Journal of Immigrant and Minority Health (2020) 22:1–2
https://doi.org/10.1007/s10903-019-00942-1
LETTER TO THE EDITOR
Domestic Workers from the Philippines in China: An Opportunity
for Health Promotion Within the Belt and Road Initiative
Brian J. Hall1,2,3 · Yuqian Zhang1 · Kun Li1 · Melissa R. Garabiles1,4 · Carl Latkin2
Published online: 29 October 2019
© Springer Science+Business Media, LLC, part of Springer Nature 2019
The Chinese government recently announced it will allow
local residents to employ foreign domestic workers (DW) in
Mainland China, after a trial period in some cities [1]. This
will expand existing legal labor migration to China, cur-
rently concentrated in the Special Administrative Regions
(in Macao and Hong Kong). This presents a unique oppor-
tunity for China to assume regional leadership in develop-
ing strategies to protect and promote transnational migrant
worker health.
Limited research was undertaken to document the health
conditions of migrant Filipino DW in China [2]. Studies
emerging from the Macao Special Administrative Region
(SAR)—a key “platform” along the ancient maritime silk
road, linking China to South East Asia, and the modern
Lusophone speaking World—demonstrated a high burden
of non-communicable diseases, including common mental
disorders [3, 4], behavioral addictions [5] diabetes, obesity,
and other cardiometabolic risks to health [6], poor HIV and
STI testing [7] and evidence of a high burden of sexual and
reproductive health challenges [8]. Poor social integration,
discrimination, and barriers to health care access are known
to be key social determinants of migrant mental health
[9–11]. Poor quality social networks and discrimination [12]
was associated with increased burden of common mental
disorders among Filipino DW in Macao, and limited mental
health treatments are currently available [13, 14]. A recent
* Brian J. Hall
brianhall@um.edu.mo
1
Global and Community Mental Health Research Group,
Faculty of Social Sciences, University of Macau, Macao,
SAR, People’s Republic of China
2
Department of Health Behavior, and Society, Johns Hopkins
Bloomberg School of Public Health, Baltimore, MD, USA
3
Centre for Macau Studies, University of Macau, Macao,
SAR, People’s Republic of China
4
Department of Psychology, Ateneo de Manila University,
Quezon City, Philippines
UN report suggested that improvements are needed to safe-
guard transnational migrants from discrimination in China
[15]. This is especially relevant in the context of Mainland
China, where most Filipina domestic workers are working
illegally due to labor policy restrictions currently in place.
Leadership from Beijing may translate to improvements in
the health of transnational migrant workers across China.
The following are several key policies, that if enacted by
the Chinese Central Government, could promote the health
and welfare of these transnational workers in China [15].
First, China could consider gradually lifting restrictions
on employment of foreign DW while concomitantly estab-
lishing legal procedures to protect existing undocumented
workers. Second, China can ratify the International Labor
Organization (ILO) Domestic Workers Convention, which
aims to set guidelines for the protection and welfare of DWs.
These guidelines could uphold standards for decent work
across China, including within the Special Administrative
Regions. Third, laws and regulations regarding non-discrim-
ination, and standard labor contracts, wages, and working
hours should be enacted. Fourth, policies can ensure access
to adequate living and working conditions, insurance cov-
erage for healthcare, and salaries to foster remittances and
savings. Fifth, establish equitable procedures to handle com-
plaints against employers. Finally, regulation of labor bro-
kering agencies can be enforced to prevent usury and debt
bondage. At present these policies do not exist in Macao.
China’s Belt and Road Initiative (BRI) promises to
increase global connectivity and provide opportunities for
economic development to participating countries. Domestic
worker protection strengthens the “people-to-people bond,”
which is one of the five priorities of the BRI. Protecting the
health status of migrant workers from regional Asian BRI
partners should be a priority. Filipinos employed as DW can
fill a critical gap in the workforce available for family care
for the large and rapidly aging population in China. By 2030,
it is estimated that 10 million caregivers will be needed.
They can also provide English language instruction for the
13
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2 Journal of Immigrant and Minority Health (2020) 22:1–2
children in their care. Providing the Philippines with this
pathway for economic opportunity is useful and mutually
beneficial, but failing to safeguard the health and wellbeing
of this migrant population may undermine the full potential
of the BRI, and exacerbate vulnerability and poor popula-
tion health.
Compliance with Ethical Standards
Ethical Approval Ethical review was not required since this is not
human subjects research.
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