D O H - I O M J o i n t

E X E E X E E X E E X E
Migrant H
Challenges, O




WHY MIGRANT HEALTH?
With nearly 10 percent of its population l
working overseas, the Philippines has ind
one of the worlds countries of migration. Esp
the 1970s, the countrys policy of inst
overseas employment, as reflected in its so
suite of institutions and programs, allow
population movements of Filipinos to othe
Today, Overseas Filipino Workers (OFWs) a
bagong bayani (new heroes), given their
contribution to the countrys continuin
growth. In 2013 alone, OFW remittances
8.4% of the countrys Gross Domestic Produc

However, while international labor migration
many benefits to the country in terms of
opportunities and economic gains, it also
new challenges, such as in the area
health. For example, various reports revea
face problems pertaining to mental health
reproductive health concerns especially in
countries. Inability to access basic health ser
has also been noted especial
irregular/undocumented migrants. The De
Health (DOH) is also sought to extend medic
to Overseas Filipinos in distress who were
back to the Philippines due to crisis situation







WHAT IS THE GLOBAL PICTURE?
Addressing the health of Filipino migrants i
aligned with international commitments
existing national policy instruments. The W
Assembly Resolution 61.17, approved by t
States of the World Health Organization in
countries to, among others, promote migr
health policies; promote equitable access
promotion, disease prevention and care f
and promote bilateral and multilateral coo
migrants health.

n t P r o j e c t o n M i g r a t i o

X E C U T I V E S U M M A R Y X E C U T I V E S U M M A R Y X E C U T I V E S U M M A R Y X E C U T I V E S U M M A R Y
nt Health in the Philippine
s, Opportunities, and Ways Forw
on living and/or
indeed become
. Especially since
institutionalized
its sophisticated
llowed massive
other countries.
s) are hailed as
their substantial
nuing economic
ces contributed
duct (GDP).
tion has brought
s of employment
also introduced
rea of migrant
eveal that OFWs
ealth issues and
ly in destination
services abroad
cially among
Department of
edical assistance
ere repatriated
tions abroad.
nts is very much
nts as well as
e World Health
by the Member
n in 2008, urged
migrant-sensitive
ccess to health
re for migrants;
cooperation on
Policy-Legal Frameworks
Promote migrant
sensitive health policies
Include migrant health
in regional/national
strategies
Consider impact of
policies of other sectors
Migrant Sensitive Health
Systems
Strengthen health
systems; fill gaps in
health service delivery
Train health workforce
on migrant health
issues; raise cultural
and gender sensitivities
Figure 1. World Health A
Actio

Most recently, the Int
Migration (IOM) published
2013 which revolved arou
Development, the first of i
the center of migration disc

Furthermore, the Philippi
ASEAN Declaration on the
the Rights of Migrant Wo
obligations of sending
protecting the rights of
ASEAN region. Migrant hea
as a key component of the
on Health Development
Philippines, along with In
appointed as one of the lea

HOW IS MIGRATION LIN
An important determinan
process itself influences
migrant, as well as his/her f

Determinant of other d
migration process also
determinants that may be d
i o n H e a l t h
pines
orward
rks
cies
lth
tors
Monitoring Migrant Health
Develop health
information systems and
collect and disseminate
data
Assess and analyze
migrants health
Disaggregate information
by relevant categories
lth

rce
ties
Partnerships, Networks,
and Multi-Country
Frameworks
Promote dialogue and
cooperation among
Member States, agencies
and regions
Encourage a multi-
sectoral technical
network
lth Assembly Resolution 61.17
ction Points
International Organization for
shed the World Migration Report
around Migrant Well-being and
t of its kind, putting the migrant at
discourse.
lippines is also signatory to the
the Protection and Promotion of
Workers, which laid down the
g and receiving countries in
of migrant workers within the
health was also recently identified
f the ASEAN Strategic Framework
ent for 2010-2015 and the
h Indonesia and Thailand, was
lead countries for this endeavor.
N LINKED WITH HEALTH?
inant of health. The migration
es the health of the individual
her family.
r determinants of health. The
so exposes migrants to other
be detrimental to health, such as
D O H - I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y






Figure 2. Links between migration and health

unhealthy lifestyle, inadequate shelter, unsafe workplace
conditions, etc.

Driver of marginalization and vulnerability. Migrant
status may also serve as a barrier to health care access.
As vulnerable and marginalized part of the general
population, migrants may not be able to benefit from the
health system in the place of origin, destination, and/or
return.

Agent of disease spread. The migration process also
contributes to the spread of infectious diseases.
Traditionally, the migrant is seen as a source and carrier
of infection, especially to places of destination and/or
return.

Most importantly, migrant health is a human rights
imperative. The basic rights to health, employment, and
mobility are inextricably intertwined. Regardless of their
status, migrants are entitled to the right of everyone to
the enjoyment of the highest attainable standard of
physical and mental health as enshrined in international
human rights instruments and guaranteed by the
Constitution.

Healthy migrants lead to healthy communities and
healthy economies. Healthy and productive migrants
contribute to the uplifting of their families living
conditions and to the countrys socio-economic
development overall.

WHAT ARE THE MAJOR HEALTH ISSUES
FACED BY MIGRANTS?
Filipino migrants face a wide range of health issues
throughout the migration cycle, from common illnesses
to barriers to health care access. However, more rigorous
research and closer monitoring still need to be done to
ascertain the extent of these health challenges.
Furthermore, health problems faced by migrants may
vary depending on the migration cycle phase or
geographic location. Below are some of the major health
issues experienced by migrants based on limited research
studies and reports.

HIV-AIDS. The Philippine HIV and AIDS registry recorded
that OFWs comprise 16% of all reported cases since
1984. In 2013 alone, 10% of the new cases are comprised
of OFWs. However, these figures may over-represent the
true share of OFWs in the total number of HIV-AIDS cases
in the country, as HIV testing is deemed compulsory for
migrant workers by many destination countries (while it
is voluntary for the rest of the population as provided by
the Philippine AIDS Act). Migrants living with HIV-AIDS
experience the double stigma carried by both the disease
and their migrant status. Migrant workers may not
receive pre- and post-testing counseling, while those who
were found positive may get deported back to the
Philippines and become unable to access appropriate
treatment and care.

Tuberculosis. The WHO considers migrants as one of the
populations at-risk for tuberculosis (TB). The disease is
identified as a common ground for disqualification from
overseas work, and patients may be unable to access
appropriate treatment. Occasionally, migrant workers
become disqualified or deported due to radiographic
findings of previous TB infection.

Emerging infections. Emerging viral diseases such as
Severe Acute Respiratory Syndrome (SARS), Influenza
A(H1N1), Middle East Respiratory Syndrome Corona Virus
(MERS-CoV), and most recently Ebola Virus Disease (EVD)
have become another major yet occasional threat to the
health of populations, including migrants. During the
period of November 2002-July 2003, the Philippines had
only 14 out of the 8,273 confirmed cases of SARS, and
only 2 out of 775 deaths. On the other hand, as of May
2014, five overseas Filipinos have already died from
MERS-CoV, while the Philippines remains MERS-CoV free
as of June 2014 despite one OFW returnee who tested
positive in April 2014.

Maternal, sexual, and reproductive health. In some
countries, pregnancy is not desired by employers
overseas, hence there were cases of women labor
migrants who tried to hide their situation until they got
eventually terminated from work and even deported
back to the Philippines. Furthermore, women migrants
also face the risk of gender-based violence (GBV)
throughout the migration process, especially in the
country of destination.

D O H - I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y




Non-communicable diseases. Given that today, both
globally and locally, two out of three deaths result from
chronic non-communicable diseases, the incidence of
hypertension, diabetes, cancer, and stroke among
migrant populations also needs to be examined.

For example, one study showed that among Filipinos in
Rome, a high prevalence of obesity, diabetes, and
hypertension was found, and about three
Filipinos with disease were unaware of being diabetic
and/or hypertensive. In addition, a news report
that stroke has become the most common illness among
Hong Kong-based OFWs, but robust data collection and
analysis are needed to verify the situation.

Mental health. There have been increasing reports of
mental health problems faced by migrant Filipinos
especially in destination countries. Stressors that were
identified include abuse and discrimination, work
pressure, loss of close family ties, and unfamiliarity with
the new socio-cultural environment. Particularly
susceptible to these mental and emotional stres
victims of domestic violence, human trafficking, and
sexual abuse.

Injuries. Migrants also face the risk of road traffic
accidents and work-related injuries leading to permanent
disability, which often result in termination from
employment and ultimately deportation back to the
Philippines.

Limited access to health care and financial risk
protection. Access to health care in destination countries
has also been identified as an important concern. Several
qualitative studies have noted various barriers to access
to health care especially during the destination phase,
such as preconceived ideas of health and disease, cultural
and language barriers, fear of deportation among
undocumented migrants, among others. Furthermore,
migrants have limited protection from health
expenditure leading to financial hardship.

To address these challenges, PhilHealth, the Philippines
national health insurance program, is now working
towards expanding benefit packages to also include
chronic outpatient care and rehabilitation; rais
awareness about coverage for dependents
Philippines; and easing the processing of
reimbursements. Overseas employers must also
complement social health insurance with additional
private health insurance in accordance with int
maritime standards and labor laws in destination
countries.
I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y
Given that today, both
globally and locally, two out of three deaths result from
communicable diseases, the incidence of
hypertension, diabetes, cancer, and stroke among
migrant populations also needs to be examined.
howed that among Filipinos in
Rome, a high prevalence of obesity, diabetes, and
hypertension was found, and about three-fourths of
Filipinos with disease were unaware of being diabetic
and/or hypertensive. In addition, a news report revealed
s become the most common illness among
based OFWs, but robust data collection and

There have been increasing reports of
mental health problems faced by migrant Filipinos
estination countries. Stressors that were
identified include abuse and discrimination, work-related
pressure, loss of close family ties, and unfamiliarity with
cultural environment. Particularly
susceptible to these mental and emotional stressors are
victims of domestic violence, human trafficking, and
Migrants also face the risk of road traffic
related injuries leading to permanent
disability, which often result in termination from
timately deportation back to the
Limited access to health care and financial risk
Access to health care in destination countries
has also been identified as an important concern. Several
riers to access
to health care especially during the destination phase,
such as preconceived ideas of health and disease, cultural
and language barriers, fear of deportation among
undocumented migrants, among others. Furthermore,
ection from health

PhilHealth, the Philippines
is now working
to also include
ilitation; raising
awareness about coverage for dependents left in the
the processing of
reimbursements. Overseas employers must also
complement social health insurance with additional
private health insurance in accordance with international
maritime standards and labor laws in destination

Figure 3. The different layers of policy
for migration health

POLICY-LEGAL FRAMEWORKS
From a health perspective, the Philippines guarantees the
right to health to all Filipinos as enshrined in its
Constitution and reflected in its adoption of various
international human rights instruments. Furthermore,
various laws and policies governing the migration and
labor sectors emphasize the need to protect the rights
and overall welfare of migrants. Particularly relevant
among these policy-legal instruments is the Migrant
Workers and Overseas Filipinos Act of 1995, which
emphasizes that the governments priority is to ensure
that the dignity and fundamental human rights and
freedoms of the Filipino citizens, shall not, at any time be
compromised or violated. The Act was then amended in
2010 to include the role of the DOH in the regulation of
clinics that provide Pre
Examination (PEME). This amendment helpe
existing rules and regulations governing OFW medical
clinics, including safeguarding the right of the aspiring
migrant to select the medical clinic and forbidding the
formation of medical clinic cartels.

Other specific health policies that
migrants include the Quarantine Act of 2004, which lays
down the principles and procedures of ethical and
scientifically-sound quarantine measures in airports and
seaports; the Philippine AIDS Prevention and Control Act
of 1998, which requires the provision of HIV
education to all OFWs even before departure; and the
National Health Insurance Act of 1995, which even
provides for an OFW member in the Board of Directors.

Migration and labor policies in the Philippines paved the
way to the creation of a broad network of government
agencies that are mandated to set standards, coordinate
efforts, and monitor developments in migration,
particularly international labor migration. While there is
no specific agency that is responsible for
I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h

. The different layers of policy-legal frameworks
for migration health
LEGAL FRAMEWORKS
From a health perspective, the Philippines guarantees the
ll Filipinos as enshrined in its
Constitution and reflected in its adoption of various
international human rights instruments. Furthermore,
various laws and policies governing the migration and
labor sectors emphasize the need to protect the rights
rall welfare of migrants. Particularly relevant
legal instruments is the Migrant
Workers and Overseas Filipinos Act of 1995, which
emphasizes that the governments priority is to ensure
that the dignity and fundamental human rights and
freedoms of the Filipino citizens, shall not, at any time be
compromised or violated. The Act was then amended in
2010 to include the role of the DOH in the regulation of
clinics that provide Pre-Employment Medical
Examination (PEME). This amendment helped strengthen
existing rules and regulations governing OFW medical
clinics, including safeguarding the right of the aspiring
migrant to select the medical clinic and forbidding the
formation of medical clinic cartels.
Other specific health policies that relate to the health of
migrants include the Quarantine Act of 2004, which lays
down the principles and procedures of ethical and
sound quarantine measures in airports and
seaports; the Philippine AIDS Prevention and Control Act
ch requires the provision of HIV-AIDS
education to all OFWs even before departure; and the
National Health Insurance Act of 1995, which even
provides for an OFW member in the Board of Directors.
Migration and labor policies in the Philippines paved the
y to the creation of a broad network of government
agencies that are mandated to set standards, coordinate
efforts, and monitor developments in migration,
particularly international labor migration. While there is
no specific agency that is responsible for performing
D O H - I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y




coordination work on migration health (aside from the
role of DOH in the regulation of medical clinics), some
non-health agencies either are already performing
health-related functions or have incorporated health
elements in their activities.

With respect to DOH, while there is no specific unit that
coordinates efforts and addresses migration health in a
comprehensive manner, some offices do conduct
activities or provide services that relate to migration
health, such as the National Epidemiology Center (NEC),
National Center for Disease Prevention
(NCDPC) and Philippine National AIDS Council (PNAC)
which ensure monitoring and care of migrants living with
HIV-AIDS; the Bureau of Quarantine (BOQ) which
conducts health assessments in ports of entry; and the
Health Human Resources Development Bureau (HHRDB)
which monitors the international migration of health
workers. Nevertheless, other existing bureaus of DOH
can play various roles in mounting a department
effort towards advancing the health of international
migrants.

MONITORING MIGRANTS HEALTH
It is important that monitoring systems are capable of
capturing relevant information about the movement as
well as the health needs of international migrants in
general, and the vulnerable subgroups of migrants as
defined by age, sex, occupational arrangements, among
others. In addition, while they are technically not
considered people on the move, there are two other
groups that need to be monitored: those who are about
to enter the migration process, such as those applying for
overseas employment and undergoing p
health assessments; and those who left the migration
process, such as those who were disqualified because of
an abnormal medical examination result as early as the
pre-departure phase or those who have already returned
to their country of origin. Most importantly, monitoring
of migrants health should provide timely and useful
information for effective policy-making and
implementation, but at the same time ensure the dignity
and privacy of the individual migrant.

Due to the fragmentation of the Philippi
information system, data about certain aspects of health
of international migrants are captured and reported
through four specific health programs: the Philippine HIV
and AIDS registry; the Overseas Filipinos Program of
PhilHealth; the BHFS which is responsible for the
regulation of OFW medical clinics; and the BoQ which is
in-charge of recording quarantine cases in airports,
seaports, and other locations of interception.
I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y
coordination work on migration health (aside from the
role of DOH in the regulation of medical clinics), some
health agencies either are already performing
related functions or have incorporated health
With respect to DOH, while there is no specific unit that
coordinates efforts and addresses migration health in a
comprehensive manner, some offices do conduct
activities or provide services that relate to migration
gy Center (NEC),
National Center for Disease Prevention and Control
(NCDPC) and Philippine National AIDS Council (PNAC)
which ensure monitoring and care of migrants living with
AIDS; the Bureau of Quarantine (BOQ) which
orts of entry; and the
Health Human Resources Development Bureau (HHRDB)
the international migration of health
workers. Nevertheless, other existing bureaus of DOH
can play various roles in mounting a department-wide
effort towards advancing the health of international

t monitoring systems are capable of
capturing relevant information about the movement as
well as the health needs of international migrants in
general, and the vulnerable subgroups of migrants as
defined by age, sex, occupational arrangements, among
. In addition, while they are technically not
considered people on the move, there are two other
groups that need to be monitored: those who are about
to enter the migration process, such as those applying for
overseas employment and undergoing pre-departure
those who left the migration
process, such as those who were disqualified because of
an abnormal medical examination result as early as the
departure phase or those who have already returned
mportantly, monitoring
of migrants health should provide timely and useful
making and
implementation, but at the same time ensure the dignity
Due to the fragmentation of the Philippine health
information system, data about certain aspects of health
of international migrants are captured and reported
through four specific health programs: the Philippine HIV
and AIDS registry; the Overseas Filipinos Program of
is responsible for the
regulation of OFW medical clinics; and the BoQ which is
charge of recording quarantine cases in airports,
seaports, and other locations of interception.
Figure 4. Monitoring the health of migrants and
vulnerable subgroups

In addition, other government agencies outside the
Department of Health also collect enormous amounts of
data about international migration to meet their
respective purposes. In fact, other non
government agencies capture some health
information as they are being reported, such as social
welfare cases, medical repatriation cases, etc. However,
the information system
will contribute greatly to the health of the community of
origin, is still a work in progress
information, whether migration
related, do exist, most of them are not summarized,
analyzed, and utilized for policy formulation and program
evaluation.

As relevant information about the health and well
of international migrants will come from different
sources, developing a data sharing culture and
strengthening coordination between agencies are crucial.
Unfortunately, the Shared Government Information
System for Migration, which was created by the Migrant
Workers Act in order to support exchange of migration
related information across government agencies,
needs to be realized.

MIGRANT-SENSITIVE HEALTH SYSTEM
While traditionally, a health system refers to
institutions, policies, and services that direc
the health needs of the population, other actors that are
conventionally regarded as non
included to describe a network of stakeholders and
activities that comprise a migrant
system. With such a broad view
regarded as not lagging in terms of building institutions
that respond to the health needs of people on the move,
especially international migrants.
I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h

. Monitoring the health of migrants and
vulnerable subgroups
ddition, other government agencies outside the
Department of Health also collect enormous amounts of
data about international migration to meet their
respective purposes. In fact, other non-health-related
government agencies capture some health-related
ormation as they are being reported, such as social
welfare cases, medical repatriation cases, etc. However,
about return migration, which
will contribute greatly to the health of the community of
still a work in progress. Ultimately, while
information, whether migration- or migration health-
related, do exist, most of them are not summarized,
analyzed, and utilized for policy formulation and program
As relevant information about the health and well-being
ernational migrants will come from different
sources, developing a data sharing culture and
strengthening coordination between agencies are crucial.
Unfortunately, the Shared Government Information
System for Migration, which was created by the Migrant
kers Act in order to support exchange of migration-
related information across government agencies, still
SENSITIVE HEALTH SYSTEM
While traditionally, a health system refers to
institutions, policies, and services that directly cater to
the health needs of the population, other actors that are
conventionally regarded as non-health have been
included to describe a network of stakeholders and
activities that comprise a migrant-sensitive health
system. With such a broad view, the Philippines can be
regarded as not lagging in terms of building institutions
that respond to the health needs of people on the move,
especially international migrants.
D O H - I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y




While there exists no overarching program for migration
health in the DOH, several services and activities consider
the health of migrants especially those who are in the
pre-departure and return phases. The PEME is the
standard basic examination which is mandatory for
aspiring migrants in order to be issued with an Overseas
Employment Certificate (OEC). Aside from the regulatory
function of DOH towards medical clinics offering
the BOQ, in tandem with other port authorities, also
handles medical examinations of intercepted individuals
suspected with infectious disease or those who are
chronically ill in need of medical assistance during travel.


Figure 5. Basic health services provided to migrants
during the pre-departure phase

International migrants have differential access to health
promotion and education throughout the migration
course. For example, through the Pre
Orientation Seminar (PDOS), OFWs who are about to
leave also receive health-related advice which are
relevant to their countries of destination, especially
regarding HIV-AIDS as required by the Philippine AIDS
Act. The challenge is how to effectively and uniformly
convey these messages, as there is a wide
health content across different PDOS providers. The
variation in health education levels further intensifies as
migrants arrive in countries of destination, as some
settings might not provide such services at all, whether
through embassies or from the health system of the
receiving country.

While not a requirement before departure, PhilHealth
membership offers some financial risk protection for at
least 10 million Filipino migrants and their dependents
through the Overseas Workers Program, whic
renamed Overseas Filipinos Program in order to expand
membership to include undocumented migrants,
immigrants, and other overseas Filipinos. While family
members left behind can directly avail of the benefits
guaranteed to Philippine-based members
Health
Assessments
Pre-Employment
Medical Exam
(PEME)
Who provides?
Who regulates?
Who pays?
Financial Risk
Protection
PhilHealth
Mandatory
Insurance
Who is registered?
How much?
What is covered?
Education and
Promotion
Orientation Seminar
I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y
While there exists no overarching program for migration
l services and activities consider
the health of migrants especially those who are in the
departure and return phases. The PEME is the
standard basic examination which is mandatory for
aspiring migrants in order to be issued with an Overseas
Certificate (OEC). Aside from the regulatory
function of DOH towards medical clinics offering PEMEs,
Q, in tandem with other port authorities, also
handles medical examinations of intercepted individuals
suspected with infectious disease or those who are
chronically ill in need of medical assistance during travel.

ided to migrants
departure phase
International migrants have differential access to health
promotion and education throughout the migration
course. For example, through the Pre-Departure
Orientation Seminar (PDOS), OFWs who are about to
related advice which are
relevant to their countries of destination, especially
AIDS as required by the Philippine AIDS
Act. The challenge is how to effectively and uniformly
convey these messages, as there is a wide variety of
health content across different PDOS providers. The
variation in health education levels further intensifies as
migrants arrive in countries of destination, as some
settings might not provide such services at all, whether
rom the health system of the
While not a requirement before departure, PhilHealth
membership offers some financial risk protection for at
least 10 million Filipino migrants and their dependents
through the Overseas Workers Program, which is now
renamed Overseas Filipinos Program in order to expand
membership to include undocumented migrants,
immigrants, and other overseas Filipinos. While family
members left behind can directly avail of the benefits
based members, overseas
members will still need to undergo some administrative
procedures in order to reimburse portions of their
hospital expenditures abroad.

Embassies and consulates of the Philippines in
destination countries also provide some welfare,
including health-related, services to overseas Filipinos in
distress. In addition, other agencies such as the Overseas
Workers Welfare Administration (OWWA) and the
Department of Social Welfare and Development (DSWD)
have been tasked to deploy additional staff to aug
these services in major destination countries.

Occasionally, overseas Filipinos in distress require
assistance for their eventual repatriation, either medical
repatriation for individuals with chronic illness, or mass
repatriation for groups of migr
situations such as armed conflict and disaster. The
embassies and consulates, under the direction of the
Department of Foreign Affairs (DFA), play a lead role in
the evacuation and repatriation process, with other
agencies coordinating to provide specific forms of
support. On an ad hoc basis, the DFA seeks the DOHs
involvement to provide assistance in terms of referring
returning migrant-patients upon arrival in the Philippines.
In 2014, the DOH was included in the Inter
Committee tasked by President Benigno
formulate and implement guidelines on giving
governmental assistance to OFWs in distress.

PARTNERSHIPS, NETWORKS,
AND MULTI-COUNTRY FRAMEWORKS
The Philippines is regarded as the country with the
greatest number of nongovernmental organizations
(NGOs) and networks focusing on migration
issues. While many of them have sought to address
issues concerning the overall welfare of migrants, some
NGOs such as Action for Health Initiatives and Scalabrini
Migration Center have conducted research
on many aspects of migration and health.

The DOH also has prior experience in network building;
one particular example is the Human Resources for
Health Network, which provides government agencies,
non-governmental organizations, and international
partners a platform for meaningful dialogue on critical
issues affecting the Philippine health workforce, from
health professional education to working conditions. The
international migration of Filipino health wo
been a major focus of the network, and many of the key
actors in migration management are also involved in this
coalition.
Health
Education and
Promotion
Pre-Departure
Orientation Seminar
What is the
content?
Who provides?
How else?
I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
members will still need to undergo some administrative
procedures in order to reimburse portions of their
hospital expenditures abroad.
Embassies and consulates of the Philippines in
destination countries also provide some welfare,
related, services to overseas Filipinos in
distress. In addition, other agencies such as the Overseas
Workers Welfare Administration (OWWA) and the
Department of Social Welfare and Development (DSWD)
have been tasked to deploy additional staff to augment
these services in major destination countries.
Occasionally, overseas Filipinos in distress require
assistance for their eventual repatriation, either medical
repatriation for individuals with chronic illness, or mass
repatriation for groups of migrants caught in crisis
situations such as armed conflict and disaster. The
embassies and consulates, under the direction of the
Department of Foreign Affairs (DFA), play a lead role in
the evacuation and repatriation process, with other
g to provide specific forms of
support. On an ad hoc basis, the DFA seeks the DOHs
involvement to provide assistance in terms of referring
patients upon arrival in the Philippines.
In 2014, the DOH was included in the Inter-Agency
tee tasked by President Benigno S. Aquino III to
formulate and implement guidelines on giving
governmental assistance to OFWs in distress.
PARTNERSHIPS, NETWORKS,
COUNTRY FRAMEWORKS
The Philippines is regarded as the country with the
mber of nongovernmental organizations
(NGOs) and networks focusing on migration-related
issues. While many of them have sought to address
issues concerning the overall welfare of migrants, some
NGOs such as Action for Health Initiatives and Scalabrini
ation Center have conducted research and advocacy
on many aspects of migration and health.
he DOH also has prior experience in network building;
one particular example is the Human Resources for
Health Network, which provides government agencies,
ernmental organizations, and international
partners a platform for meaningful dialogue on critical
issues affecting the Philippine health workforce, from
health professional education to working conditions. The
international migration of Filipino health workers has
been a major focus of the network, and many of the key
actors in migration management are also involved in this
D O H - I O M J o i n t P r o j e c t o n M i g r a t i o n H e a l t h
E X E C U T I V E S U M M A R Y




The Philippines has a history of forging bilateral labor
agreements (BLAs) with receiving countries, facilitating
overseas employment and ensuring adequate minimum
protection for OFWs. While BLAs in general mention the
importance of protecting the rights and welfare of
Filipino migrant workers, specific health provisions still
need to feature in these important policy instruments.

HOW DO WE MOVE FORWARD?
To facilitate economically sound yet ethical and rights-
based migration, and in the spirit of the migration and
development nexus espoused by the international
community, addressing the health needs of migrants is of
critical importance now more than ever. Looking into
health and well-being puts the migrant at the center of
policy and practice, not at migration as a mere
contributor to economic development. As one of the
biggest source countries in the world, the Philippines is
rightly placed to champion the right to health of the
international migrant and to put in place domestic
policies and programs to advance this cause. Since most
efforts today originate from destination countries, the
Philippines also can serve as an exemplar in how a source
country can ensure the protection of health rights of
migrants overseas through the entire migration process.

With a long history of institutionalized labor migration,
supported by policies and institutions that evolved
throughout the decades, the Philippines is not starting
from scratch when it comes to managing migration and
labor at large, and migration health in particular.
Furthermore, while traditionally not seen as an actor in
migration governance, the DOH has a huge potential
leadership role in addressing migration health,
performing various functions such as norm-setting,
providing technical guidance, coordinating intersectoral
efforts, and monitoring progress. The Philippines can
better improve its existing efforts in migration health by
adhering to the following principles:

Adoption of a rights-based approach to migration,
labor, and health. Migrants, just like the rest of the
population, are guaranteed by various international and
national policy-legal frameworks with an inalienable right
to health, decent employment, and mobility within and
across national borders.

Use of the Health in All Policies (HiAP) paradigm as
framework for migration health governance. The HiAP
approach emphasizes that health should be considered in
the formulation and implementation of policies under
the auspices of other sectors.
Clarifying roles and strengthening coordination across
government. The challenge with addressing cross-cutting
issues is ensuring that each responsible agency or
stakeholder is able to perform its mandated duties while
in close coordination with others.

Ensuring equity in health within migrant populations
and between migrants and the larger society. The goal
of addressing migrants health is to reduce their
vulnerability to avoidable health risks and ensure
equitable access to essential health care services. Their
migrant status should not serve as a deterrent for them
to achieve the highest level of health possible.
Furthermore, special attention should be accorded to
subgroup of migrants who are in a worse position than
others to achieve health equity among migrants.

Implementing universal minimum approaches while
adapting to specific situations and destination country
contexts. To ensure that all migrants, regardless of their
situation, are guaranteed basic protections and services,
the Philippines must design universal approaches such as
the PhilHealth Overseas Filipinos Program while
considering migrants diverse situations and contexts.

Enshrining monitoring and evaluation to track progress
and improve programs. While the Philippines has been
lauded for establishing a comprehensive suite of policies
and programs that contribute to the countrys labor
migration policy, it also has to do better in terms of
regularly monitoring migrants and their well-being as
well as evaluating its performance for further
strengthening and improvement.

References
International Organization for Migration and Scalabrini Migration Center
(2013) Country Migration Report: The Philippines 2013. Manila:
International Organization for Migration.
International Organization for Migration, World Health Organization, and
United Nations Office of the High Commissioner on Human Rights (2013)
International Migration, Health and Human Rights. Geneva: International
Organization for Migration.
National Epidemiology Center (2014) Philippine HIV and AIDS Registry: July
2014. Manila: Department of Health.
World Health Organization (2010) Health of migrants the way forward.
Report of a global consultation. Geneva: World Health Organization.
Zimmerman C, Kiss L, Hossain M (2011) Migration and Health: A Framework
for 21st Century Policy-Making. PLoS Med 8(5): e1001034.
doi:10.1371/journal.pmed.1001034

This Executive Summary was prepared by Dr. Renzo Guinto,
consultant for the DOH-IOM Joint Project on Migration
Health. Inputs were also provided by Director Maylene
Beltran, Dr. Aleli Annie Grace Sudiacal, and Dr. Joel
Buenaventura of the Bureau of International Health
Cooperation, Department of Health, and Dr. Poonam Dhavan,
Dr. Predrag Bajcevic, and Mr. Ricardo Casco of the
International Organization for Migration.