Why Gender and SRHR Matter in International Migration Discussions? Inter-linkages and Intersections Malu S. Marin Coalition of Asia-Pacific Regional Networks on HIV/AIDS (7Sisters)
Migration as a gendered experience Migration, as a process and experience, play out differently for women and men. Migration can provide new opportunities to improve women s lives and change oppressive gender relations. It can also entrench traditional roles and inequalities and expose women to new vulnerabilities as the result of precarious legal status, exclusion and isolation.
Sexual and Reproductive Health State of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. It implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Source: International Conference on Population and Development (ICPD) Programme of Action 4
SRHR manifests in all phases of migration, but begins even before people move. Migrants straddle a transnational existence and simultaneously live multilocated selves. Maintain their familial and social connections and ties to their places of origin while at the same time renegotiate and establish a new set of social linkages and relationships in their places of destination
Sexual and Reproductive Health Realities Migrants do not leave their sexual and reproductive lives once they cross the border. There are specific areas where migrants congregate, interact and seek opportunities for social and sexual interaction. Migrants are able to find creative solutions to meet their sexual and reproductive health needs.
Regulation of reproduction Approximately 60 governments have established healthscreening procedures upon application, arrival and renewal of work permits. The administration of physical examinations result to denial of work permits or termination of contracts on the basis of test results. Pregnancy HIV and other STIs Cannot establish a family Unsafe abortions Stateless children
Determinants to Access to SRH services Regular/Irregular status Provisions in employment contracts (benefits and entitlements, job categories Attitude of employers Fear of termination due to illness
Determinants to Access to health services including SRH services Affordability (cost) Accesibility (Cultural and communication barriers) Availability
Compulsory HIV testing has highlighted the vulnerabilities faced by migrant workers. Prohibition of entry and deportation resulting from positive diagnosis. Concern about highlighting the so-called moral dimensions of HIV which could result to stigma and discrimination against HIV+ migrants. Need to strategically position HIV and AIDS within the broader frame of migrants health
Policy and Legal Issues Migrants Health Policy coherence across migration and health sectors is a challenge. The debate between public health versus human rights has permeated the discourse on migrant health. Who bears the financing for migrant health services? It is important to recognize the intersectionality of gender, health and rights issues in the context of migration.
Moving Forward Addressing migrants health involves integrating key human rights concepts into sound public health approaches. Promote migrant-friendly health policies and work towards the development of mechanisms that enhance social protection, health and safety of migrants. Create an enabling environment for migrants by eliminating disparities in access to health services, facilities and goods between migrants and host populations.
Generate information and analysis on trends and patterns in the SRHR status of migrant workers Mapping of existing SRHR services, policies and information Identification of good practices in addressing SRHR needs of migrant workers
SRHR responses can be integrated in existing programmes and services for migrants. Capacities of health care providers must be built and enhanced to enable them to render culturally competent, gender-sensitive, age-responsive and migrant-friendly health services Secure cooperative involvement of countries of origin or return, transit and destination.
Acknowledgments Action for Health Initiatives (ACHIEVE), Inc. Coordination of Action Research on AIDS and Mobility in Asia (CARAM-Asia) Asian-Pacific Resource & Research Centre for Women (ARROW) participation was made possible with the aid of a grant from the International Development Research Centre (IDRC), Ottawa, Canada through the Regional Office for Asia
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