Sexual and reproductive health (SRH) of women migrant workers in the ASEAN region: a systematic narrative review and synthesis

Context
Sexual and reproductive health (SRH) is central to achievement of UN sustainable development goals (SDGs). Women’s migration has wide-reaching implications for their SRH, increasing vulnerabilities and risky behaviours with potential negative implications for both migrants’ fitness to work and host countries’ public health systems. Given the scale of migration within the ASEAN region, we synthesise the literature and identify priorities for future research.
Methods
Systematic narrative review and synthesis of empirical research. Following application of inclusion criteria, a systematic search of databases (Medline-PubMed, EBSCO host, BioMed Central, CINAHL, Psych INFO, Web of Science and Scopus) using keywords to identify relevant literature published between 2010 and 2020 identified 42 papers for review.
Findings
Empirical studies focus primarily on HIV/AIDs, unwanted pregnancies, contraception and abortion, rendering other SRH needs under-explored. Access to SRH information, contraceptives and culturally sensitive SRH interventions each promote health-seeking behaviours. Barriers include vulnerabilities informed by personal and socio-economic characteristics; unfamiliar surroundings; limitations of local health care systems and lack of regulatory / employer support; and adverse institutional / social /cultural norms. Successful interventions require integration of migrants into host communities; cultural responsiveness; state responsibility; use of familiar technologies to facilitate access; and sensitivity to workplace characteristics. Significant methodological weaknesses in evaluations of SRH service interventions to date severely hampers the development and dissemination of robust, evidence-informed SRH services for these women.
Conclusions
While much is known of the nature of the services required to safeguard the SRH of women migrant workers, we outline the limitations of the current evidence base and indicate research priorities to address the limitations of this inchoate field.