Dr Lilian Miles, Senior Lecturer in Law, has been leading a project to advance the sexual and reproductive health rights of women migrant workers in Malaysia. Here, Lilian highlights the impact of this work and how it can be used to further improve the situation of migrant women working in the country.
Objectives of Funding
I led a research project funded by the United Nations Gender Theme Group, Malaysia (April 2017-April 2018) to investigate how the sexual and reproductive health (SRH) rights of women migrant workers in Malaysia can be protected. There was a particular interest in this country, given that it continues to be one of the largest importers of labour in Asia. Women migrant workers constitute a significant workforce in its manufacturing, service and domestic sectors. They work under severe and punitive conditions in Malaysia, with few rights and entitlements at work and in their communities. Their SRH needs are largely ignored.
What did we do?
Together with our Malaysian collaborators from Universiti Sains Malaysia, and our own Professor Suzan Lewis (Department of Management, Leadership and Organisations), we investigated the barriers and challenges to meeting these women’s SRH needs. We explored the extent to which their allies can support them in their journey toward empowerment so that ultimately, they can assert their SRH rights. We focused on women factory workers, since for research purposes, they were a sizeable and visible workforce. After organising one workshop, conducting a literature review (which looked at interventions in other Asian countries to meet SRH needs of women migrant workers), and engaging in five months of empirical work (uncovering challenges in the local context and recommending solutions), we developed the first ever SRH toolkit in Malaysia for use by these women’s allies and other stakeholders who come into contact with them. These include NGOs, unions, health care providers, employers, foreign embassies and government. The toolkit both challenges and encourages allies and stakeholders to evaluate their practices against evidence-based good practice to advance these women’s SRH rights. Indeed, if allies and stakeholders can support women migrant workers in this area, this will lead to reduction of the effects of poor SRH practices, increased health-seeking behaviours and healthier workforces.
The toolkit
Briefly, the toolkit focused on improving knowledge of SRH among the women migrant worker community, setting up workplace interventions to meet the SRH needs of these women, and training healthcare providers to offer responsive SRH services to women migrant workers:
- Increasing knowledge among women migrant workers of SRH: many women migrant workers did not understand what SRH meant, or else refused to acknowledge/are not aware they had SRH problems. SRH is a taboo subject which is regarded as personal and shameful and consequently women did not talk about it, leading to undiagnosed problems. We recommended a variety of ways in which unions, NGOs and healthcare providers can help these women understand the importance of SRH (educational materials, forums, mobile technology, social media) and adopt health-seeking behaviours.
- We recommended setting up interventions in the workplace and involving employers. The factory is a direct point of contact with women migrant workers. It is also a forum whereby employers can come together with other stakeholders to jointly address the SRH needs of the women migrant workforce. Among workplace interventions which can be set up are mobile clinics, counselling hotlines, awareness creation forums and training of male supervisors to be aware of SRH needs.
- Healthcare providers (doctors, community nurses, pharmacists) can help increase women migrant workers’ health literacy, provide “culturally competent” care and help them navigate the healthcare system. We recommended training of healthcare providers in meeting SRH needs of women migrant workers, and for links to be established between the healthcare community, employers and these women and their champions to develop workplace interventions.
What is the impact of the research?
The toolkit was welcomed by many stakeholders in Malaysia. To my mind, the impact of the research is three-fold: first, it underscored a need for further research to be undertaken by Malaysia’s academic community to address the SRH needs of women migrant workers. This is a critical area of investigation, so far overlooked by researchers. Secondly, already, women’s NGOs and healthcare providers have integrated toolkit’s recommendations in their daily practice, in particular how to create awareness on the part of women migrant workers of the importance of taking care of their SRH, and in developing novel ways in which SRH healthcare can be brought into the workplace. A few employers were willing to ‘trial’ practices in the toolkit, which was exactly what we had hoped for. Finally, the research has highlighted the urgency of this aspect of health nationally, and the UN Gender Theme Group is working hard to have women migrant workers’ SRH needs regarded as a priority issue.
What next?
We are working with the UN Gender Theme Group to explore ways in which the toolkit can be implemented fully in factories. We hope to pilot a project to raise SRH awareness, implement mobile clinic schemes to attend to SRH needs in the workplace, and collaborate with healthcare providers, unions and NGOs to provide better support for these women. The training of women migrant worker leaders will be a crucial aspect of the pilot.
Moving forward
The process of developing the toolkit was a challenging one, in light of a context characterised by resistance from a range of stakeholders who come into contact with women migrant workers, and crucially, a deep lack of knowledge about SRH issues on the part of women migrant workers themselves. There are, nonetheless, many supportive stakeholders who believe passionately that there is no distinction between migrant women and local women (all are entitled to the same healthcare), and many stakeholders invested time and resources in helping develop the toolkit. A small cluster of stakeholders will participate in the pilot project.
We are very grateful to the United Nations Gender Theme Group, Malaysia, for their generosity, which has enabled us to research an area which is of critical importance, yet which has so far been ignored.