Migrant Health Care

By:

Sharuna Verghis

Affiliations:

Health Equity Initiatives

Policy Code:

3i Health

Problem Statement:

Malaysia is host to 1.4 million registered migrant workers and an estimated three million irregular migrants. Besides paying high taxes vis-à-vis citizens with similar income levels, migrants contribute significantly to the country’s GDP.

However, the absence of a coherent labor migration policy and a legal/administrative framework for refugees/asylum seekers/stateless persons have contributed to the experience of precarity including exploitative work conditions, insecure legal status, and even violence.

The above factors have been associated with poor occupational health, sexual/ reproductive health, and mental health outcomes in migrants. Additionally, access to health care has been problematic at public hospitals owing to policies mandating exorbitant, unsubsidized "foreigners' rates, prescriptions restricting medicines to a five-day supply, and policies directing the arrest of undocumented migrants. Documented migrants are vulnerable to deportation for specific infectious diseases and pregnancy and obtain limited medical coverage despite purchasing two mandatory medical insurance policies.

Value(s) and Belief(s):

Migrants make significant contributions to the Malaysian economy and are deserving of subsidized health care. Moreover, policies of universal access to prevention, treatment and health promotion including migrants meet the criteria of good public health, health equity and universal health coverage besides promoting health security in the country.

Proposal of Solution:

1. Migrants should be entitled to the same medical benefits that Malaysian citizens in the public health system.
2. Mandatory testing and deportation of migrant workers for infectious diseases should be replaced by universal approaches to testing and treatment.
3. Abolish the 2001 Bil (1)dlm.KKM/62/BPKK(AM)/Pel-22-Garispanduan melaporkan pendatang tanpa izin yang mendapatkan perkhidmatan kesihatan di hospital dan klinik kesihatan and institute firewalls delinking immigration enforcement actions from delivery of health care.
4. Abolish the five day medication policy.
5. Institute reform in detention health care services including standard setting, monitoring progress in disease prevalence and deaths, and establish a specific mechanism of accountability at a higher level where both Immigration and the Ministry of Health are reporting on indicators w.r.t. health care access, disease prevalence, deaths in detention centres. Prioritize alternatives to detention and stop the detention of children.
6. Collaborate with civil society organizations (CSOs) and community based organizations (CBOs) to expand access to health care for migrants by setting up translation services and incorporating cultural safety in health services at government hospitals. Involve CSOs and CBOs in screening, contact tracing, and health education activities for migrants.
7. Make accessible disaggregated data on migrant health in the country.

Additional Information:

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