Migrant domestic workers (MDWs) often face exclusionary policies in receiving countries and face barriers in accessing preventive health services such as vaccination. In Singapore, low-wage, semi-skilled workers were disproportionately affected by the Covid-19 pandemic, with migrant workers accounting for about 90% of all reported Covid-19 cases. The uneven attack rate highlights the increased vulnerability of migrant workers to disease threats, further compounded by a lack of equitable access to protective health services.
The Singapore government started vaccination of Singapore citizens and permanent residents against Covid-19 on 30 December 2020, targeting high-risk groups such as healthcare workers and the elderly first, followed by progressive vaccination of other age groups. While massive publicity campaigns were undertaken by the government to assure Singaporeans of the safety and efficacy of Covid-19 vaccines to encourage them to get vaccinated, these campaigns did not consider the information needs of foreign domestic workers. While foreign domestic workers are eligible to get vaccinated against Covid-19, inadequate information might cause them to forgo vaccination due to fears or concerns. Hence, a study was conducted to explore prevailing knowledge and beliefs MDWs about getting vaccinated against Covid-19 and identify any information gaps, vaccine hesitancy and the prevalence of employer influence on getting vaccinated.
A mixed methods study using a two-phased approach was conducted from April to July 2021. In the first phase, an online survey was conducted with 104 MDWs to identify their beliefs about the Covid-19 vaccines, level of vaccine hesitancy and sources of information used by MDWs, followed by in-depth interviews with 22 MDWs to explore these areas further in the second phase. We found that MDWs faced both vaccine-related and non-vaccine-related barriers when deciding whether to get vaccinated against Covid-19. Vaccine-related barriers included receiving misinformation about Covid-19 vaccines and their side effects, concerns over the safety and efficacy of Covid-19 vaccines and misconceptions about how vaccines worked.
Non-vaccine related factors predominantly revolved around linguistic barriers, having limited channels of accurate information on Covid-19 vaccination, difficulties with registering for vaccination and accessing helplines, and unsupportive employers. In addition, employers exerted significant influence over MDWs in their decision to get vaccinated against Covid-19. We also identified negative practices of some employers in barring MDWs from accessing Covid-19 vaccination services. Our findings also highlighted prevalent information gaps with regards to Covid-19 vaccine information in the MDW community.
Thus, we urge policy makers to be inclusive of the informational and healthcare needs of MDWs by:
Establishing formal centralized informational networks for MDWsto have avenues to receive essential information about accessing healthcare and exercising their rights
Actively engaging and building stronger partnerships with NGOslike TWC2 and HOME in using their well-established platforms to disseminate crucial health-related information to MDWs
Conducting active outreach programmes for MDWsto dispel vaccine misinformation
Engaging employers to equip them with accurate information about Covid-19 vaccines andempowering them to play proactive rolesin disseminating reliable information to their MDWs
Encouraging employers to provide adequate rest days for MDWs who receive Covid-19 vaccination to allow them to recuperate.
Ratifying ILO and UN conventions governing rights and protections for MDWs, in particular, the ILO C189 Domestic Workers Convention, 2011 (No. 189) to provide MDWs with basic labour rights and to minimize employer gatekeeping of healthcare
Extending the Employment Act to cover all MDWs to ensure adequate labour protection and equitable access to healthcare, including the provision of subsidies to make medical services more affordable to MDWs.
The report in PDF format can be downloaded by clicking the icon at right.