2019 (5.5% of all DALYs). In conclusion, the proportional contribution of mental disorders to total disease burden has increased significantly in the last three decades in Nepal, with apparent sex and age differentials in prevalence and DALY rates. Effective program and policy responses are required to prepare the health system for reducing the growing burden of mental health disorders in Nepal.

Health needs of migrant female head porters in Ghana: evidence from the Greater Accra and Greater Kumasi Metropolitan areas

BACKGROUND

In low-and middle-income countries, migrants are confronted with health needs which affect the promotion of their well-being and healthy lives. However, not much is known about the health needs of migrant female head porters (Kayayei) in Ghana. This study assesses the health needs of migrant female head porters in the Greater Kumasi Metropolitan Area (GKMA) and Greater Accra Metropolitan Area (GAMA).

METHODS

The study adopted a convergent mixed methods design where both qualitative and quantitative data were used. A representative sample size of 470 migrant female head porters was used for the study.

RESULTS

The study revealed that ante-natal care, post-natal care, treatment of malaria, treatment of diarrhoea diseases, mental health, sexual health, and cervical cancer were health needs of migrant female head porters. The findings showed that participants from the GAMA significantly have greater cervical cancer needs (71.6% vrs 67.1%, p = 0.001) compared to those from the GKMA. Kayeyei from the GKMA significantly have greater mental health needs than those from the GAMA (84.6% vrs 79.2%, p = 0.031). Also, Kayeyei from the GKMA significantly have higher attendance of post-natal care compared to those from the GAMA (99.4% vrs 96.2%, p = 0.013).

CONCLUSION

The findings underscore differential health needs across geographical localities. Based on the findings of the study, specific health needs such as ante-natal care and post-natal care should be included in any health programmes and policies that aim at addressing health needs of migrant female head porters in the two metropolitan areas of Ghana.

Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible?

OBJECTIVE

The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub-Saharan Africa (SSA).

DESIGN

We analysed cross-sectional data of 108971 women in sexual unions from the most recent Demographic and Health Surveys of 26 countries in SSA. The predictors of physical violence were examined using a multilevel binary logistic regression. All the results were presented as adjusted odds ratios (aORs) with their corresponding 95% confidence intervals (CIs).

SETTING

Twenty-six countries in SSA.

PARTICIPANTS

108 971 women who had ever been pregnant.

OUTCOME MEASURE

Physical violence during pregnancy.

RESULTS

Physical violence was identified in 6.0% of pregnant women in SSA. The highest prevalence (14.0%) was reported in South Africa, while Burkina Faso recorded the lowest (2.1%). Women who had primary (aOR=1.26, 95% CI=1.15, 1.38) and secondary education (aOR=1.15, 95% CI=1.01,1.32); those who were cohabiting (aOR=1.21, 95% CI=1.11, 1.32); those who were working (aOR=1.17, 95% CI=1.08, 1.28); and those whose partners had primary (aOR=1.15, 95% CI=1.04, 1.28) and secondary education (aOR=1.14, 95% CI=1.01, 1.28) were more likely to experience physical violence during pregnancy compared with those who had no formal education; those who were married; those who were not working, and those whose partners had no formal education, respectively. Moreover, women whose partners consumed alcohol (aOR=2.37, 95% CI=2.20, 2.56); those who had parity of four or more (aOR=2.06, 95% CI=1.57, 2.72); and those who perceived intimate partner violence (IPV) as a culturally accepted norm (aOR=1.55, 95% CI=1.44, 1.67) had higher odds of experiencing physical violence during pregnancy compared to those whose partners did not consume alcohol, those with parity zero, and those who did not perceive IPV as culturally accepted, respectively. On the contrary, women who were aged 35-39, those who were of the richest wealth index, and those in rural areas had reduced odds of experiencing physical violence during pregnancy.

CONCLUSION

Based on the findings, community leaders are encouraged to liaise with law enforcement agencies to strictly enforce laws on gender-based violence by prosecuting perpetrators of IPV against pregnant women as a deterrent. Also, intensifying education on what constitutes IPV and the potential consequences on the health of pregnant women, their children, and their families will be laudable. Improving the socioeconomic status of women may also help to eliminate IPV perpetration against women at their pregnancy stage.

Partner alcohol consumption and intimate partner violence among women in Papua New Guinea: a cross-sectional analysis of Demographic and Health Survey

OBJECTIVE

We examined the association between partner alcohol consumption and the experience of intimate partner violence among women in Papua New Guinea.

DESIGN

We performed a cross-sectional analyses of data extracted from the 2016-2018 Papua New Guinea Demographic and Health Survey. We included 3319 women in sexual unions. Multilevel binary logistic regression analysis was used to examine the association between partner alcohol consumption and intimate partner violence, controlling for the covariates. Results from the regression analysis were presented using the crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95% confidence intervals (CIs).

SETTING

Papua New Guinea.

PARTICIPANTS

Women aged 15-49 years in sexual unions.

OUTCOME MEASURES

Physical, emotional, and sexual violence.

RESULTS

The prevalence of physical, emotional and sexual violence among women in sexual unions in Papua New Guinea were 45.9% (42.4 to 47.7), 45.1% (43.4 to 46.8) and 24.3% (22.9 to 25.8), respectively. The level of partner alcohol consumption was 57.3%. Women whose partners consumed alcohol were more likely to experience physical violence (aOR=2.86, 95% CI=2.43 to 3.37), emotional violence (aOR=2.89, 95% CI=2.44 to 3.43) and sexual violence (aOR=2.56, 95% CI=2.08 to 3.16) compared with those whose partners did not consume alcohol.

CONCLUSION

This study found a relatively high prevalence of intimate partner violence among women in Papua New Guinea. Most importantly, this study found partner alcohol consumption to be significantly and positively associated with intimate partner violence. The study, therefore, recommends that interventions seeking to reduce intimate partner violence among women in Papua New Guinea should intensify behaviour change and education on reducing or eliminating partner alcohol consumption.

Health and Wellbeing of Nepalese Migrant Workers in Gulf Cooperation Council (GCC) Countries: A Mixed-methods Study

Introduction

Migrant workers support low- and middle-income economies through remittances, often bearing considerable health risks with long-term consequences. This study aims to understand the health and wellbeing issues of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries, a major destination for low-skilled Nepalese workers.

Methodology

We conducted a mixed-methods study in Dhading district of Nepal. A pilot survey was carried out with returnee migrants from GCC countries to understand key health and wellbeing issues faced by workers. In addition, in-depth interviews were conducted with a subset of these returnee migrants and their families, and related stakeholders. These aimed to understand broader societal and policy implications in relation to labour migration. Quantitative data from the survey were analysed using descriptive statistics and thematic analysis was used for qualitative interviews.

Results

60 returnee migrants (58 males, 2 females) took part in the survey (response rate, 100%). Median age of the survey participants was 34 (IQR, 9) years and 68% had completed school level education. Returnee migrants reported suffering from various physical and mental health issues during their stay in GCC countries including cold/fever (42%), mental health problems (25%) and verbal abuse (35%). 20 participants took part in the qualitative study:10 returnee migrants (8 males, 2 females), four family members (female spouses) and six key stakeholders working in organizations related to international migration. Interview participants reported severe weather conditions resulting in physical health problems (e.g. pneumonia, dehydration and kidney disease) as well as mental health issues (including anxiety, loneliness and depression). Participants raised concerns about the usefulness and appropriateness of pre-departure training, and the authenticity of medical tests and reports in Nepal. Female migrants reported facing stigma after returning home from abroad. Language difficulties, alongside issues related to payment, insurance and support at work were cited as barriers to accessing healthcare in destination countries.

Conclusion

Our study shows that Nepalese migrant workers experience severe weather conditions and suffer from various physical and mental health issues, including workplace abuse and exploitation. The study highlights an urgent need for strategies to enforce compulsory relevant pre-departure orientation and appropriate medical screening in Nepal, and fair employment terms and full health insurance coverage in destination countries. Greater collaboration between the Nepalese government and GCC countries is needed to ensure necessary legislation and regulatory frameworks are in place to safeguard the health and wellbeing of migrant workers.

Impact of a sanitation intervention on quality of life and mental well-being in low-income urban neighbourhoods of Maputo, Mozambique: an observational study

OBJECTIVES

Toilet users often report valuing outcomes such as privacy and safety more highly than reduced disease, but effects of urban sanitation interventions on such outcomes have never been assessed quantitatively. In this study, we evaluate the impact of a shared sanitation intervention on quality of life (QoL) and mental well-being.

DESIGN

We surveyed individuals living in intervention and control clusters of a recent non-randomised controlled trial, and used generalised linear mixed regression models to make an observational comparison of outcomes between arms.

SETTING

Low-income unsewered areas of Maputo City, Mozambique.

PARTICIPANTS

We interviewed 424 participants, 222 from the prior trial's intervention group and 202 from the control group.

INTERVENTIONS

The control group used low-quality pit latrines. The intervention group received high-quality shared toilets, with users contributing 10%-15% of capital cost.

OUTCOMES

Our primary outcome was the Sanitation-related QoL (SanQoL) index, which applies respondent-derived weights to combine perceptions of sanitation-related disgust, privacy, safety, health and shame. Secondary outcomes were the WHO-5 mental well-being index and a sanitation Visual Analogue Scale.

RESULTS

The intervention group experienced a 1.6 SD gain in SanQoL compared with the control group. This adjusted SanQoL gain was 0.34 (95% CI 0.29 to 0.38) on a 0-1 scale with control mean 0.49. Effect sizes were largest for safety and privacy attributes. Intervention respondents also experienced a 0.2 SD gain in mental well-being. The adjusted gain was 6.2 (95% CI 0.3 to 12.2) on a 0-100 scale with control mean 54.4.

CONCLUSIONS

QoL outcomes are highly valued by toilet users and can be improved by sanitation interventions. Such outcomes should be measured in future sanitation trials, to help identify interventions which most improve people's lives. Since SanQoL weights are derived from respondent valuation, our primary result can be used in economic evaluation.

Reproductive health practices and use of health services among immigrant Indonesian women working in Malaysia

OBJECTIVE

To describe the reproductive health practices of immigrant Indonesian women working in Malaysia and their accessibility to health services.

METHODS

A cross-sectional study using a validated self-administered questionnaire was conducted with 593 immigrant Indonesian workers who stayed in Malaysia for at least six months and within the reproductive age group.

RESULTS

About 13.5% of the respondents have used health facilities for reproductive health-related problems. Less than half of the respondents preferred to use public health facilities. Only 15% used treatment available in health facilities related to irregular menstrual cycles (34.6%), severe dysmenorrhea (58.7%) and nonspecific symptoms related to menstruation (31.7%). Family planning services were the most required health service. However, only 31.5% met the needs for family planning services. One-third of the respondents had sexual reproductive health problems and required treatment, but only 9.9% sought reproductive health services when needed.

CONCLUSIONS

Strategies to improve the accessibility to sexual reproductive health services requires a collaboration between the Indonesian government representatives in Malaysia and non-governmental organizations to address the reproductive health issues among immigrant Indonesian women in Malaysia. Health policy related to immigrant workers is needed in order to enhance the accessibility to women's health needs for universal health coverage.

Protocol for a scoping review on transition-related surgery procedures, outcome measures and access to care

INTRODUCTION

Transgender and gender diverse (TGD) individuals often identify with a gender different to the one assigned at birth. Transition is a term used to describe the process TGD individuals take to live as their true gender. Surgery can be a very important aspect of care for members of TGD communities. Transition-related surgery (TRS) refers to many different types of surgeries completed to meet a TGD individual's gender-related goals. While various systematic reviews have attempted to synthesise the existing peer-reviewed literature around aspects of TRS, there are few scoping reviews in this area. Our scoping review aims to address this gap through providing an up-to-date overview of the TRS literature in order to provide an overarching view of the topic.

METHOD AND ANALYSIS

This review will follow the methods outlined by the Joanna Briggs Institute's methodology for scoping reviews and will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. A search of nine scientific databases resulted in 20 062 potential articles. After removing duplicates, articles will be screened for inclusion using Covidence. Data extraction and synthesis will be carried out using NVivo and reviewed by team members.

ETHICS AND DISSEMINATION

As this study is a scoping review of the existing literature, no ethics review is required. The findings from this review will be disseminated through multiple pathways including open access publication, submission to conferences, social media and Listservs. The findings of the study will also be readily available to clinicians, organizations, interest groups, and policy-makers.

Cross-sectional study on knowledge, attitude and prevalence of domestic violence among women in Kaduna, north-western Nigeria

BACKGROUND

Domestic violence is a global issue of public health concern with detrimental effects on women's physical, mental and social well-being. There is a paucity of community-based studies assessing the knowledge and attitude of women towards domestic violence in Nigeria.

OBJECTIVE

To assess knowledge, attitudes, prevalence and associated factors of domestic violence among women in a community in Kaduna, Nigeria.

DESIGN

A descriptive cross-sectional study.

SETTING

A selected community in Kaduna South Local Government Area in Kaduna State.

PARTICIPANTS

In total, 170 women aged 15-49 years participated in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcomes were knowledge, attitude and prevalence of domestic violence.

RESULTS

The mean age of the respondents was 28.7+7.9 years. A total of 113 (66.5%) respondents had high level of knowledge about domestic violence with 114 (67.1%) having non-tolerant attitudes towards domestic violence. The lifetime prevalence and 12-month prevalence of domestic violence were 47.1% and 35.3%, respectively. The results of logistic regression identified the educational status of women as a significant predictor of knowledge of domestic violence (adjusted OR (aOR)=0.32; 95% CI 0.15 to 0.68), while marital status (aOR=0.21; 95% CI 0.05 to 0.96), occupation of women (aOR=2.49; 95% CI 1.13 to 5.49), their tolerance of wife beating (aOR=0.33; 95% CI 0.15 to 0.72) and their partners' consumption habit of alcohol/substance use (aOR=7.91; 95% CI 3.09 to 20.27) were identified as significant predictors of the women's experience of domestic violence.

CONCLUSION

Domestic violence was relatively high among women. Though a majority had high level of knowledge about domestic violence, a significant third had tolerant attitudes towards it. Appropriate health interventions need to be implemented by governmental and relevant stakeholders to target negative attitudes and address associated factors of domestic violence against women.

Patterns of death among migrant domestic workers in Jordan: retrospective analysis of 63 cases in a tertiary hospital

Background

This article examines the patterns of death in migrant domestic workers (MDWs) in Jordan. Abuse and difficult circumstances may lead to attempts to escape, neglect, or suicide, but the current literature on death in this population is limited. We systematically explored all medico-legal cases of MDW deaths referred between 2006 and 2016 to the forensic department of one of the main tertiary medical centers in Jordan.

Results

Sixty-three recorded cases of MDWs death were found. Forty-seven (74.6%) died due to unnatural causes, 15 (23.8%) died naturally, and 1 (1.6%) was undetermined. The rate of suspected suicide comprised 58.3% of unnatural deaths. The most common methods of suicide were hanging and falling from a height.

Conclusions

This study shows high rates of unnatural death among MDWs in Jordan, many of which with suspicious circumstances. It also indicates that natural deaths are largely attributed to preventable causes. Future studies should include other referral sites (hospitals and forensics departments), to better address the complexity and magnitude of this population’s death circumstances, gain a comprehensive understanding of their issues, and work toward finding a solution. We recommend that special attention is given to MDWs in Jordan and the region to protect their rights on all levels.

Health and well-being issues of Nepalese migrant workers in the Gulf Cooperation Council countries and Malaysia: a systematic review

OBJECTIVE

To summarise the evidence on health and well-being of Nepalese migrant workers in the Gulf Cooperation Council (GCC) countries and Malaysia.

DESIGN

Systematic review.

DATA SOURCES

EMBASE, MEDLINE, Scopus and Global Health databases.

ELIGIBILITY CRITERIA

Studies were eligible if they: (1) included Nepalese migrant workers aged 18 or older working in the GCC countries or Malaysia or returnee migrant workers from these countries; (2) were primary studies that investigated health and well-being status/issues; and (3) were published in English language before 8 May 2020.

STUDY APPRAISAL

All included studies were critically appraised using Joanna Briggs Institute study specific tools.

RESULTS

A total of 33 studies were eligible for inclusion; 12 studies were conducted in Qatar, 8 in Malaysia, 9 in Nepal, 2 in Saudi Arabia and 1 each in UAE and Kuwait. In majority of the studies, there was a lack of disaggregated data on demographic characteristics of Nepalese migrant workers. Nearly half of the studies (n=16) scored as 'high' quality and the rest (n=17) as 'moderate' quality. Five key health and well-being related issues were identified in this population: (1) occupational hazards; (2) sexual health; (3) mental health; (4) healthcare access and (5) infectious diseases.

CONCLUSION

To our knowledge, this is the most comprehensive review of the health and well-being of Nepalese migrant workers in the GCC countries and Malaysia. This review highlights an urgent need to identify and implement policies and practices across Nepal and destination countries to protect the health and well-being of migrant workers.

Common mental disorders and its associated factors and mental health care services for Ethiopian labour migrants returned from Middle East countries in Addis Ababa, Ethiopia

BACKGROUND

The migration of young Ethiopian men and women to the Middle East countries was mainly for economic reasons. The migration was largely irregular that posed a wide range of unfavorable life conditions for some of the migrants. The overall objective is to assess common mental disorders and its associated factors for Ethiopian migrants returned from the Middle East countries and to describe mental health care services targeting these migrants.

METHODS

The study employed a mixed-methods approach. For the quantitative part, a systematic random sampling technique was used to select a sample of 517 returnees. An interviewer-administered questionnaire based on Self Report Questionnaire-20 was used to collect data from respondents. The qualitative study employed a phenomenological study design to describe mental health care services. Key informant interviews and non-participant observation techniques were used to collect qualitative data.

RESULTS

The prevalence of common mental disorder among Ethiopian migrants returned from the Middle East countries was found to be 29.2%. education (AOR=2.90 95%CI: 1.21, 6.94), physical abuse (AOR=12.17 95%CI: 5.87, 25.22), not getting salary properly and timely (AOR=3.35 95%CI: 1.47, 7.63), history of mental illness in the family (AOR=6.75 95%CI: 1.03, 43.95), detention (AOR=4.74 95%CI: 2.60, 8.62), guilty feeling for not fulfilling goal (AOR=9.58 95%CI: 4.43, 20.71), and denial of access to health care (AOR=3.20 95%CI:1.53, 6.67) were significantly associated with a common mental disorder. Shelter based and hospital-based mental health care services were rendered for a few return migrants with mental disorders. The services were primarily targeted, female return migrants.

CONCLUSION

The prevalence of common mental disorder was high among migrants returned from the Middle East countries. Despite the high burden of mental distress, only a small proportion of return migrants with mental illness is getting mental health care services.

Psychological morbidity in Nepali cross-border migrants in India: a community based cross-sectional study

BACKGROUND

Since Nepali cross-border migrants can freely enter, work and stay in India, they are largely undocumented. The majority is involved in semi-skilled or unskilled jobs with limited labour rights and social security, a fact which predisposes them to psychological distress. We aimed to assess the prevalence of and factors associated with psychological morbidity among Nepali migrants upon their return from India.

METHODS

A community based cross-sectional study was conducted in six districts of Nepal between September 2017 and February 2018. A total of 751 participants who had worked at least six months in India and returned to Nepal were interviewed from 24 randomly selected clusters. The General Health Questionnaire (GHQ)-12 was used to measure the psychological morbidity. Data were analysed using Poisson regression analysis.

RESULTS

The majority was younger than 35 years (64.1%), male (96.7%), married (81.8%), had at least a primary education (66.6%), and belonged to Dalit, Janajati and religious minorities (53.7%). The prevalence of psychological morbidity was 13.5% (CI: 11.2-16.1%). Participants aged 45 years and above (adjusted prevalence ratio (aPR) = 2.74), from the Terai (aPR = 3.29), a religious minority (aPR = 3.64), who received no sick leave (aPR = 2.4), with existing health problems (aPR = 2.0) and having difficulty in accessing health care (aPR = 1.88) were more likely than others to exhibit a psychological morbidity.

CONCLUSION

This study demonstrated that psychological morbidity was prevalent in the study participants and varied significantly with individual characteristics, work conditions and health. Multifaceted approaches including psychological counselling for returnees and protection of labour and health rights in the workplace are recommended to help reduce psychological morbidity.

The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks

Background: Most health research on Nepali migrant workers in India is on sexual health, whilst work, lifestyle and health care access issues are under-researched. Methods: The qualitative study was carried out in two cities of Maharashtra State in 2017. Twelve focus group discussions (FGDs) and five in-depth interviews were conducted with Nepali male and female migrant workers. Similarly, eight interviews were conducted with stakeholders, mostly representatives of organisations working for Nepali migrants in India using social capital as a theoretical foundation. Results: Five main themes emerged from the analysis: (i) accommodation; (ii) lifestyle, networking and risk-taking behaviours; (iii) work environment; (iv) support from local organisations; and (v) health service utilisation. Lack of basic amenities in accommodation, work-related hazards such as lack of safety measures at work or safety training, reluctance of employers to organise treatment for work-related accidents, occupational health issues such as long working hours, high workload, no/limited free time, discrimination by co-workers were identified as key problems. Nepali migrants have limited access to health care facilities due to their inability to prove their identity. Health system of India also discriminates as some treatment is restricted to Indian nationals. The strength of this study is the depth it offers, its limitations includes a lack of generalizability, the latter is a generic issue in such qualitative research. Conclusion: This study suggests risks to Nepali migrant workers’ health in India range from accommodation to workplace and from their own precarious lifestyle habit to limited access to health care facilities. We must conduct a quantitative study on a larger population to establish the prevalence of the above mentioned issues and risks. Furthermore, the effectiveness of Nepali migrant support organisations in mitigating these risks needs to be researched.

Disposability and gendered control in labor migration: Limiting women’s mobility through cultural and institutional norms

In this article, I draw upon interviews with 30 Nepali returned women migrant workers to elucidate how the gendered institutional logics of both the Nepali state and for-profit manpower companies synergistically function to constrain women’s mobility. In particular, I focus on women migrant workers who migrate illegally to Gulf countries to work as domestic laborers, as this constitutes one of the largest channels of women’s labor migration from Nepal. To illuminate the particulars of Nepali women migrant workers’ experiences, I employ two theoretical frameworks, both developed by feminist political economists within the context of feminized workplaces broadly and global factory floors specifically. The first framework presents a logic of female disposability as shaping the feminized workforce of the global South. The second framework presents a logic of gendered control as doing the same. In this article, I show how these dual logics can be applied to women’s foreign labor migration in Nepal, and argue that these logics operate simultaneously through the various institutions that Nepali women navigate during migration. The Nepali case shows how both logics serve ultimately to limit women’s mobility and bolster the authority of institutions and organizations historically controlled by men—for example, the family, the state, transnational corporations—over women migrants. By bringing these two logics to bear on a case of women domestic workers’ migration from the global South, this article offers new insights into the functioning of institutions central to this large-scale, transnational movement of people.

Global output of research on the health of international migrant workers from 2000 to 2017

BACKGROUND

Approximately 150 million international migrant workers work under conditions that increase their risk of illness and injuries. The current study aimed to assess and analyze the global output of research on the health of international migrant workers to promote national and international policies that could help improve the health of international migrant workers.

METHODS

A bibliometric methodology was implemented using Scopus database after retrieving documents relevant to the health of migrant workers during the study period from 2000 to 2017.

RESULTS

In total, 955 documents were retrieved. The mean number of authors per document was 4.5 while the mean number of citation per document was 10.2. The retrieved documents were mainly in health policy and systems (n = 452; 47.3%), infectious diseases (n = 252; 26.4%), and mental and psychosocial health (n = 239; 25.0%). The health of Latino migrant farmworkers represented the largest cluster of keywords. The USA led (n = 389; 40.7%) with regard to the number of publications followed by China (n = 86; 9.0%) and the UK (n = 66; 6.9%). Researchers from the USA and Spain dominated the field. There were limited international research collaboration and a limited number and size of research networks. The American Journal of Industrial Medicine was most active (7.1%; n = 68) in publishing documents on health of migrant workers while the Wake Forest University was the most active (10.9%; n = 104) institution in this topic.

CONCLUSION

The volume of global research output on the health of migrant workers was low. There was inadequate research on non-communicable diseases and maternal health of migrant workers. International research collaboration and the number of research networks were limited. Role of several world regions, particularly Arab region with 11% of international migrant workforce was also limited. There is an urgent need to prioritize research on migrant workers, especially female migrant workers in regions with low research contribution.