Protecting the Health of International Labor Migrants through Intersectoral Action from a Source Country Perspective: The Philippines

Author(s) Ramon Lorenzo Luis Guinto1
Affiliation(s) 1None, None, Manila, Philippines.
Country - ies of focus Philippines
Relevant to the conference tracks Social Determinants and Human Rights
Summary This source-country perspective study examines how intersectoral action can be harnessed to protect the health of international labor migrants. With nearly 10% of its citizens living overseas, the Philippines, with its decades-long history of institutionalized labor migration, has established structures and processes that ensure migrants' rights and welfare. While best practices exist, there is room for improving intersect oral action to  address migrants' health, such as strengthening the Department of Health's coordinating role, developing monitoring and evaluation mechanisms, and emphasizing health in bilateral labor agreements with destination countries.
Background With nearly 10% of its citizens living overseas, the Philippines has been a key provider of migrant labor force to over 200 countries in hundreds of occupational categories and employment arrangements, in addition to a sizeable number of immigrants. The progressive growth of international migration of Filipinos has been significantly attributed to a wide institutionalized network of government organizations with respective legal mandates and programs. The country’s international labor migrants have greatly contributed to the growth of the country’s gross domestic product especially in recent decades. While much has been documented about the social and economic dimensions of international migration in the Philippines, little is known about the health of Filipino workers overseas – and the structures and mechanisms that govern migration health. Furthermore, much of the available migration health literature analyse the situation in destination countries, so a source country perspective is of critical importance and usefulness for developing sound migration health policy in today’s increasingly mobile world.
Objectives Since both migration in general and migration health in particular are complex issues that require action across a wide range of stakeholders, this study will examine how intersectoral action can be harnessed to protect the health of migrants, particularly international labor migrants. While most studies looked at destination countries, this study will present experience and lessons in addressing migration health from a source country such as the Philippines. In this study, policies, programs, institutions, and mechanisms that support the health of "Overseas Filipino Workers" or OFWs will be mapped and described. As a result of this situational analysis, challenges and opportunities in the Philippines approach to migration health will be identified, and priorities and activities that the government and other stakeholders can undertake in order to advance the health of Filipino migrants overseas will then be proposed.
Methodology In order to guide the direction of this qualitative analysis of migration health governance in the Philippines, a conceptual framework was developed, which provided a strong emphasis on the principle of intersectoral action for health. An extensive desk review of relevant literature, including existing policies, was initially conducted. This was followed by a multi-stakeholder analysis using key informant interviews and focused group discussions as primary methods of data collection. Various organizations that represent various stakeholder groups (government, private sector, civil society, and intergovernmental organizations located in the Philippines) were pre-identified according to the findings of the literature review and served as key sources of information. During the interviews and group discussions, a discussion guide was used to ask the participants about key themes that reflect the different phases of the whole migration process (pre-departure, travel, interception, destination, and return) as well as the migration health action points articulated in the World Health Assembly resolution 61.17 on the health of migrants: monitoring migrants’ health, existence of policy-legal frameworks, building migrant-sensitive health systems, and participating in local and international partnerships and networks. Data gathered from both literature review and multi-stakeholder analysis were individually analyzed and then triangulated.
Results There exist a limited number of studies that have been conducted to assess the health needs of Filipino migrants overseas. However, much of the available grey literature indicate mental health problems as a common cause of illness among OFWs, while HIV-AIDs is becoming a growing concern, especially among returnees. Such a dearth of robust information is indicative of a weak information system that is supposed to monitor the health status and needs of migrants. In terms of policy-legal frameworks, the Philippines has instituted a number of laws that protect the rights and welfare of international labor migrants, which also cover some health-related aspects. Meanwhile, most of the existing migration health services are provided during the pre-departure phase of the migration process (i.e. pre-departure medical assessment). On the other hand, there is a limited amount of health supportive services that address the health needs of returning Filipinos. The Philippines is also a signatory to a number of international frameworks that commit to advancing migrants’ health, both at the international and regional levels. Interestingly, government institutions that craft policies, regulate actors, and provide services related to migration health lie outside of the health sector (i.e. labor), while at present, the Department of Health plays a minimal role (i.e. implementing quarantine among returnees suspected with contagious disease). While no concrete or clear mechanism exists to coordinate migration health-related efforts, there are some interactions occurring between various government agencies in order to implement certain functions.
Conclusion The existing structures and mechanisms that protect and ensure the health rights of Filipino labor can provide the template for a more concerted whole-of-government approach to migration health. While certain migration health policies and services do exist, there remain gaps in some key action areas recommended by the WHA resolution, especially in terms of monitoring migrants’ health and establishing migrant-sensitive health systems. The Department of Health should therefore assume a greater coordinating and technical role to support the migration health-related functions already performed by various non-health government agencies and other stakeholders. Furthermore, as international labor migrants interface with health systems of destination countries, source countries such as the Philippines should strengthen their diplomatic functions so they can negotiate for better provision and protection of health for their citizens residing overseas. Finally, the cause of advancing the health of international labor migrants offers an opportunity for governments, most especially countries that serve as sources of international workforce, to implement meaningful intersectoral action for health.

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