Work life, relationship, and policy determinants of health and well-being among Filipino domestic Workers in China: a qualitative study

Abstract

Background Overseas Filipino workers (OFWs) comprise one of the largest populations of migrant workers globally. Within China, they represent the largest group of imported domestic workers. Little is known about their working conditions or how this might affect their health and wellbeing. Methods This qualitative study explored the working conditions and risk factors for poor health in a sample of temporary female Filipino domestic workers in Macao, China. Focus group discussions with female domestic workers ( n = 22) and in-depth interviews with key informants ( n = 7) were conducted. Results Domestic workers reported physical (e.g., hypertension, chronic pain, diabetes, poor sleep), and mental health problems (depression, anxiety), and addictive behaviors (gambling, alcohol misuse), along with significant structural, linguistic, financial, and cultural barriers to healthcare access to address these concerns. Adverse working conditions including poor treatment and abuse by employers, lack of privacy and inadequate sleeping areas in employers’ homes or in crowded boarding houses, language barriers, inadequate and poor enforcement of labor protections, and discrimination. Domestic workers also cited exorbitant agency fees and remittances causing significant financial stress. Kinship network ties with family members back home were fraught with infidelity, difficulty parenting, misuse of remittances, and family misconceptions of domestic workers’ situation abroad. Lack of quality social support and peer social networks exacerbated these conditions. Conclusions In this sample of Filipino migrant domestic workers, stressors experienced within the host country were commonly reported. Indebtedness and low salaries limits social mobility. Psychosocial and policy-level interventions are needed to improve the health and wellbeing of this population of migrant women.

Narrative identities of overseas Filipino domestic worker community in Macao (SAR) China

“…One major issue concerns their workplace. They are at risk of experiencing abusive supervision by employers, which includes hostile verbal and nonverbal behaviors (Bernardo, Daganzo, & Ocampo, ; Hall, Garabiles et al, ). Working in their employer's home contributes to limited personal autonomy and agency and increased susceptibility to employer control.…”

“…Working in their employer's home contributes to limited personal autonomy and agency and increased susceptibility to employer control. This leads to problems, such as needing to abide by rigid rules, long work hours, inadequate rest and food, and violation of labor contracts (Constable, ; Hall, Garabiles et al, ; van der Ham, Ujano‐Batangan, Ignacio, & Wolffers, ). Consequently, health‐related problems like physical ailments (e.g., hypertension and chronic body pain) and mental health concerns like trauma, depression, and anxiety (Cheung, Tsoi, & Chung, ; Garabiles, Lao, Hung, & Hall, ; Hall, Garabiles et al, ; Hall, Yip et al, ; Hall, Pangan, Chan, & Huang, ; van der Ham et al, ) are prevalent.…”

“…Another major source of stress is the relationship between domestic workers and their stay‐behind family. Even while abroad, they are still expected to fulfill their role as mothers and as breadwinners, nurturing their families by providing for the emotional and financial needs of their family while away (Garabiles et al, ; Hall, Garabiles et al, ; Parreñas, ; Parreñas, ; Tungohan, ). They experience loneliness and homesickness due to geographic distance (Garabiles et al, ; Hall, Garabiles et al, ; Nakonz & Shik, ; van der Ham et al, ), and some have marital problems due to misunderstandings and extramarital affairs (Garabiles et al, ; Hall, Garabiles et al, ; Parreñas, ; Parreñas, ).…”

“…They likewise seek support from peers (Bortel et al, ; van der Ham et al, ), their family (Garabiles et al, ), and god (Bortel et al, ; Nakonz & Shik, ). They maximize rest days by beautifying themselves (Hall, Garabiles et al, ; Lan, ; Nakonz & Shik, ). For some, they directly negotiate work arrangements by expressing concerns to employers (Lan, ).…”

“…Community narratives empower groups to articulate their own stories instead of being subject to the stories that were written for them (Rappaport, ). This is especially important to groups that lack social, political, and economic power (Rappaport, ) like migrant domestic workers who are vulnerable and beset with many problems but may lack resources to uplift themselves from their situation and to address their problems (Hall, Garabiles et al, ).…”