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Research Article

Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis

Roles Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Writing – original draft, Writing – review & editing

Affiliations Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia, Universiti Malaya Centre for Community & Sustainability, University of Malaya, Kuala Lumpur, Malaysia

Roles Data curation, Formal analysis, Methodology, Resources, Supervision

Affiliations Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia, Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

Roles Data curation, Methodology, Software

Affiliation Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia

Roles Formal analysis, Writing – original draft, Writing – review & editing

Roles Conceptualization, Methodology, Writing – review & editing

Affiliations Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia, Department of Social & Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

Roles Funding acquisition, Project administration, Resources, Supervision, Writing – review & editing

* E-mail: [email protected]

Affiliations Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia, Universiti Malaya Centre for Community & Sustainability, University of Malaya, Kuala Lumpur, Malaysia, Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

• Siti Idayu Hasan, 
• Anne Yee, 
• Ariyani Rinaldi, 
• Adlina Aisya Azham, 
• Farizah Mohd Hairi, 
• Amer Siddiq Amer Nordin

• Published: December 2, 2021
• https://doi.org/10.1371/journal.pone.0260221
• Reader Comments

Previous literature has shown that migrant workers manifested higher common mental issues (especially depressive symptom) compared to local workers due to stressors such as financial constraint and lack of access to healthcare. The aim of this systematic review and meta-analysis is to summarize the current body of evidence for the prevalence of depression and anxiety among migrant workers as well as exploring the risk factors and the availability of social support for migrant workers. Seven electronic databases, grey literature and Google Scholar were searched for studies from 2015 to 2021 related to mental health, social support and migrant workers. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Study heterogeneity was evaluated using I 2 statistics. Random effects meta-analysis results were presented given heterogeneity among studies. The search returned 27 articles and only seven studies were included in meta-analysis, involving 44 365 migrant workers in 17 different countries. The overall prevalence of depression and anxiety among migrant workers was 38.99% (95% CI = 0.27, 0.51) and 27.31% (95% CI = 0.06, 0.58), respectively. Factors such as age, biological (health issue, family history of psychiatric disorder), individual (poor coping skills), occupational (workplace psychosocial stressors, poor working condition, salary and benefits issue, abuse), environmental (limited access towards healthcare, duration of residence, living condition) and social factor (limited social support) were associated with a mental health outcome in migrant workers. The availability of social support for migrant workers was mainly concentrated in emotional type of support. A high prevalence of depression and anxiety was found among migrant workers across the globe. This finding warrants a collective effort by different parties in providing assistance for migrant workers to promote their mental well-being.

Citation: Hasan SI, Yee A, Rinaldi A, Azham AA, Mohd Hairi F, Amer Nordin AS (2021) Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis. PLoS ONE 16(12): e0260221. https://doi.org/10.1371/journal.pone.0260221

Editor: Baltica Cabieses, Universidad del Desarrollo, CHILE

Received: June 1, 2021; Accepted: November 4, 2021; Published: December 2, 2021

Copyright: © 2021 Hasan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript paper its Supporting Information files.

Funding: This study was supported by LENDLEASE PROJECTS (M) SDN. BHD. (Grant Number: PV049-2020).

Competing interests: The authors have declared that no competing interests exist.

Introduction

Globalization has improved the interconnectedness between countries which has impacted human mobility in the aspect of migration [ 1 , 2 ]. According to the International Organization for Migration (IOM) (2019), the number of international migrants has increased significantly from 84 million in 1970 to 272 million in 2019. In 2019, the highest two regions that hosted the total global international migrant stock were Europe and Asia, while Oceania, North America and Europe were the highest when a comparison made based on the size of the population in each region. Nearly half of the number of international migrants around the globe is originated from Asian countries (e.g., India, China, Bangladesh) followed by Mexico and the Russian Federation [ 3 ].

In 2017, the migrant workers’ population was still highly concentrated in higher-income countries (68%). However, due to economic development and issue related to immigration regulation in higher-income countries, there was an evident shift in the residence of migrant workers in middle-income countries. In terms of gender composition, the number of male migrant workers (58%) was higher than female migrant workers (42%) with apparent gender imbalance geographically in several regions such as the Arab States, where male migrant workers were highly demanded as the labor opportunities were more concentrated in the construction sector [ 3 ].

It is known that migrant workers commonly hired for jobs related to 3Ds (dangerous, dirty, difficult) [ 4 , 5 ] or precarious employment which increased their exposure to environmental hazards at work site. They were at higher risk of workplace injuries due to inadequate safety protection at the workplace [ 6 , 7 ]. Migrant workers were also reported to have poor working conditions such as low wages, higher working hours, low job security and workplace abuse [ 8 ]. Both occupational hazard and poor working environment have increased the vulnerability of migrant workers to poor health outcomes, especially on their mental well-being. Previous research indicated that migrant workers reported experiencing higher mental health problems in comparison to native workers [ 9 – 12 ].

The most prevalent mental health issues reported among migrant workers are the manifestation of depressive symptoms [ 13 – 17 ]. A systematic review assessing the prevailing psychological disorders among migrant workers also found that these workers were experiencing other issues such as anxiety, alcohol or substance abuse and poor sleep quality [ 17 ]. This psychological distress experienced by the migrant workers are commonly linked to several stressors: financial difficulties, health risks (due to working condition), limited access to healthcare and presence of social issue (i.e., language barrier, discrimination) [ 12 , 13 , 18 – 21 ]. A previous study has indicated the difference in stressors experienced by migrant workers according to gender and working industry [ 14 ]. Furthermore, World Health Organization (WHO) and International Labour Organization (ILO) has also highlighted the mental health impact of COVID-19 on migrant workers around the world, which mainly due to social isolation and job insecurity [ 22 – 24 ].

Looking for a potential solution to address the issue of mental health among migrant workers is a frame of reference in the discussion of protection on their welfare. One of the protective factors that may promote mental well-being of migrant workers is social support. Social support has been found to promote the mental well-being [ 25 , 26 ] including in immigrants [ 27 , 28 ] and refugees [ 29 ]. According to the traditional theoretical framework of social support, four types of social support were identified: emotional support (i.e., expressions of love, trust, and empathy), instrumental support (i.e., tangible aid and service), informational support (i.e., advice, suggestion) and esteem (i.e., useful information for self-evaluation) [ 30 ]. These difference in dimensions of social support may provide another focus for the intervention of the psychological well-being of the migrant workers.

Hence, in addressing the concern of mental well-being among migrant workers, this paper aims to conduct a systematic review of literature and meta-analysis in examining the prevalence of mental health issue (i.e., depression and anxiety) among migrant workers, as well as determining the risk factors of mental health outcomes and exploring the availability of social support for migrant workers.

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 31 ]. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD42021232181).

Search strategy and selection criteria

A systematic search of all English-language literature published from 2015 to 2021 from MEDLINE, Education Research Complete, Psychology and Behavioral Sciences Collection, ERIC, SAGE, Science Direct, Scopus and Google Scholar search was performed. The following keywords (a) mental health or mental illness or mental disorder or psychiatric illness (b) anxiety (c) depression or depressive disorder or depressive symptoms or major depressive disorder (d) social support or social networks or social relationships or social inclusion or social exclusion or social isolation and, (e) migrant workers were used. The screening process in this review also included references of the selected articles, book chapters, papers presented at conferences, dissertations, editorial and commentaries. In addition, the authors of this paper attempted to contact the respective authors via email to obtain the full articles and detailed data if the articles were unavailable or information of the quantitative studies was inadequate.

Two independent reviewers performed all of the titles and abstracts screening, followed by an analysis of the full-text articles. All duplicates were removed. Any discrepancies were resolved by a third reviewer. Data from eligible studies were extracted by a reviewer and all extracted data were reviewed by two independent reviewers.

Inclusion and exclusion criteria

Inclusion and exclusion criteria were set to identify and choose the studies that were most relevant to our research.

The inclusion criteria were the following:

• Any study design (quantitative, qualitative, mixed-methods studies)
• Published between 2015 and 2021
• Published in English
• Any migrant workers

The exclusion criteria were the following:

• Published prior to 2015
• Published in a language other than English
• Internal/external migrants moving within the same country

Quality assessment

Study quality was assessed using the appropriate appraisal tool for each research design: the Newcastle Ottawa Scale (NOS) for Cohort studies [ 32 ], the Newcastle Ottawa Scale adapted for Cross-Sectional Studies [ 33 ] and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) [ 34 ]. For mixed-method studies, the quality assessment was conducted based on the data used in this review. If both quantitative and qualitative data were included in this review, both the Newcastle Ottawa Scale and JBI-QARI were used to conduct the quality assessment, while if only one, the study quality was evaluated using either any one of the tools (based on the data used). It was performed by two reviewers and any discrepancies were discussed with the third reviewer.

Statistical analysis

All data analyses were performed using Stats Direct (version 2.7.9). The presence of heterogeneity between the trials was tested using the I-squared ( I 2 ) statistic. An I 2 of more than 75% indicated significant heterogeneity. If the I 2 was significant, pooled prevalence of anxiety and depression were calculated by using a random-effects model [ 35 ]. Conversely, the data were pooled by using a fixed-effects model [ 36 , 37 ]. Publication bias was assessed with the Begg-Mazumdar and Egger test. Qualitative meta-analysis was also conducted to summarize, compare and contrast the extracted data.

Ethics approval

Ethical approval was obtained from Universiti Malaya Research Ethics Committee (UMREC) (UM.TNC2/UMREC_1187).

Electronic database searching identified a total of 3962 articles. Additional literature was also identified using Google Scholar with 160 articles. After removal of duplicated publication, screening of title and abstract and screening of full-text, 27 studies were included in the present systematic review (see S1 Table ). Out of these 27 studies, only seven articles had the data on the proportion of depression and anxiety for meta-analysis. Fig 1 shows the data extraction conducted in accordance with the Quality of Reporting of Meta-analyses Guidelines [ 31 ].

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https://doi.org/10.1371/journal.pone.0260221.g001

Study characteristics

Most of the literature included were cross-sectional studies (18), followed by longitudinal studies (4), mixed-method studies (3) and qualitative studies (2). Participants were recruited using various sampling method including convenience sampling (7), purposive sampling (5), random sampling (5), snowball sampling (4), cluster sampling (2), stratified multi-stage probability proportional to size (1), cluster and occasional sampling (1), systematic random sampling and purposive (1) and convenience and snowball sampling (1).

Five of the studies were conducted in Australia [ 38 – 42 ]. Two studies were conducted in each of these countries: Singapore [ 43 , 44 ], Hong Kong [ 45 , 46 ], Italy [ 47 , 48 ], The United States of America [ 49 , 50 ], Spain [ 51 , 52 ] and United Kingdom [ 53 , 54 ]. The remaining studies were conducted in Israel [ 55 ], India [ 56 ], South Korea [ 57 ], Malaysia [ 58 ], Thailand [ 59 ], Japan [ 60 ], Norway [ 61 ], Ethiopia [ 62 ], Chile [ 63 ] and China [ 64 ].

There were 44 365 subjects included from the 27 studies (see S1 Table ) with a sample size ranged between 40 and 15 321. Only seven studies reported the mean age of the participants, which range from 28.17 to 43.60 years [ 43 , 44 , 50 , 53 , 56 , 59 , 64 ] Out of 24studies that reported on gender composition, 13 studies had more female participants while another 11 studies had more male participants. Five studies did not state any information on the gender composition of their participants [ 43 – 46 , 50 ].

In total, 39 psychometric instruments were used in 24 studies. Another remaining three studies used interview questions [ 44 , 45 ] and combination of digital audio recorder and notes on emotion non-verbal cues [ 49 ].

Study quality

Table 1 showed summary of study quality for cross-sectional by using the NOS scale. The articles’ scores range from seven to nine stars. Of the 18 studies, 17 could be regarded as good quality [ 38 , 39 , 41 – 43 , 46 , 48 , 54 , 55 – 57 , 59 – 64 ] and only one was scored to be of poor quality [ 58 ]. The summary of study quality for longitudinal studies assessed using the NOS scale was presented in Table 2 . The articles’ score ranges from six to eight stars. Of the four studies, one could be regarded as good quality [ 40 ] and three were scored to be of poor quality [ 51 – 53 ].

https://doi.org/10.1371/journal.pone.0260221.t001

https://doi.org/10.1371/journal.pone.0260221.t002

For qualitative studies, most of the studies met the criteria of the JBI-QARI except for (1) the indication of locating the researcher culturally or theoretically (Criteria 6) and (2) the indication of the influence of the researcher on the research (and vice-versa) (Criteria 7) (see Table 3 ). For Criteria 7, only two studies met the criteria [ 44 , 49 ].

https://doi.org/10.1371/journal.pone.0260221.t003

Meta-analysis

Seven studies assessed the prevalence of depression and anxiety which ranged from 10.7% to 85% for the former and 6.9% to 58.47% for the latter. Pooled proportion of depression was 38.99% (95% CI = 0.27, 0.51) (see Fig 2 ) and pooled proportion of anxiety was 27.31% (95% CI = 0.06, 0.58) (see Fig 3 ).

(95% CI = 0.27 to 0.51), I 2 (inconsistency) = 99.2% (95% CI = 99.1% to 99.3%), Egger: bias = -1.679764 (95% CI = -21.867931 to 18.508402), P = 0.84, Begg-Mazumdar: Kendall’s tau.

https://doi.org/10.1371/journal.pone.0260221.g002

(95% CI = 0.06 to 0.58), I 2 (inconsistency) = 98.9% (95% CI = 98.5% to 99.2%), Egger bias = <too few strata> (95% CI = * to *), P = *, Begg-Mazumdar: Kendall’s tau = <too few strata.

https://doi.org/10.1371/journal.pone.0260221.g003

Qualitative meta-analysis

Depression..

Nine studies explored the presence of depression among migrant workers [ 41 , 48 – 50 , 57 , 58 , 64 , 65 ]. The prevalence of depression among Myanmar migrant workers in Malaysia was 70.8% (N = 136) [ 58 ]. Chen et al. [ 64 ] found the prevalence of depression among migrant workers in China was 24.3%. In the study conducted by Hatch et al. [ 53 ], 10.7% of the respondents reported experiencing depressive episodes. Organista et al. [ 50 ] evaluated the challenging working and living conditions and the psychological distress in Latino migrant workers. Their study found a mean of 0.77 (SD = 0.54) for depressive symptoms, based on standardized factor loadings of 1.00. In another study [ 64 ], the mean of depressive symptoms reported by participants was 32 (SD = 9.6, range = 10–50).

In the semi-structured interview conducted by Crocker [ 49 ], the reported depressive symptoms were 70% among male participants (N = 14) and 85% among female participants (N = 17). While in the study conducted by Hong & Lee [ 57 ], the prevalence of depression was higher in migrants from low-income countries compared to migrants from middle- or high-income countries (male = 27.1% > 23%; female = 37.1% > 31.2%).

Adebayo et al. [ 41 ] investigated the prevalence of acculturation stress and mental health issue (i.e., depression, anxiety, stress) among migrant workers in Australian residential aged care facilities. Based on Depression Anxiety Stress Scale-21 (DASS-21), their results found that 84.7% of the migrant workers in the normal range. Only 1.8% and 0.8% were in the range of severe depression and extremely severe depression, respectively.

Similarly, Gambaro et al. [ 48 ] found that 42.37% of the migrant workers in Italy reported no depressive symptoms, based on the Zung Self-Rating Depression Scale (SDS). 38.14% of the participants were in the low range, 14.41% in the mild range and only 1.69% in the high range.

Four studies assessing the presence of anxiety among migrant workers were identified [ 41 , 48 , 50 , 53 ]. Hatch et al. [ 53 ] reported 6.9% of their participants manifested generalized anxiety disorder (GAD). In another study, Organista et al. [ 50 ] reported a mean of 0.66 for anxiety symptoms (SD = 0.60), based on standardized factor loading of 1.00.

Adebayo et al. [ 41 ] found in their studies that 74.5% of the migrant workers were in the normal anxiety range of DASS-21. Only 2.3% and 3.8% were in the range of severe anxiety and extremely severe anxiety, respectively. In another study [ 48 ], 38.98% of the participants reported no symptoms of anxiety, based on the rating on Zung Self-Rating Anxiety Scale (SAS). 49.15% of the migrant workers were in the low range and another 9.32% were in the mild range of anxiety.

Five studies explored the prevalence of stress (including acculturation stress and post-traumatic stress disorder) among migrant workers [ 41 , 43 , 48 , 49 , 54 ].

The prevalence of stress among female migrant domestic workers in Singapore was 52.5% (N = 85) [ 43 ]. Crocker [ 49 ] found in his study that 95% of male participants (N = 19) and 80% of female participants (N = 16) reported feeling stressed. In another study [ 54 ], the mean of perceived stress among the respondents was 16.89 (SD = 7.19). Adebayo et al. [ 41 ] revealed in their study that based on the DASS-21, 89.9% of the migrant workers were in the normal range. Only 1.8% of the workers reported being on the severe level of stress scale. The study also evaluated the prevalence of acculturation stress among migrant workers in Australia. It was found that the mean of acculturation stress was 38.4 (SD = 14.1).

In the study conducted by Gambaro et al. [ 48 ], based on PTSD Checklist for DSM-5 (PCL-5), 53.95% (N = 63) reported scoring above the median score of 33 which suggested higher level of post-traumatic stress disorder symptoms.

Other mental health outcome

Three studies identified the prevalence of common mental health issues (both depressive and anxiety symptoms) [ 47 , 59 , 61 ]. Two studies measured the mental well-being of migrant workers using the Hopkins Symptoms Checklist-25 (HSCL-25) [ 59 , 61 ]. The prevalence of participants with depressive and anxiety symptoms was 12.7% [ 61 ] and 11.9% [ 59 ]. In another study by Capasso et al. [ 47 ], the prevalence of the anxious-depressive disorder among migrant workers was 32.8%.

Risk factors for mental health outcome

Six studies found the effect of age on the mental well-being of the migrant workers [ 43 , 55 – 57 , 61 , 64 ]. Chen et al. [ 64 ] reported in their findings that the prevalence of mental health issue was higher among younger group of migrant workers (25–39 years old) (M = 6.96, SD = 4.67, p = .008). Similarly, age was found to inversely associated with the symptoms of anxiety and depression (OR = 0.95, p = .03) [ 55 ]. Another study also found that older age (> 50 years old) was correlated with less psychological distress (M = 78.2, SD = 11.9, p < .001) [ 43 ].

In contrast, a study found that older age group (> 45 years old) was associated with higher psychological distress (aPR = 2.74, CI = 1.01–7.41, p < .05) [ 56 ]. Straiton et al. [ 61 ] also reported in their study that the older age group experienced more mental health issue (16.0% vs 11%, p < .001). In addition, the prevalence of depressive symptoms was found to be higher in immigrants aged above 65 years old (40.5%) [ 57 ].

Psychological factors.

Several studies explored the association between the coping skills of migrant workers and their mental well-being [ 48 , 52 ]. Resilience among migrant workers was found to inversely associated with depressive symptoms (r = -0.24, p < .05) and suicidal intention (r = - 0.31, p < .05) [ 48 ]. In addition, lower attention to feelings (i.e., thinking about one’s feelings) (standardized path coefficient = 0.38 (T1), 0.49 (T2), p ≤ .01) and higher mood repair (i.e., one’s ability to regulate moods when experiencing negative emotions) (standardized path coefficient = -0.39 (T1), -0.41 (T2), p ≤ .01) were linked to better psychological well-being among migrants in Spain during both data waves [ 52 ].

In addition, migrant workers with higher negative affectivity (i.e., temperamental style characterized by stable tendency to experience negative emotions) (OR = 1.961, p < .05) and higher social inhibition (OR = .343, p < .05) were associated with higher level of anxious-depressive disorder [ 47 ].

Biological factors.

Two studies found the biological risk factors that influenced the mental health outcome among migrant workers [ 56 , 62 ]. Higher psychological distress was reported among migrant workers with existing health issues (aPR = 2.0, p < .001) [ 56 ] and history of psychiatric illness in their family (OR = 6.75, 95% CI = 1.03, 43.95) [ 62 ].

Occupational factors.

Daly et al. [ 39 ] reported that higher psychological distress among migrant workers in Australia was associated with workplace psychosocial stressors including complex/demanding jobs (OR = 2.6, p < .0001), jobs with low control (OR = 1.8, p < .0001), jobs with low security (OR = 3.4, p < .0001) and overall job adversity (OR = 2.7, p < .0001). In a similar study, they found that higher mental well-being was associated with higher skill discretion (OR = 0.40, p < .001), higher decision authority (OR = 0.36, p < .001) and lower job insecurity (OR = -1.08, p < .001) [ 42 ].

A study found that the effect of occupational roles on acculturation stress among migrant workers in Australia [ 41 ]. It was described that in comparison to other roles in registered aged care facilities, enrolled and registered nurses reported higher level of acculturation stress (F(3, 254) = 3.0, p = .03).

In the study conducted by Organista et al. [ 50 ], poor working conditions (measured by working days, working hours and earnings) were associated with higher level of desesperación (i.e., feeling of isolation) (β = -0.10, p ≤ .01) and depression (β = -0.11, p ≤ .01). Miller et al. [ 60 ] found in their study that higher employment satisfaction was associated with better mental health outcome among migrants working in Japan (B = 4.9; p < 0.001). In addition to poor working conditions, experiencing physical abuse at workplace was also found as a risk factor of psychological distress among migrant workers (OR = 12.17, 95% CI = 5.87, 25.22) [ 62 ].Several studies also reported the risk of mental health issues among migrant workers when experiencing an occupational issue related to salary and benefits [ 56 , 58 , 62 ]. Myanmar migrant workers in Malaysia reported higher depressive symptoms when there was absence of financial aid from employer if they had physical health issue (80.9%, p = .001) [ 58 ]. Similarly, receiving no sick leave (aPR = 2.4, p < .001) [ 56 ] and unable to get salary timely (OR = 3.35, 95% CI = 1.47, 7.63) [ 62 ] were also associated with the presence of psychological distress among migrant workers.

Environmental factors.

Two studies identified having limitation towards healthcare access in the working country as one of the risk factors of mental health issues among migrant workers [ 56 , 62 ]. Higher presence of common mental disorder symptoms was reported by Ethiopian labour migrant returnees working in Middle East countries when they were denied access to healthcare (OR = 3.20, 95% CI = 1.53, 6.67) [ 62 ]. In another study [ 56 ], the risk of psychological distress was identified among Nepali migrant workers in India who experienced barriers to healthcare access (aPR = 1.88, p < .001).

Duration of residence was also found to associate with the mental well-being among migrant workers. Htay et al. [ 58 ] indicated in their study that migrant workers who had lived in Malaysia for a duration of five years and more were found to manifest more depressive symptoms (81.9%, p < .001) in comparison to those who stayed less than five years. Similarly, migrant workers who had stayed in Spain for more than 10 years also reported higher incidence of common mental health problem compared to those with shorter residence duration in Spain (1–10 years) (ORa = 0.06, 95% CI = 0.26–0.01) [ 51 ].

Furthermore, poor living condition in migrant workers was linked to the depression (β = −0.17, SE = 0.02, p ≤ .001), desesperación (i.e., feeling of isolation) (β = −0.19, SE = 0.03, p ≤ .001) and alcohol use (β = −0.13, SE = 0.43, p ≤ .01) [ 50 ].

Risk factors of mental health outcome during COVID-19.

Two studies explored the risk factors of the mental health outcome among migrant workers during COVID-19 [ 46 , 55 ]. In the study by Attal et al. [ 55 ], they found that emotional distress among the workers was associated with household food insecurity (OR = 5.85, p < .001), lower in confidence to care for themselves and employer during COVID-19 (OR = 3.85, p < .001), poorer general health (OR = 2.98, p < .003), country of origin (i.e., those who were not from Philippines) (OR = 2.83, p < .001) and gender (i.e., female) (OR = 2.34, p < .04). In another study, the anxiety symptoms experienced by Filipino domestic helpers in Hong Kong was associated with lack of protective equipment (OR = 1.54, p = .00), higher workload during pandemic (OR = 1.95, p = .00) and worried about termination if getting COVID-19 (OR = 1.43, p = .00) [ 46 ].

Social factors/social support.

The feeling of isolation was associated with higher psychological distress outcome [ 43 , 60 ]. Female migrant domestic workers in Singapore with higher level of stress was associated with feeling isolated (M = 17.6, SD = 3.4) [ 43 ]. Migrants working in Japan reported that lower feeling of isolation promoted their mental well-being (B = 3.2, p = .008) [ 60 ].

In the study conducted by Straiton et al. [ 61 ], mental health issues were found higher among those without social support (20%) in comparison to those with social support (11.2%). A qualitative study conducted by Van Bortel et al. [ 44 ] reported that the respondents indicated social support was an important coping resource for them with two themes identified which were the comfort of company and having someone to talk to. In contrast, in the study conducted during COVID-19, it was revealed that no association was found between social support from employers, family, friends and community organizations and anxiety symptoms (OR = 1.21, p = 0.16) [ 46 ].

In the study conducted by Baig & Chang [ 45 ], their qualitative data described the difference in help-seeking behaviour among migrant domestic workers in Hong Kong between formal and informal support systems. It was found that the workers approached the formal social support (e.g., consulate, local government departments, agency) for the issue related to employment. On the other hand, these migrant workers preferred to seek informal social support (e.g., family, friends) when experiencing emotional distress. Another qualitative data found that limited formal social support (from established organization) was provided for Ethiopian migrant workers returnees from Middle East countries who experienced mental health issues [ 62 ]. Only three organizations were reported to provide formal social support (in terms of mental health care services: two of them provided a rehabilitation center and another one provided hospital-based mental health care.

The present systematic review and meta-analysis included a total of 27 studies, with most studies being cross-sectional. The review of studies has fulfilled the aim of identifying the mental health issue among migrant workers and their risk factors. Our meta-analysis literature review highlights the pool prevalence of depression and anxiety among migrant workers. The prevalence of depression and anxiety was 38.98% and 27.31%, respectively. There was a notable increase in the prevalence in comparison to a decade ago where the reported prevalence of depression and anxiety among labour migrants was 20% and 21%, respectively [ 66 ]. This could be influenced by the increasing trends of working-related migration in the last ten years [ 3 ].

It was also found that refugees had a similar prevalence of depression and anxiety, with 40.9% and 26.6%, respectively [ 67 ]. Another study reported a wide variation in prevalence rates for depression and anxiety among first-generation migrants with, 5% to 44% and 4% to 40%, respectively [ 68 ]. This shows that migration in general amplified the risk for an individual to experience mental health issues. However, the wide variation noted in the study between first-generation migrants may highlight the difference of the postmigration environment between migrant workers, refugees and first-generation migrants which warrants further investigation.

This review also identified the prevalence of stress, including acculturation stress and post-traumatic stress disorder, among migrant/migrant workers. Most of the studies found a high prevalence of stress, except for Adebayo et al. [ 41 ]. In that study, migrant healthcare workers working in aged care residential facilities reported a higher level of acculturation stress in comparison to general stress. Acculturation stress is known to be a common issue among migrant labours [ 69 ].

Risk factors associated with mental health issues among migrant workers

Our review had identified numerous factors associated with mental health issues among migrant workers including age, psychological factors, occupational factors, biological, environmental factors and social factors. Firstly, there were no age group differences in terms of its influence on mental well-being. This could be due to the methodological heterogeneity across studies, which restricted this review to make an inference regarding the age difference.

Psychological factors were found to be associated with mental health issues among migrant workers. Migrant workers with higher resilience and a higher level of emotional intelligence (i.e., good perception, understanding and management of their feelings) reported a higher level of psychological well-being. Resilience and emotional intelligence are known as protective factors that can contribute to better psychological health as it helps an individual to adapt and to regulate their emotions better during stressful situations [ 70 – 72 ]. Personality traits (i.e., negative affectivity and social inhibition) were also linked with the mental well-being of migrant workers, where those who did not display the traits reported a higher level of mental well-being. This is consistent with previous literature [ 73 – 75 ]. These findings on the relationship between migrant workers’ mental well-being and their resilience, emotional intelligence and personality traits suggest that intervention may focus on a psychological aspect such as building resilience and emotional regulation to promote mental well-being among migrant workers.

Biological factors, particularly family psychiatric history and existing health conditions, have also been identified as risk factor for mental health issues among migrant workers. healthcare service. It is established that the likelihood for an individual to experience mental health issue is higher when they have a family member/relative who is diagnosed with a psychiatric disorder in comparison to those with no family history [ 76 ]. This also may be moderated and/or mediated by other factors including stressful life events, poor coping skills and lack of social support [ 77 ]. Moreover, it is interesting to highlight the presence of existing health conditions in migrant workers together with another risk factor found which was the barriers to healthcare access. Migrant workers are common experiencing financial limitations and a lack of formal medical protection which restricted them from seeking formal healthcare service [ 78 – 80 ]. This barrier will put a constraint on health-seeking behaviour among migrant workers, including those with existing health issues.

In addition to barriers to healthcare access, other environmental factors which were duration of stay and poor living conditions were noted as the risk factors of mental health issues among migrant workers. Our findings found that a longer duration of stay in the working country was related to the poorer mental health of migrant workers. Previous research has shown mixed findings of the relationship between migrant workers’ mental well-being and their length of stay at working country [ 81 , 82 ] which suggests that other plausible factors (e.g., occupational, social, psychological) should be considered to explain this association. Concerning the poor living condition as another risk factor, this aspect has been highlighted by Organisation for Economic Co-operation and Development (OECD) reports. A decent living environment is a socioeconomic indicator that influences the social integration of migrants in the host or working country and as a result, improves their general well-being [ 83 , 84 ].

Our review identified the association between occupational stressors and mental health issues among migrant workers. The stressors include job characteristics, type of occupational role, poor working conditions, salary and benefits issues and physical abuse at the workplace. Migrant workers reported a poorer level of mental well-being due to job characteristics such as demanding jobs, jobs with low control and high job insecurity. Our findings were consistent with previous literature that discussed job characteristics as a predictor of mental health issues among employees in the general population [ 85 – 88 ]. Job characteristics have also been found to predict job satisfaction [ 89 – 91 ]. One of the studies in our review showed in their findings that employment satisfaction was related to higher mental well-being among migrants working in Japan [ 60 ]. This suggests that migrant workers’ job satisfaction and mental health are likely to be explained by the characteristics of their jobs, emphasizing the importance of evaluating each of these factors in maintaining the mental well-being of migrant employees.

On another note, Adebayo et al. [ 41 ] discussed the difference between occupational roles and acculturation stress (i.e., mental challenges of adapting to a new culture) where migrant nurses were found to report a higher level of acculturation stress. Migrant workers were known to be at higher risk to experience discrimination and communication problems at the workplace [ 20 , 92 , 93 ]. These issues may intensify the stress level of these nurses as they are working directly with the community which requires quick adaptation to the culture of their working country. As for the remaining occupational risk factors (poor working conditions, salary and benefits issues and physical abuse at the workplace), they can be seen as a result of a lack of labor rights protection for the migrant workers. All of the stated factors are identified by ILO as the common violations experienced by migrant workers [ 94 , 95 ].

Several studies included in this review also identified the associated factors of mental health issues among migrant workers during COVID-19, which mainly related to job stressors such as lack of confidence to properly care for themselves and their employer, lack of protective equipment, higher workload and worries being terminated if contracting COVID-19. It is known that migrant workers had lower job security compared to local workers [ 96 ]. The job insecurity issue is likely to amplify during COVID-19 as the whole world is currently struggling economically. This is consistent with a qualitative study conducted among migrant workers from Bangladesh working in Southeast Asia and the Middle East regions [ 97 ]. The fear of losing jobs and worry about not getting a salary had taken a toll on their mental health, in which in several extreme cases, some of the migrant workers committed suicide.

Finally, social support was also linked with the presence of mental health issues among migrant workers. All of the four studies identifying the association measured the dimension of social support related to connectedness with others. Social disconnectedness has been established as a risk factor for psychological distress [ 98 – 101 ] which highlights the importance of assisting migrant workers to maintain socially connected with their family or friends in seeking emotional support to act as a coping resource for them. However, in contrast, a study conducted during COVID-19 indicated that social support was not associated with the symptoms of anxiety among migrant care workers [ 46 ]. This is inconsistent with previous studies that discussed the effect of lower social support and the presence of mental health issues among healthcare workers during COVID-19 [ 102 , 103 ]. Different types of job characteristics between care workers and healthcare workers may have played a role in observing the difference.

Only two studies discussed the availability of material and informational support for migrant workers. Although emotional support is important in assisting migrant workers in promoting their mental well-being, having additional access to material and informational support may help the migrant workers to cope better with the exposed stressors. This may also increase the help-seeking behaviour in migrants with or at risk of psychiatric disorder.

Strengths and limitations

This review has several strengths. Firstly, a comprehensive searching strategy was carried out in the literature sources, the grey literature and the reference lists of the eligible articles which allowed this review to capture a large number of studies. This review was also systematically conducted using the preferred reporting items criteria of PRISMA guidelines. The majority of the studies included in this review was identified to be of high quality. Furthermore, this study increased the theoretical knowledge on the associated risk factors of mental health issues among migrant workers. This information may act as a reference for the policymakers, authorities and employers to create preventive strategies for migrant workers.

However, there are limitations warrant consideration. Firstly, most of the studies included were conducted in cross-sectional, thus, no causal relationship can be established. Next, there is the presence of heterogeneity of the method and tools across the studies. There is a consideration that should be taken in interpreting the findings in this review. This review also only included study in the English language. Hence, some literature that meets the inclusion criteria may not have been reviewed.

In summary, this review and meta-analysis have provided an overview of the mental health outcome among migrant workers. There is evidence of an increase in depressive and anxiety symptoms in this specific population and various risk factors were identified to associate with the mental health issue, including social support. It is recommended for future research to conduct more cohort and longitudinal studies in looking at the trend or progress of the mental health outcome associated with different factors including demographics, biological, psychological, environmental, occupational and social.

The high prevalence of mental health problems among migrant workers warrants the implementation of necessary intervention strategies in addressing this issue. This may be adopted from the guideline provided by WHO [ 104 ] in promoting mental health in refugees and migrant. The area of interventions mentioned in the guideline including endorsing social integration and reducing the gap of barriers towards healthcare. A specific social support program related to the maintenance of connection with their family members and friends in their origin country should also be designed to act as a coping resource for the migrant workers.

The employer can also play a role in addressing the mental health concern among migrant workers. Some of the strategies that can be taken by employer are acknowledgement of mental health issue as a workplace concern, development of preventive strategies and mental health policies at workplace and facilitate the workers with mental health problems in accommodating at workplace [ 105 ].

Finally, the role of policymakers is vital in tackling this issue of mental distress among migrant workers. Based on the scientific evidence available, policies on healthcare, including mental health, should be prioritized with detailed planning and evaluation to ensure the sustainability of the policy. Close collaboration with non-governmental organization (NGO) can also take place to ensure a more comprehensive discussion can be taken which may lead to the rapid implementation of policies.

Supporting information

S1 checklist..

https://doi.org/10.1371/journal.pone.0260221.s001

S1 Table. Study characteristics.

https://doi.org/10.1371/journal.pone.0260221.s002

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• Published: 14 October 2021

The plight of migrants during COVID-19 and the impact of circular migration in India: a systematic review

• Joshy Jesline   ORCID: orcid.org/0000-0001-5774-8149 1 ,
• John Romate   ORCID: orcid.org/0000-0003-0487-7849 1 ,
• Eslavath Rajkumar   ORCID: orcid.org/0000-0002-3012-0391 1 &
• Allen Joshua George   ORCID: orcid.org/0000-0001-9662-9863 1  

Humanities and Social Sciences Communications volume  8 , Article number:  231 ( 2021 ) Cite this article

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As per the reports of WHO, the COVID-19, first reported in December 2019, put the whole world in an unprecedented crisis and lingering uncertainty with innumerable deaths, generalised economic depression, unemployment, quarantine, unavoidable lockdown, and travel-ban that was imposed globally as a necessity to tackle the pandemic. Among the populace, the migrants were found to be one of the most vulnerable groups in this lockdown, as their very livelihood came to a complete standstill. This review-paper aims to investigate in detail the multiple facets of adversities the migrants went through in India during the lockdown and the socio-psychological impact of circular migration. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, studies on migrant workers during COVID-19 and on circular migration were searched. Database searches on Scopus, PubMed, and PsychNet and manual searches on Google Scholar were carried out. From the initially identified 15,697 articles, 15 articles that met the inclusion criteria were chosen for review. The findings highlight the different plight of the migrants, who had the pressing need to head back home to safety despite the acute financial crisis and the travel problems. The poor quality of the relief camps with meagre rations and lack of facilities especially put the women and children in distress and generated a lot of psychosocial issues. The present study urges the mental health-care professionals to groom themselves for facing the challenges of a surge in mental illnesses by taking necessary measures. It also emphasises the need to establish a strong ethical alliance between the local population, health systems, local government mechanisms, and human rights associations in order to take a relook at the national migration policies.

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The year 2019 brought with it a new pandemic, the COVID-19 that was first reported in the month of December as per the reports from World Health Organisation, and put the whole world in an unprecedented crisis, that has pushed it into a state of lingering uncertainty (WHO, 2020 ). The coronavirus disease 2019, commonly known as the COVID-19 pandemic, a corollary of severe acute respiratory syndrome coronavirus-2 infection, has led to a global public health crisis, innumerable deaths, generalised economic depression, redundancy, and quarantines (Aragona et al., 2020 ). The virus brought about a massive change to the existing systems and generated a whirlpool of hurdles that the people had never faced before or had no idea how to overcome. This eventually created overwhelming fear and mounting anxiety among the people due to the novelty of the crisis, the uncertainty it brought with it about how and when the situation will get back to normal, as well as the dread of an impending doom (Mishra and Sayeed, 2020 ). One of the biggest challenges was the complete lack of an effective treatment method or a preventive vaccine to overcome the virus (Rolland, 2020 ). To make matters worse, the pandemic affected people not only physically but also psychologically, economically, socially, and politically. People belonging to various socio-economic strata were affected adversely in this situation, regardless of their social status, as everyone had fallen prey to this crisis in one way or another. It is undeniably true that the life in the pandemic era effected a far-reaching change in the way people think, work and interact with one another around the world (Aragona et al., 2020 ). What is more, it has also taught the world the new normal ways of human relationships and social distancing, which are sure to linger on for quite a while (Ram, 2020 ; Rolland, 2020 ). It has also provided the world a lesson about the worthlessness of the rat race and the fragility of human life. It is certainly true that the pandemic has led the world to a paradigm shift in the attitude and behaviour of people as never before.

The pandemic brought with it lockdowns and travel-bans that were imposed by the governments all over the world as a necessity to tackle the pandemic and to rein in its outspread. However, the lockdown upset the daily routines of the people especially the working class who were put in a major financial predicament (Chander et al., 2020 ). A new normalcy of surviving in a state of constant panic came into place, with the people being asked to live in this uncertainty for a longer duration than what was anticipated in the beginning of the pandemic. A batch of novel practices came into existence as part of rigorous mitigation efforts, such as, “social distancing, household quarantine, facemasks, vigilant sanitisation and hand washing, and avoidance of public gatherings, public transportation etc.” (Rolland, 2020 ). As time passed and the situation became worse, the pandemic has slowly unmasked its harsh reality and people have started grasping this truth that the current state of the situation is going to last longer than what was presumed of it in the beginning, and this has affected them rather drastically. The transformational process of adapting to this pandemic risk as a public or global calamity, while dealing with the fear of contracting COVID-19, and managing the disease, is highly exhausting and not doable by all (Rolland, 2020 ).

The daily wagers were the worst sufferers of this lockdown. With the enforcement of the lockdown, not only were they without jobs but also were frustrated because of the cessation of their daily income on which they survived (Ram, 2020 ). Their very livelihood came to a complete standstill; as a result, they could not meet theirs as well as their families’ daily needs (Chakma, 2020 ). The migrants were found to be the most vulnerable among the working class to come under this economy fallout (Nanda, 2020 ). The situation affected people belonging to all classes; moreover, it has exposed in the bare open the blatant disparities that exist in the socio-economic and health-care facilities (Aragona et al., 2020 ). In addition, it has been found that the perils of sickness and deaths vary colossally by “social location, such as, race, social class, gender, age, ability, and geographic location” (Rolland, 2020 ). There were many reported cases of suicide and suicidal attempts especially by people from economically lower classes, as they were not able to cope with the problems stemming from the loss of job and income (Kumar and Vashisht, 2009 ; Mukhra, 2020 ; Nelson, 2020 ).

In addition, the mental strain this pandemic imposed on the common people was especially enormous. One such group that was highly and adversely affected by this crisis situation was the migrants, who had to move out to different parts of the country in search of jobs to sustain their families (Singh, 2020a , 2020b , 2020c ). There are about 100 million internal migrant workers in India, and most of them are daily-wage labourers who have travelled out from different states like Uttar Pradesh, Bihar, Jharkhand, Odisha, West Bengal, etc. to other states in search of unskilled or semi-skilled jobs (Hazarika, 2020). Based on the data obtained from the National Sample Survey (NSS) 2007–2008, out of the total workforce in India, about 28.3% were migrants. According to 2011 census, about 37% of India’s total population were found to be migrants (Singh, 2021 ). This was a climb of 139 million migrants from what was reported in 2001 census (Census of India, 2011 ; Singh, 2020a , 2020b , 2020c ).

These migrants too were trapped in the lockdown with no jobs and no money, facing major economic setback, besides being isolated from their families due to the sudden lockdown (Mishra and Sayeed, 2020 ). While India’s population of 1.3 billion people could not but come to terms with the changes of imposed social distancing, millions of migrant workers in India had other daunting tasks also to confront with (Londhe, 2020 ). The concept of social distancing bears no meaning for the migrants because of the persistence of even more pressing and nagging problems of insecurity and hunger. Based on the data obtained from Census 2011, it was found that there was a rise in total number of migrants by 30% from that of 2001, whose major destinations are growth centres and states like Delhi, Maharashtra, Tamil Nadu, Gujarat, Andhra Pradesh and Kerala (Census of India, 2011 ; Dandekar and Ghai, 2020 ; Nanda, 2020 ). Even though, the lockdown situation affected the community at large and people were obliged to stay at home, the migrants could not even be in the comfort of being locked in with their families; instead, they were destined to be stuck in a migrant land with no means to survive (Kumar et al., 2020 ). Therefore, this community had to endure more appalling hardships than anyone else, not only financially but also socially and mentally (Aragona et al., 2020 ; Singh, 2020a , 2020b , 2020 c).

In order to alleviate the suffering of migrants it is necessary to investigate, understand, and analyse the hardships they have been undergoing. In-depth explorations of the studies in the Indian context dealing with circular migration and their psychological impact are needed to foster greater awareness among the public and to introduce new measures that can be adopted to safeguard the rights of the migrants.

This review-paper aims to study in detail the multiple facets of the predicaments the migrant workers were going through in the Indian context during the pandemic and the lockdown. Its main objective is to focus on the hardships that have led the migrants to a circular migration or reverse migration and the adversities that have been brought about by circular migration during the pandemic upon the migrants. The study also aims to shed light on the psychological toll inflicted by this pandemic on the migrants and the resultant reverse migration. Furthermore, it focuses on the means to address the issues concerning their mental health-care, and makes recommendations on the measures to protect their human rights and safeguard their lives and livelihood.

To the best of the authors’ knowledge, this is the first systematic review that has specifically focused on the plight of the migrant workers during the pandemic and the issues revolving around circular migration in the Indian context. The consequences of this pandemic have put the world in a state of impending doom and therefore, there is a compelling need to address the situation especially of the migrants who are among the groups, which are most affected by the adverse outcomes of COVID-19 and subsequent restrictions on mobility. A systematic review helps to synthesise the data related to this from all available sources and to integrate them in order to efficiently reach and promote awareness among health-care professionals, policy makers, administrative staff, future researchers, and the general public. The findings of this study could therefore be used for formulating new strategies for the betterment of migrant workers.

Types of studies included

Studies on migration and circular migration of Indians during the COVID-19 crisis were considered to be included in the current systematic review, regardless of the type of study, research design, or the outcomes. However, studies on emigrants, immigrants, and migrants in other countries were excluded from the study.

Subjects of the study

The population for the study were unskilled migrant workers in India, who were among the most affected during the lockdown due to their low socio-economic status, besides being increasingly prone to mental health issues.

Search strategy

The search string used in Scopus was: TITLE-ABS-KEY (“circular migration”) OR TITLE-ABS-KEY (migration) OR TITLE-ABS-KEY (migrant) AND TITLE-ABS-KEY (covid) OR TITLE-ABS-KEY (covid-19); in PsychNET (Abstract: “circular migration” OR Abstract: “migration” OR Abstract: “migrant” AND Abstract: “covid” OR Abstract: “covid-19” AND Publication); and in PubMed (“circular migration” [Title/Abstract] OR “migration” [Title/Abstract] OR “migrant” [Title/Abstract]) AND “covid” [Title/Abstract]) OR “covid-19” [Title/Abstract]).

Data management

All pinpointed references were imported to Zotero, a bibliographic reference management tool, and all duplicates were removed. The de-duplicated citations in Zotero were imported to the data extraction form for coding.

Selection of studies

The first and third authors simultaneously screened the articles for the titles and abstracts and did the initial screening and data extraction independently. Articles that dealt with the plight of migrant workers during COVID-19 pandemic were included for the full text review. After the primary screening, the selected articles were reviewed for full text reading to determine their eligibility. The articles were selected if they were falling under the time-period of 2019–20 and discussed the plight of migrants during the lockdown and also addressed their psychological issues during this crisis in the Indian context. Final decision on the eligibility and the reasons for exclusion of studies were documented on the data extraction form.

Study characteristics

The final sample for the systematic review included 15 studies, which were all published in the year 2020. Most of the studies were descriptive and qualitative in nature ( n  = 12) and discussed the plight of the migrants and the various adversities encountered by them in India during the lockdown, while the others ( n  = 3) were quantitative in nature that addressed in-depth the psychological issues faced by the migrants. All the articles were based on the Indian context, and most of the articles were pan Indian in their approach, while some articles ( n  = 4) focused on conditions of migrants in their respective states or cities alone, specifically Chandigarh, Delhi, Bangalore and Kolkata. The articles discussed the various economic, social and psychological issues faced by the migrants. Some articles ( n  = 8) also elaborated on the steps taken by the government and made suggestions about policies that can be adopted to better the lives of the migrants. Among this, some studies ( n  = 3) also focused on making psychological interventions to help the migrants (Chander et al., 2020 ; Singh, 2020a , 2020b , 2020 c; Kumar et al., 2020 ).

The characteristics and main findings of these studies are summarised and presented in Table 1 .

Identification of the studies

In total, 15,697 studies were detected through database searching; among which 15 studies met the inclusion criteria and were further analysed for the present review. (The PRISMA flow diagram is shown in Fig. 1 ). Out of the 15,697 studies, 450 were from PsychNet, 14,988 were from PubMed, 229 from Scopus and 30 from Google Scholar. After the initial screening (which included the removal of duplicates), 106 articles were selected and assessed for eligibility, from which 91 studies were excluded and the final 15 were selected.

Stages involved in finalizing the articles for analysis after obtaining the data.

Distribution of migrants

Based on the data obtained in the Census 2011, it was found that the distribution of migrants to the total population across cities were, Delhi 43.1%, Mumbai, 54.9%, Kolkata 40.8%, Chennai 51.8%, Bangalore 52.3%, Hyderabad 64.3%, Ahmedabad 48.7% and Pune 64.8% (Census of India, 2011 ). As per the reports from a study, it was found that the highest number of COVID-19 cases as of 13 th April 2020 was reported in Delhi with 898 cases followed by Mumbai with 880. The share of COVID-19 cases from these metropolitan cities to the total percent was 38% (Bhagat et al., 2020 ).

Plight of migrants

All the studies focused on the various problems that the crisis has brought for the migrants, including the psychological and social issues. Out of the articles chosen for the current systematic review, the findings from a study (Kumar et al., 2020 ) on the psychological impact of the pandemic on the migrants ( n  = 98), revealed that about 63.3% of participants underwent loneliness and around 48% of them felt that there was a decrease in their social connectedness. Also, they found that roughly 50% experienced fear of death, around 58.2% individuals experienced frustration and tension, about 51% felt irritable and anxious, and three fourth of the participants were diagnosed with depression.

Statistics obtained from studies also suggested that almost only 4% of the total population of the migrants received rations that were allotted by the government, and 29% did not receive rations despite having ration cards (Farooqui and Pandey, 2020 ). Almost 90% of the migrants either faced loss of pay or a reduction in their salary (Shahare, 2020 ). International Labour Organization (ILO) estimated a decline of 22.6% in the wages of migrant workers post lockdown (Gothoskar, 2021 ). A survey conducted across 179 districts in India from May 30, 2020 to July 16, 2020 found that around 35% of the migrants went without any meal the whole day (Pandit, 2020 ).

The findings from some articles focused on circular migration and its adverse consequences ( n  = 5), while a few other articles reported the problems of discrimination faced by migrants belonging to the disadvantaged communities ( n  = 2). Some articles also emphasised the financial crisis created by this pandemic ( n  = 4), which was particularly acute for the migrants. All the studies shed light on the psychological issues faced by the migrants and among this, a few studies ( n  = 3) also suggested interventions for the migrants (Chander et al., 2020 ; Singh, 2020a , 2020b , 2020 c; Kumar et al., 2020 ). Many studies ( n  = 8) also pointed out the urgent need for revising the existing government-policies and taking new initiatives by the government for the betterment of the migrant workers.

Among the 15 studies, one study (Chander et al., 2020 ) reported visiting various spots across the city ( n  = 140), contacting around 5048 migrants and offering assistance to nearly 3944 migrants. In another study under the District Mental Health Program, Chandigarh, many migrants ( n  = 61) were attended to for their mental health issues and taken care of (Singh, 2020a , 2020b , 2020 c). In the same city, another study was carried out among migrants ( n  = 98), which found that the majority of the participants were facing one or the other mental health issues and made interventions on a limited scale (Kumar et al., 2020 ).

One of the key elements and an integral factor contributing to development among the human civilisation is migration (Nanda, 2020 ). Migration happens at both individual and community levels, and occurs due to multiple reasons such as the lookout for better job opportunities, improved living conditions and for enhanced productivity and thereby greater income (Raj, 1981 ; Shahare, 2020 ). Migration takes place based on the various vital resources that are available in the ecosystem (Ram, 2020 ). The practice of migration has happened from time immemorial and can be traced from the beginning of humanity, as it first existed in the form of nomads who moved in groups from one place to another in the lookout for better resources, and later on as invasions by various rulers (Rolland, 2020 ).

Migration is regarded as a continuous process that is common to all living beings (Virupaksha, 2014 ). There are two major types of migration: one that takes place within a country across a district or a state-border, which is known as internal or national migration; and the other a migration that involves crossing international borders, which is referred to as external or international migration (Bhagat, 2020a ). Migrants associated with these types of migration are called in-migrants and out-migrants respectively (Sinha, 2005 ). Further, based on the place of origin and destination, migration can be classified into four categories: (i) rural–rural, (ii) rural–urban, (iii) urban–urban and (iv) urban–rural (Amin, 2018 ; Kishore and Kiran, 2013 ). The types of labour migration can be broadly classified as (i) Permanent, (ii) Commuting, and (iii) Circular (Haas and Osland, 2014 ). Permanent refers to the situation when the migrant does not intend to return to their native lands. Commuting refers to the regular movement between an individual’s home and work, which is characterised by the separation between the workplace and residence (Colla et al., 2017 ). Circular migration is a situation where the migrants do not stay in the migrated lands forever but instead go back to their native lands after some time, and then might move again to a different place (Gomathi, 2014 ).

In general, the migrants go to their destinations to fulfil their livelihood/career aspirations and/or to satisfy their basic requirements, but they return to their places of origin after a certain period to settle down, which is a “circular” process (Ghosh, 1985 ). “Hence circular migration is viewed as a cyclic journey of the migrants, which encompasses with their living pattern in two worlds i.e., urban insecure employment and stable homeland” (Nanda, 2020 ).

According to the National Sample Survey (NSS) and the India Human Development Survey (IHDS), the migrant labourers are mainly from rural areas and come from very poor backgrounds and belong to the lower social classes like the Scheduled Castes (SC), Scheduled Tribes (ST) and Other Backward Classes (OBC) (Shahare, 2020 ). According to the Organisation for Economic Co-operation and Development (OECD), the inter-state migration in pursuit of an occupation every year around the world was estimated to be around 9 million, and this is acknowledged as “temporary, contingent and non-standard” in nature with minimal access to societal perks and labour privileges (Chander et al., 2020 , p.1). The administrative and socio-cultural barriers and the language differences in addition to geographical variance further hinder the process of migration (Aragona et al., 2020 ). The migrant workers are inclined to falling prey to adverse mental health impacts of various traumas created through interfaces of multiple factors such as, “abject poverty, malnutrition, cultural bereavement, loss of religious practices and social protection systems, malalignment with a new culture, coping with language difficulties, changes in identity, substance abuse, poor access to health-care, in addition to the poor living conditions and financial constraints”, as a result of migrating to a new state (Choudhari, 2020 , p. 5).

A large majority of the migrants are daily wagers who have low-income and poor living conditions that are dilapidated, unhygienic and scarce of basic amenities like clean water supply, and electricity (Kusuma et al., 2014 ). Most of the migrants are slum-dwellers with inadequate sanitation facilities and are forced to go for open defecation because of the lack of lavatories. As the migrants are not used to the food of the lands of their migration, many of them turn towards fast food centres, which deprives them of nutritious and healthy diets (Babu et al., 2017 ). The above-mentioned factors have made them susceptible to multiple physical and mental health problems (Chander et al., 2020 ). There are no government machinery, department, board or other direct administering body to address the grievances of these migrant workers; neither do they have any rights or privileges in the regions in which they work or in the villages to which they belong (Nirmala, 2020 ).

Upon the rise of the pandemic, the migrants were among the groups of victims who were acutely affected by the lockdown (Choudhari, 2020 ). These daily wagers are said to be the weakest and socially neglected community that forms the classic nobodies among Indian citizens (Shahare, 2020 ).

The migrants were trapped in their migrated lands, far away from their families and loved ones with minimal health-care facilities, poor living conditions, besides being devoid of a job and having no money or means to survive (Ram, 2020 ). The migrants are more likely to fall prey to various traumas emanating from all three domains- social, psychological, and emotional, which stem from the dread of being discriminated and ignored by the local community around them and the grave concerns that arise about the safety and comfort of their families in their native places (Kumar et al., 2020 ).

Circular migration, as a result of the pandemic, generated severe stress, tension, despair, addiction to substance use, and self-harm behaviour among the migrants. In addition, they had greater concerns that deeply affected them, such as, “uncertainty about the duration of the lockdown; desperate longing to travel and meet their families; fear of being abandoned/deserted by their employers; insecurity about job and income; acute distress that arose from their inability to look after the health issues of children and pregnant women” (Chander et al., 2020 , p. 2)

Desire to return to their homeland

Once the lockdown was implemented, the primary concern for most of the migrants was to return safely to their families. Being isolated from the families created more stress and tension among them and caused a lot of growing anxiety about the travel possibilities.

On 19th March 2020, the Indian Railways announced the sudden suspension of passenger trains and, as a consequence, there was a mass exodus of utterly terrified migrant workers. Thousands of migrant workers across Delhi and the National Capital Region (NCR) were seen carrying heavy baggage and wailing children walking on national highways, boarding tractors, and shoving each other around for seats in buses to leave for their homes. The government, upon understanding the problems of jobless migrants to access food and shelter, tried to reassure them by announcing an assistance by an extended scheme under the Prime Minister’s Garib Kalyan Yojana (PMGKY). This offered relief packages to the migrants and daily wagers with the aim of blocking any disruptions to their employment besides supporting small establishments. However, this initiative was not satisfactory, because despite these efforts of the government, a huge number of migrants spent restless nights without food, asylum and/or travel facilities (Nanda, 2020 ). Failure in the implementation of the government’s assurance to provide basic necessities such as food and water forced thousands of migrant labourers to flock to the city’s bus terminals (Singh, 2020a , 2020b , 2020 c). However, not everyone could get on a bus and leave for their homelands (Ram, 2020 ).

Since most of the public transport was suspended as part of COVID-19 safety precautions, the migrants were stuck at their place of work and felt completely miserable (Chander et al., 2020 ). Even though they were aware of the risks involved in travelling back to their hometowns, both for them and their families, most of them desperately longed to get back home. They believed that it would be comforting to be with their loved ones during this time of uncertainty of impending death and was increasingly impatient to travel back home. They yearned to go back, so much so that they were even willing to put up with the discomforts of the travel quarantine norms imposed by the government (Chander et al., 2020 ).

From surveys conducted by NGOs like Stranded Workers Action Network (SWAN), it was found that due to scarcity of money and food, many of the migrants had very little to eat and some were even on the brink of starvation (Staff, 2020 ; Shahare, 2020 ). Most of these migrants suffered hunger pangs and police brutality and hundreds of people died tragically enroute to their homelands during the pandemic (Santoshini, 2020 ).

Fear of losing job

As much intense was the desire of the migrants to go back to their families, so were their worries about losing their jobs. Millions of migrant labourers employed across various sectors like construction, agriculture, manufacturing, transport and other services were stuck in their migrant locations during the lockdown. Even those migrant labourers who did not lose their jobs, as they were employed in essential services, had to suffer from wage-cuts imposed by their employers. They were therefore worried over how they would meet their regular expenses like those on food, clothing, medicines and accommodation. For those who were away from their worksite for several days together, there was absolutely no job security, and this led to a mounting panic in them. On the other hand, those who lost their jobs had the additional worries about whether and how they could return to their hometowns. Owing to the prevailing travel restrictions and the non-availability of transport facilities, there was no certainty about whether and when they would be able to travel back. The dread of being forsaken by their employers and the creeping fear of being abandoned with no job, wages or place to stay was indeed a traumatic experience for them (Chander et al., 2020 ).

Financial distress

As per the certified employment valuation, Indian industries have millions of internal migrant staff who make significant contributions to the economy of India. (Deshingkar and Akter, 2009 ; Choudhari, 2020 ). Although India’s economic growth is dependent to a great extent on the cheap labour of such migrants who work for even less than the minimum wages, they remained unrewarded and obscure in Delhi and the National Capital Region (NCR), and were excluded from relief funds during the COVID-19 crisis (Shahare, 2020 ).

The International Labour Organization (2020) has observed that migrant labourers are the worst-hit by the current economic crisis. The costs of basic hygienic products necessary for individual security during the pandemic (such as detergents, soaps, sanitisers) have become prohibitively expensive and unaffordable for the migrants, because they were thrown out of their jobs and had no other sources of income (Srivastava, 2020 ). Many employers have either fired the migrant workers without any prior notice or have stopped paying them salaries. The financial crisis caused by the COVID-19 pandemic has inflicted severe difficulties for the lower income families in meeting the costs of food, clothing and medicines (Mishra and Sayeed, 2020 ). Adding to the financial woes of the migrants, the NITI Aayog (a public policy think-tank of the Government of India) reduced food subsidies from 75 to 60% in rural areas and from 50 to 40% in urban areas (Gothoskar, 2021 ). Studies done on earlier recessions (Kumar et al., 2020 ) have pointed out that the work-loss during an economic crisis often leads to “longstanding unemployment and wage impediments, deteriorating or worsening the health of unemployed workers and thereby increasing poverty” (Khanna, 2020 , p. 3–4).

Quality of the relief camps

Not all migrants could travel back to their homelands before the lockdown. All those who were left behind were allotted food and accommodation by the government (Singh et al., 2020 ). Numerous labourers had to remain in extremely tiny and congested rooms with nearly nothing to live on. Seven to eight individuals were confined in a tiny room with practically no ventilation, and no appropriate space to cook food (Shahare, 2020 ).

In majority of the relief camps there were no essential facilities such as power, light, fan, latrines and water, and most of them were absolutely packed, and the old occupants were not permitting new ones to come in. Consequently, there were a lot of fights, maltreatments and bullying among the migrant groups (Shahare, 2020 ).

The anxiety of catching the disease, as described in the words of a Dalit migrant as a personal experience account was such, “that we were scared that we might get infected with the virus because there was a COVID-19 positive patient in my neighbouring street … we did not want to stay anymore in Mumbai because we were anxious of getting the infection through using the public toilet or sharing food because we lived in a slum and we don’t have separate toilet and housing; thus we decided that now we shall return to our village” (Pankaj, 2020 , p. 5). Although the government had allotted food and shelter for the migrants, it was found that in most of the shelter homes and relief camps people did not receive sufficient quantity and quality food on time. They had to wait for three to four hours in long queues since morning for their meals. Thousands of calls related to scarcity of food were made to the police from these camps on a daily basis (Shahare, 2020 ).

Shortages in the allotted rations

The report by SWAN that was released on 15th April 2020, stated that, “only 51%, of who were surveyed, had rations left for less than one day” (Farooqui and Pandey, 2020 ). It further observed that, “two weeks into the lockdown, only 1% of the stranded workers had received rations from the government, and three weeks into the lockdown, 96% of the migrants had not received rations from the government at all, 70% had not received any cooked food, 78% had less than Rs.300 left with them and 89% had not been paid by their employers at all during the lockdown” (Shahare, 2020 , p. 6). The distribution of rations was on the basis of the person possessing a ration card, but most of the migrants did not have a permanent residence or necessary legal documents, and therefore were unable to get a ration card.

This distribution system became faulty due to the lack of an inter-state portable ration cards acceptable in all states. The impact of this problem has got aggravated, as a large section of the migrants neither have a valid ID proof nor have been registered under any special schemes set up for them. Although the government has enacted the Inter-State Migrant Workmen Act, 1979 to facilitate the lives and work of migrant labourers, it has remained ineffective due to poor implementation, as per the reports of the Standing Committee on Labour (PRS India, 2020).

An article in The New Indian Express , published on 29 March 2020, reported that about 200 migrant workers belonging to the Soliga tribe were stranded at coffee estates in a village of Kodagu (formerly known as Coorg) district in the Indian state of Karnataka and were running out of food and were living in awful conditions (Chakma, 2020 ). On the publication of this article, the government of Karnataka reached out to them and distributed rations of rice and pluses and other necessary food products like eggs, ghee and edible oil to the tribal families (Chakma, 2020 ).

The Delhi Government has developed shelter homes, quarantine homes and relief camps for the migrants and are taking care of about 600,000 individuals, besides providing food to more than 2.2 million migrants under their Free Ration Scheme, facilitated by the One Nation One Ration Card Scheme of the Government of India. Despite this, millions of migrants are still excluded from these schemes and have not received any help from the Government (Mukhra, 2020 ).

Insufficient health-care facilities

The migrant population including mothers, children, and pregnant women, were deeply apprehensive about their well-being, and had serious concerns about their health inside the shelter homes. This group at large was already predisposed to communicable diseases due to their malnutrition, socio-economic status, occupational hazards, and the poor living conditions (Choudhari, 2020 ). The deplorable conditions in the relief camps prevented them from following any basic safety precautions like practising social distancing, regular washing of hands, use of sanitiser and masks, that each individual was required to do as part of the standard procedure for fighting COVID-19. Unfortunately, practising these measures was extremely difficult or impossible in their crowded and ill-equipped camp-accommodations, and this has put the group at great risk of contracting the disease (Andrade, 2020 ; Chander et al., 2020 ). Even the symptoms of common cold, such as “fever, cough and throat pain” among the people were feared as Covid-infections, which threw everyone into a panic and caused a lot of bitter resentment amongst those living in the community (Chander et al., 2020 ).

Hardships of women in the camps

Female migrant workers confronted daunting challenges while living along with unknown men in these shelter homes. One major problem was in using the common toilets with them, which was highly unhygienic and likely to cause infections under the prevailing pandemic conditions. There was no privacy or protection available for the women during day or night. The plight of pregnant women was particularly miserable as they were greatly inconvenienced in these camps and shelter-homes. There were no facilities for regular medical check-up by doctors or for taking scans or conducting the necessary tests.

It was found in one of the surveys that nearly 42% of the pregnant migrant women did not receive any medical check-ups during the lockdown (Pandit, 2020 ). All these were highly disconcerting for the women who were forced to live in these camps (Shahare, 2020 ).

Withdrawal symptoms

Majority of the migrants use one or the other type of substances such as tobacco or alcohol. Therefore, the non-availability of these products during the lockdown has led to severe withdrawal symptoms in many of them. In a study conducted in Bangalore (Chander et al., 2020 ) a few migrants spoke out that they all have become “sober” due to non-availability of alcohol and other substances. Some of them even spoke about their withdrawal issues, which caused a lot of frustration in them and resulted in relationship problems, domestic violence, and psychiatric illnesses. Heavier alcohol usage and criminal sexual behaviour have been reported in communities of predominantly single men compared to those living with their families.

Psychological issues

The poor living conditions of the migrants the shortages for the basic necessities have caused severe mental stress to many of them, which got manifested in their lives in the form of relationship problems, substance abuse, alcoholism, sexual exploitation, domestic violence, and psychiatric illnesses (NACP III, 2007 ; Kumar et al., 2020 ). Adding further to the burden of the awful shock wave of physical distress caused by the pandemic, there was a gigantic wave of psychological issues among migrant labourers, with deaths due to suicides as its lead sign (Singh, 2020a , 2020b , 2020 c). Suicidal tendencies were provoked among the migrants, as they lived constantly under severe financial worries, loneliness, anxiety, fear, and feelings of hopelessness and isolation (Choudhari, 2020 ). The constant fear of an impending doom of a completely dark future has further intensified their psychological distress and discomfort.

With the imposition of the lockdown, not all were able to go back to their homelands. Instead, they were stranded in the migrant lands with no income but only uncertainty about travelling back home, which made them mentally disturbed and agitated (Singh, 2020a , 2020b , 2020 c). As all the workplaces were shut down, there was an increasing panic about whether and when they would be reopened. Even if the workplaces are reopened, there was no guarantee that all the former employees would be hired back. There was a lingering fear in the minds of these displaced workers that the recession in the aftermath of the pandemic would result in large scale firing of employees. This fear and distress accompanied the migrants who travelled to their native lands and at the same time restrained some of them from going back to their native lands (Nanda, 2020 ).

The living conditions of the migrants also induced distress and concern as they were heavily crammed up and unhygienic, which was the complete opposite of an ideal place to be in during the pandemic. The fear and agony of living in such harsh conditions and the lingering uncertainty about the future gave rise to many psychiatric issues among them, such as anxiety disorders and substance abuse. In a study on migrants, it was found that there is increased risk for the manifestation of schizophrenia and related non affective psychosis among first- and second-generation migrants (Henssler et al., 2019 ). As most of the migrants belonged to the socio-economically backward classes, they are subjected to much inequity and prejudice from the people in the migrant lands, and were never able to fit in with the new surroundings. Studies from the clinical psychology perspective have found that experiencing discrimination and social exclusion has led to increased rates of psychotic experiences among migrants (Mishra and Sayeed, 2020 ).

In most of the cases of the migrants, the absence of a caretaker or a family member with them has caused an unceasing feeling of loneliness and frustration (Zhou et al., 2020 ). There was also a continuous feeling of helplessness caused by their inability to meet the livelihood and health requirements of their families, living away in their homelands. This has greatly deepened their agony of being stuck far away from home (Choudhari, 2020 ).

Apart from causing harmful effects on the body, the virus has the ability to inflict longstanding psychological disorders such as “depression, anxiety, panic disorder, and psychosomatic manifestations” (Qiu et al., 2020 , p. 2). There were several reported attempts of self-harm and suicides by the migrants (Singh, 2020a , 2020b , 2020 c). The pathetic situation they are in and the ambiguity about the extent of the crisis created a panic response among the migrants and made them act out frantically. The nagging anxiety levels that were mounting among the masses day by day led them to set out on their travel on foot for several hundred miles in order to reach their destinations, their homelands, with no facility of food or shelter during the journey (Choudhari, 2020 ).

Although the mental-distress cases were escalating, it was noticed that there was a drastic decline in the number of patients (both new and follow up cases) visiting the psychiatric outpatient services after the lockdown. Apparently, the reluctance to visit the clinics was out of the fear of contracting the virus. However, the danger of ignoring any psychological treatment at a time when they are estimated to be rising holds the possibilities of adverse effects on the efficacy of treatment. In addition, the considerable decline in follow-up visits also paves way to the threat of relapse (Aragona et al., 2020 ).

Racial discrimination of the North Eastern migrants

It was reported by the Rights and Risks Analysis Group (RRAG) on 26 March 2020, that, during the time-period from 7th February 2020 to 25 th March 2020, there were twenty-two incidents (in different parts of the country) of racial discrimination and assaults against individuals from the North East (Chakma, 2020 ). They were called names such as “Corona”, “Chinese”, and “Chinki”, and were glared at, along with shouting of expletives. India’s mongoloid looking citizens were subjected to insults while they were strolling on the roads, doing their shopping or travelling in trains and buses. They were called “Covid”, and coercively isolated, even though they had negative COVID-19 certificates. They were denied entry into public places, and were driven out of eateries and shared transports.

Psychosocial issues

The high levels of anxiety and stress induced among the general public by the lockdown during this pandemic was felt more intensely among the migrants, leading to many more psychosocial issues among them. The stress generated in the migrants made them behave in socially unacceptable ways and caused panic attacks on them. Consequently, they started fleeing hastily from the migrant lands. In order to go back to their home states at the earliest, they started crowding at the local bus stands and railway stations in desperation, ignoring all lockdown rules. This reckless behaviour of violating the norms of preventive measures resulted in the perpetual vicious cycle of being exposed to infection, quarantine, distress and hostilities (Choudhari, 2020 ). Although the most pressing need for all migrants at that time was the immediate return to their homelands from the migrant lands, the reverse migration came with a lot of appalling hardships and several other related problems (Tandon, 2020 ; Wong et al., 2019 ; Chakma, 2020 ).

Issues of reverse migration

Owing to circular migration or reverse migration, there was an acute shortage of workers in the urban areas from where the migrant workers had left for their homelands (Srivastava, 2020 ). This shortage, combined with the new relaxed laws in both occupational and industrial health, compelled the available local workers to work for longer durations than what was actually expected of them, which was in fact against the Factories Act of 1948 (Rivera et al., 2020 ; Wong et al., 2019 ). As a result, there was a drastic decline in the resting hours of the workers, which in turn led to the rise in stress and burnout among them and made them more prone to mental health issues (Choudhari, 2020 ).

The phenomenon of reverse migration has a bigger effect on the indigenous communities in the migrant lands as well. Reverse migration can mop out endangered indigenous Indian communities’ inhabitants and eternally ruin the subsistence of several such communities. As there were millions of people belonging to outside communities, such as those from the North East, have migrated to the urban cities in search of work in unorganised sectors, the lockdown induced re-migration would adversely affect the urban economies for want of labourers, as well as lead to the destruction of the economy of the migrants’ homelands because of the loss of jobs and income for those families and the resultant food and hunger crisis (Chakma, 2020 ).

The problems of the migrants did not cease to exist even after their reverse migration to their homelands. On reaching back to their homelands, their problems were mainly about staying in quarantine and the difficulties associated with it (Mishra and Sayeed, 2020 ).

Issues with quarantine after reverse migration

As part of the travel protocol prescribed for the pandemic-times, all migrants going back to their homelands were expected to be tested for COVID-19 and were expected to stay in self-isolation or quarantine at their homeland-residences for a minimum of fourteen days. Most of the migrants come from poor backgrounds with only a single room in their houses. Under this situation, they had to spend their quarantine period outside their houses. It was reported that in the Purulia district of West Bengal, some migrants spent their quarantine period outside the village limits by sleeping under trees, inside trucks or buses, or in make-shift shelters (Chakma, 2020 ). Similarly, in the Siwan area of Bihar, the labourers who managed to arrive at their hometowns were placed in extremely small spaces behind an iron gate in an infectious condition. To their good fortune, they were rescued from there on the following day and were transported in trucks to the isolation centres of their respective panchayats (Mishra and Sayeed, 2020 ).

Since the panchayat-shelters were also makeshift arrangements, there were very few protective measures provided to the residents. As the migrants were crowded in these shelters in high concentration, there was a significant risk of infection. In most places, the migrant labourers were stuck in these makeshift camps for many days, with poor infrastructure and inadequate food supply (Mishra and Sayeed, 2020 ).

Since the imposition of the lockdown, the media has featured several stories of the pathetic situation of the migrant labourers in various parts of the country. In the Bareli district of Uttar Pradesh, many migrants including women and children were forcefully pushed to clean themselves up in chemical baths as a sanitisation measure (Sammadar, 2020 ).

In general, the overall condition of the migrants was inexpressibly pathetic. Their worries and adversities did not come to an end. From being stuck in the lockdown in migrant lands to going through the difficulties of reverse migration and the struggles of survival, battling through quarantine and financial crisis during the pandemic-time was a fierce combat they had to wage while trying to stay alive and safe from the risk of starvation and infection.

This paper is an attempt to assess (based on published research papers) the plight of the migrants during the Covid crisis, in terms of their economic, social and health conditions. It brought into limelight the adversities, vulnerabilities, as well as the physical and psychological distresses and discriminations faced by the migrants under the onslaught of this pandemic in the Indian context, along with the problems of the resultant circular migration. From the survey of the 15 selected studies, it was clear that most of the problems faced by the migrants were due to them having been stranded in the migrated lands due to the lockdown. They were stuck in relief camps that had poor living conditions, with no job or income and, therefore, no means to travel back to their homelands. They became vulnerable to many physical and psychological illnesses, and received hardly any medical care from the government. In addition to suffering from the lack of basic physical facilities and the scarcity in the allocated resources, they also faced social issues such as discrimination and attacks from the local people.

Owing to the unpredictable nature of the pandemic and the uncertain turns it was taking with the passage of time, there was no end in sight for the crisis, and so the migrants couldn’t expect any relief from this tragic situation they were locked down in. The government launched several initiatives for the welfare of the migrants. One of them is the “The Aatma Nirbhar Bharat Abhiyaan”, through which they distributed free food grains for migrant workers without ration cards for a period of 2 months. Another government program was the “Affordable Rental Housing Complexes for Migrant Workers and Urban Poor”, which provided affordable rental housing units under the Pradhan Mantri Awas Yojana (PRSIndia, 2020 ). Although there were many such initiatives by the government, most of them were poorly implemented, and therefore, they became non-functional and failed to reach the entire migrant population.

Through the present study, the authors conclude that, based on the evaluation of the factors affecting the migrants, it is necessary to adopt immediate interventions for the welfare of the migrants.

Recommendations

One of the most pressing needs of the migrants is to have access to health services, which are equitable, non-discriminatory, and appropriate according to age and gender. In order to ensure maximum effectiveness, these measures must be people-centred and migrant sensitive, so as to deliver services that are culturally and linguistically appropriate because migrants are different from the people in the migrated lands, as they are subjected to different kinds of distress and exploitation.

Additionally, addressing and improving the mental health of the migrants are extremely necessary. Providing regular facilities such as in-person counselling, tele-counselling, therapies and psychosocial services is a necessity. In addition to this, systematic assessments must be conducted for early detection of and early interventions for any mental disorders among the migrants. Forming a strong ethical alliance between the local population, health systems, local government, and human rights associations to ensure the welfare of these migrants is also necessary. Furthermore, it is vitally important to prevent the spread of any fake news about the virus and to convey evidence-based accurate information to the public.

A major issue that calls for special attention is the well-being of women and children among the migrants. Women should be provided adequate services for maintaining reproductive health, maternal health, postnatal care, paediatric care and preventive/remedial measures for dealing with domestic or sexual abuse. These services must be focused on risk assessment and treatment for improving their health conditions and must not be used to screen out their health issues; nor should they be used as a tool for discrimination or for enforcing any restrictions. The migrant community must also be given priority for vaccination by the local administrations because of their particular vulnerability to the virus-infection. Furthermore, since the major cause for their health issues is the deplorable living conditions of the relief camps, the respective state governments should take the necessary steps to improve the living conditions in all relief camps.

It is essential to monitor health-care practices of the migrants and generate a repository of relevant health-care information during the pandemic period, which can be used to support future studies on the health issues of migrants during any Covid-like pandemics. Moreover, this will also facilitate sharing of health-related information between states, so as to facilitate the implementation of effective treatment strategies for migrants from various places.

A major social issue among the migrants is their fear of losing their jobs, income and housing. On these matters also it is the governments that can help, as they can take unbiased actions in case of any exploitation or labour complaints regarding their right to stay and work. It will also be of help if assistance is provided to the migrants to form associations and cooperative societies to support the livelihood of those who have returned to their native lands.

In view of the need to effectively manage the health issues of the migrants, it is necessary to give special attention to the migrants’ housing facilities, as their present unhygienic living conditions are a breeding ground for innumerable diseases. Government initiatives like The Aatma Nirbhar Bharat Abhiyaan, must be properly implemented. Similarly, NGOs and aid agencies should be persuaded to raise funds to construct affordable housing units, which should be made available to migrants for minimal rents (PRSIndia, 2020 ). For migrants who are not able to afford even these minimum-rental houses, the relief camps must be kept open with better facilities for a longer period.

Another social issue as explained in the SWAN report is the irregular and uneven distribution of basic necessities among the migrants (Shahare, 2020 ). Hence, there is a need for a universal and uniform mechanism for the distribution of both financial aid and essential items such as grains, medicines, and water to the migrant families. In order to ensure efficient distribution of financial aid and basic necessities among the migrants, it will be a good idea to entrust this work to the respective “panchayats” (the Indian local administrative councils operating at the village, block and district levels) to register and enrol these migrants and distribute these resources to them as per their eligibilities. Since they are already facing severe financial difficulties, subsidies must be increased as opposed to initiatives like NITI Aayog (Gothoskar, 2021 ).

A major political issue faced by the migrants is the absence of a body or agency to represent them in the respective state governments of the migrated lands. Since the migrants are only entitled to vote in their home constituency, and not in their migrated states, their political clout is limited and therefore their voices are rarely heard (Deshingkar and Akter, 2009 ). In order to present their demands and concerns to the governmental agencies, they have to be a part of a legitimate political system, which is authorised to represent them in these migrated lands.

There is an immediate need to push for a pro-migrant attitude in the general society, a better acknowledgement of the contribution of the migrants to the society, and the adoption of a proactive role in educating them and safeguarding their labour rights. This study further emphasises the urgent need to revise the national migration policies, which should help assist and protect the migrants and the returnee migrants who are either travelling from or to the areas affected by the pandemic.

Limitations

One of the main limitations of the reviewed studies was the inability to make any alterations with the brief interactive interventions with the migrants as their distress levels were much higher. These studies were restricted due to being retrospective single-centre studies and so generalising these findings across all services are difficult.

This review limited its focus to migrant workers alone and passed over the similar issues faced by the emigrants who have returned to the country post lockdown and also on the immigrants who were stuck in the country due to the lockdown rules and regulations. These two groups also have undergone trauma along the same lines as the migrant workers group and, therefore, future studies focusing on these are highly relevant and in need.

Data availability

The data that support the findings of this study were derived from the databases (PubMed, Scopus, PsychNet, and Google Scholar) available in the public domain.

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Jesline, J., Romate, J., Rajkumar, E. et al. The plight of migrants during COVID-19 and the impact of circular migration in India: a systematic review. Humanit Soc Sci Commun 8 , 231 (2021). https://doi.org/10.1057/s41599-021-00915-6

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(not that) essential: a scoping review of migrant workers’ access to health services and social protection during the covid-19 pandemic in australia, canada, and new zealand.

1. Introduction

1.1. immigration policies in australia, canada, and new zealand, 1.2. covid-19-related policies in australia, canada, and new zealand, 2. materials and methods, 2.1. database search strategy, 2.2. grey literature search strategy, 2.3. data extraction and synthesis, 3.1. demographics of included migrant workers, 3.2. immigration status of included migrant workers and their employment sectors, 3.3. access to health services during the covid-19 pandemic, 3.4. access to social protection during the covid-19 pandemic, 3.5. racism, 4. discussion, limitations, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Istiko, S.N.; Durham, J.; Elliott, L. (Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. Int. J. Environ. Res. Public Health 2022 , 19 , 2981. https://doi.org/10.3390/ijerph19052981

Istiko SN, Durham J, Elliott L. (Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. International Journal of Environmental Research and Public Health . 2022; 19(5):2981. https://doi.org/10.3390/ijerph19052981

Istiko, Satrio Nindyo, Jo Durham, and Lana Elliott. 2022. "(Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand" International Journal of Environmental Research and Public Health 19, no. 5: 2981. https://doi.org/10.3390/ijerph19052981

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Despite significant media attention and criticism, we know very little about the living and working conditions of low-income migrants in the Arab Gulf states, how migrants themselves view these conditions, or what factors most shape migrant worker well-being. Utilizing data from a unique, nationally representative survey of migrant workers living in labor camps in Qatar, this paper uses subjective and objective indicators to provide a more complete picture of migrant worker well-being and its determinants. We create a composite score of well-being based on migrant worker satisfaction with their job, human rights, salary, company treatment, and medical care. We then utilize ordinary least square to examine the degree to which migrant well-being is shaped by demographic characteristics, contract honoring, salary and debt levels, working conditions, human rights, and living conditions. Results identify contract-related issues as the strongest determinant of well-being, including whether a contract was honored, whether a copy of the contract was provided, and whether the details of employment in the contract were clear. More broadly, our results point to workers having low levels of overall awareness of their legal rights under existing Gulf labor law. Migrant worker well-being can thus be improved by raising this awareness and enforcing existing laws.

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The Arab Gulf states or Gulf Cooperation Council (GCC) countries include Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates.

For the purpose of this study, we are limiting our definition of migrant workers to male, blue-collar workers (primarily in the construction and service sectors) who live in labor camps or shared accommodations.

The report for this study will be made available on SESRI’s website at http://sesri.qu.edu.qa/research/sesri/ . Additionally, the full dataset can be made available to researchers by request.

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Appendix: Factor Analysis for Worker Well-Being Index

To measure well-being, we asked workers five subjective questions about whether they are satisfied with their job, with the way their rights are respected in Qatar, with their salary, with how their company treats them at the workplace, and with their medical care. The answer choices for these questions are based on the 5-point Likert scales: Very satisfied, somewhat satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, very dissatisfied. To make sure that these questions can be collapsed into a single index, we conducted an explanatory factor analysis, commonly used method for index construction. The following show all 5 questions in the survey:

Overall, how satisfied are you with your job? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?

Overall, how satisfied are you with the way your rights are respected here in Qatar? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?

How satisfied are you with the following aspects of life in Qatar: Salary? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?

Overall, how satisfied are you with the way your company treats you at your workplace? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?

How satisfied are you with the following aspects of life in Qatar: Medical Care? Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?

We used STATA to run the factor analysis (with the “factor” command) using all 5 questions. The scree plot is used to show the eigenvalues and the number of factors (see below). According to this plot, the model clearly have only one factor as the line connecting the dot is quite flat after 2 factors. To confirm this result, we also run the parallel analysis and the dotted line from this analysis is plotted on the Scree plot. Since the dotted line cut the Scree plot just before factor 2, we have further confidence that there is only 1 factor (or one single index) for this model (Fig.  1 ).

Scree plot with parallel analysis

We also measure the internal consistency among these 5 questions with the Cronbach’s alpha and its value is as high as 0.76 which give us more confidence in the reliability of the well-being index.

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Ewers, M.C., Diop, A., Le, K.T. et al. Migrant Worker Well-Being and Its Determinants: The Case of Qatar. Soc Indic Res 152 , 137–163 (2020). https://doi.org/10.1007/s11205-020-02427-3

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Challenges of reverse migration in India: a comparative study of internal and international migrant workers in the post-COVID economy

• Asma Khan   ORCID: orcid.org/0000-0001-6008-8006 1 &
• H. Arokkiaraj 2  

Comparative Migration Studies volume  9 , Article number:  49 ( 2021 ) Cite this article

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In India, the major drivers of both internal and international migration are the prevailing unemployment, competitive labour market and enhanced livelihood prospects in the destination state or country. However, the nationwide lockdown and the sealing of inter-state and international borders to control the COVID-19 pandemic triggered the reverse migration of informal migrant workers. This requires the central and state governments to collectively forge strategies to enable their reverse migration and smooth reintegration in the post-COVID economy. In this paper, we have focused on the inter-state migrants in India and returnee migrants only from Gulf countries as they account for two-thirds of Indian migrants living abroad. This study conducted a comparative analysis of the Indian government’s varied approach towards its internal and international migrants during their reverse migration, repatriation and reintegration after the announcement of the lockdown. Firstly, the paper compares the challenges faced by internal and international migrant workers during these stages with the help of in-depth interview data collected from migrants and social workers. Secondly, the varied governmental responses towards their repatriation are discussed. Thirdly, it analyses the obstacles in their economic reintegration to help frame suitable welfare policies for the Indian migrant community.

Introduction

India has a predominant share of internal migration and is also the top origin country of international migrants (De, 2019 ; UNDESA, 2020 ). The Indian Census (2011) data calculated the total number of internal migrants accounting for inter and intra-state movement to be 450 million, an increase of 45% since the Census 2001 (De, 2019 ). The Economic Survey of India 2017 estimated the inter-state migrant population as 60 million and the average annual flow of migrants between states was calculated at 9 million between 2011 and 2016 (Sharma, 2017 ). Uttar Pradesh (UP), Bihar, Madhya Pradesh (MP), Rajasthan are among the major origin states, while Delhi, Kerala, Maharashtra, Gujarat, and Tamil Nadu are among the important destination states for these migrant workers (Kamal, 2018 ).

India has the largest diaspora (18 million) with the number of migrant workers in Gulf countries alone accounting for 8.4 million (Ministry of External Affairs, 2021 ; UNDESA, 2020 ). Among the Gulf countries, United Arab Emirates (UAE), Saudi Arabia and Kuwait are the top most favoured destination countries for the Emigration Check Required (ECR) categories from India. Footnote 1 India is also amongst the largest recipient of remittances at USD 78.6 billion (International Organisation for Migration, 2020 ). In recent years, the low-skilled labour outflows to Gulf countries from relatively poorer states such as UP, Bihar and West Bengal has increased substantially while those from more prosperous states like Kerala, Tamil Nadu, and Karnataka have reduced (Sasikumar & Thimothy, 2015 ). Poor wage rates in less prosperous states, persistent wage inequalities between regular and casual workers and lack of formal employment opportunities leads to low-skilled and semi-skilled workers migrate overseas to enhance their economic well-being (Karan & Selvaraj, 2008 ; Sasikumar & Thimothy, 2015 ). Owing to the infrastructural development and growing demand in important sectors of the Gulf Cooperation Council (GCC) countries, the reliance on low-skilled or semi-skilled workforce (which constitutes around 85% of the total workforce predominantly engaged in construction and service sector) from India and other Asian and African countries will remain high (GIZ and ILO, 2015 ).

Migration thus gives an optimistic livelihood strategy for migrant workers and their families, contributes to the economic growth of the destination state/country, while the origin state/country benefits from the remittances and the skills acquired during their migration. Migrants from Kerala, a southern state in India, earn high wages as high-skilled workers in the Gulf, allowing them to remit more (Rajan & Zachariah, 2020 ). Even though labour migration compensates for labour shortages in the destination states/countries, workers employed in the low-skilled, labour-intensive sectors suffer malpractices such as wage-related abuse, working overtime without compensation, lack of social security cover and lack of protection during recruitment and employment (Srivastava, 2013 ; International Organisation for Migration, 2020 ). This points to the vulnerable position of these migrant workers which was heightened further during the COVID-19 crisis.

On 24th March 2020, in order to contain the virus, a strict nationwide lockdown was imposed by India with immediate sealing of the inter-state and international borders within four hours of its announcement. This shocked the unprepared migrant workers, both internal and those working abroad. Similarly, with the spread of COVID-19, the Gulf economy was also halted which led to migrant workers being stranded without food, livelihood, safe place to stay and being desperate to return to India. The lack of governmental planning to ensure the well-being of migrant workers within India and abroad led to a “crisis within a crisis”. In this context, this study conducts a comparative analysis of the challenges of reverse migration of India’s internal and international migrant workers. Three major research questions have been covered a) what are the economic and social challenges during their reverse migration, b) what are the varied governmental responses towards the repatriation of both the categories of migrant workers and c) what is the process of economic integration for the reverse migrants. This paper is divided into five parts. First, the introductory part which provides a basic overview of internal migration within India and international migration from India. The second part explains the research methodology and the third consists of the primary findings presented in a comparative manner in accordance with the research questions. The fourth part consists of the analysis which examines the common themes emerging from the experiences of the internal and international migrants from India. The fifth part provides a brief conclusion for this study.

Research methodology

In order to study the three research questions mentioned above, telephonic interviews with 65 reverse migrants were conducted during May–August 2020 in India. Table  1  presents the profile of the reverse migrants interviewed for this study. Internal migrants belonging to Indian states such as Bihar, UP, MP, Odisha and Chhattisgarh who had returned from the destination states such as Delhi, Gujarat, Karnataka, and Maharashtra were interviewed. Only reverse international migrants from Gulf countries were contacted as a majority of Indian workers are employed in this region. All the workers covered under this study belong to the low-skilled and semi-skilled workers category. A list of contacts of these migrants was prepared with the help of social workers and other researchers working with them. Telephonic interviews, which proved to be the most appropriate method due to COVID-19 lockdown restrictions, with all the migrants have been written as notes and analysed. The snowball sampling method was adopted at a stage where communication was established with some migrants who connected us to other returnees. Further, interviews with labour migration experts and social workers in Delhi and UP, who have worked closely with the migrants, during the lockdown were conducted and guidance from labour migration experts was sought. Interviews were semi-structured and involved key themes covered in the research questions. The interviews were carried out in Tamil and Hindi, which were the preferred languages of the migrants. In order to protect their identities, pseudonyms have been used to refer to the migrants.

Further, this research did not attempt to offer representative samples, rather it aimed to provide narratives of the experiences and challenges faced by the migrants during their reverse migration, repatriation and reintegration. The method of narrative analysis was employed to provide a qualitative understanding of the subjective perceptions and experiences of the reverse migrants during the pandemic which may not be adequately captured by statistics. A comparative analysis of the interviews of the internal and international migrants was done to identify the differences and the common challenges faced by the Indian migrant community during a crisis which needs urgent attention during policy making and implementation.

Some of the operational definitions used in this study are as follows. ‘Internal migrants’ refers to inter-state migrant workers who were stranded in different destination states within India. ‘International migrants’ refers to Indians who had migrated to one of the Gulf countries in search of work. The term ‘origin’ and ‘destination’ refers to one’s native place and place of work, respectively. The term ‘reverse migration’ refers to the process of internal and international migrants returning to their place of origin from the destination state/countries. The term ‘economic reintegration’ refers to finding stable employment at one’s origin state. Low-skilled workers includes migrants who are commonly understood as ‘unskilled workers’.

Findings of the study

This section consists of the primary findings arranged thematically to highlight the various challenges faced during the reverse migration, repatriation and reintegration of both the categories of migrant workers. Under each subheading, first the narratives of the internal migrants are presented followed by those of international migrants. In the next section, a comparative analysis of the findings is done and some common problem areas emerging from the findings have been delineated.

Economic challenges during reverse migration

Due to the COVID-19-induced lockdown, the working class, especially the low-income migrant workers, have been the worst affected (Pandey, 2020 ). They were retrenched in large numbers, were rendered unemployed with their wages unpaid in the destination states which forced them to return to their origin states. Lokesh, one of our respondents and a construction worker who returned from Karnataka to Odisha, the lack of employment and wage theft pushed him to return to his native state during the lockdown. Similarly, Mahesh who was working in a hotel when the lockdown was imposed stated:

“I was in Delhi for the past 15 years… During the lockdown I was provided with full salary for March and very less salary for April. The salary for the month of May was unpaid. I cannot survive in Delhi on my savings without any job. So finally, I came back in the month of June to Bihar.”

A few internal migrants reported that they received work under the same employer/contractor after the lockdown but complained of non-payment of wages during the lockdown period. They were forced to return to their villages due to unpaid wages, no place to live with basic facilities such as electricity and water provided by the contractor/employer and no immediate governmental protection. While recalling the plight of these migrant workers, a social worker in Delhi explained how the migrants faced wage theft and retrenchment by their employers when the lockdown commenced, however, when the restrictions eased and industrial work resumed, they were ready to pay the workers. Such instances reveal how the migrant workers were treated as a means to an end and not as citizens whose welfare matters. However, there were a few internal migrants who had stayed back in Delhi, which was their destination state, even during the lockdown period. The reason they reported for not returning was lack of work in their village and that they still hold their jobs in Delhi. They also stated how their employers had arranged for a place to live on the construction premises, took care of the basic facilities like food, electricity and water supply and that they resumed work once the restrictions were lifted.

Similar despicable conditions were experienced by the Indian migrant workers in Gulf countries. There was an urgency to return to India among them caused by large-scale retrenchments due to the unplanned lockdown (Kumar & Akhil, 2021 ). Hassan, a driver by profession and the only earning member of his household, was one of the many workers retrenched by the private companies in UAE. He was forced to survive on his savings after returning to his native state Tamil Nadu. Wage theft was commonly reported by both internal and international migrants. Bala, a returnee from Oman to Tamil Nadu, reported how his employer did not pay him his due wages, retrenched him and did not even offer to cover the flight expenses to India. Arun, a construction worker, who returned from Kuwait to Tamil Nadu stated his plight:

“Along with me, three were working as helpers in a construction site. Since the lockdown the work was halted, and we were not getting paid. For a few days, the employer gave us food…Then he asked us to return to India as he has no money to take care of us. When we asked for our salary, he threatened us that he would file a false complaint to the police against us if we ask for money…”

However, a few international migrants reported that their employers paid their due wages, arranged for their return, got their Covid tests done and therefore did not face any problem as far as their return to their village was concerned. None of the respondents of this study were a part of trade unions.

Social challenges during reverse migration

This segment consists of the social challenges faced by migrants before and after the governmental repatriation. The migrants interviewed reported instances of discrimination against them and being viewed as the spreaders of the virus in the destination city/state, during their journey back home, in quarantine facilities and in their villages. Maitheli, who is a wife of a migrant construction worker, experienced stigmatization when returning from Maharashtra to her village in MP a week before the lockdown. She narrated:

“We started our journey before the lockdown in a bus as we had to attend a wedding in March… However due to the news of the spread of Covid, even then people were avoiding interactions with us… some people even placed a cloth to cover their mouth and nose while passing by…”

Rahul returning from Delhi to the state of Bihar reported his experience of caste-based discrimination at the quarantine centre. He explained how people belonging to the higher castes resided on the ground floor with all the facilities while those belonging to the lower castes were kept on the second floor without facilities. Another international migrant reported lack of basic facilities at the quarantine facility in UP and that his family had to provide him with food. This points to the gross neglect of the migrants and puts the entire rationale of quarantine and social distancing into question.

Amanatullah, an international migrant returning from Kuwait to UP reported how even after completing the quarantine period in both the origin and destination states with proper Covid testing done, the villagers, though temporarily, maintained their distance for a few weeks. The interviews revealed that the nature of discrimination in the villages ranged from physical distancing to isolation and hostility which included threats of cutting off supplies of basic necessities to the migrant workers and their families on the basis of mere suspicion of being infected with COVID-19. Dilip, a construction worker returning from UAE to his village in MP, also reported similar discrimination. However, when inquired about his sentiments regarding this, he also blamed the migrant workers for inviting such discrimination:

“Yes some villagers discriminated against us… It felt bad… but even the migrants are at fault as they hide their symptoms, escape the Covid tests and don’t follow the rules so somewhere or the other the villagers rightly set their distance with them since the nature of virus is dangerous...”

At the destination countries, the Indian migrant workers in Kuwait were stripped of their accommodation and were forced to resort to cramped shelters and unhygienic living spaces. Raju, described the despicable situation of Indian workers in Kuwait, where he had been staying under a shed in a nearby car parking space for the 2 weeks along with 150 more workers. Hailing mostly from Indian states like Uttar Pradesh, Odisha and West Bengal, these migrant workers were getting limited support from a voluntary organization of one meal per day.

Since the international migrants had to incur their own travel fare during their repatriation, the interviewed returnees had inculcated a feeling of discrimination when compared to other Indian citizens who could afford the expenses to return to India. Most of them had limited financial resources which were insufficient to bear the cost of accommodation, food and return tickets. This category of migrants have low literacy level and have little to no bargaining power with their employers who retrenched them abruptly and alienated them in a foreign country.

Migrant workers’ mobility challenges

Initially, the central government was reluctant to rescue the stranded migrants both within and abroad, despite appeals from different stakeholders such as state governments, civil society and trade unions (Desai, 2020 ; Haider, 2020 ). Despite the strict mobility restrictions imposed by the government, the distressed internal migrants kept moving on foot or in unsanitary lorries or trucks towards their origin states due to their inability to sustain in the expensive urban areas (Rather & Yousuf, 2020 ). They faced numerous problems while attempting to cross state borders such as police brutality, grievous injuries with reports of even death due to exhaustion and dehydration (FPJ Bureau, 2020 ). There was a lack of coordination among the central and state governments resulting in contradictory stances while handling the mass migration (Rather & Yousuf, 2020 ). At the same time, the employers retrenched the migrant labourers as their businesses were shut due to the lockdown. This resulted in thousands being stranded on various inter-state borders such as Karnataka-Maharashtra and Delhi-Uttar Pradesh (Abi-Habib & Yasir, 2020 ). Rannvijay , a construction worker who returned from Delhi to Bihar, was rendered jobless and due to lack of proper transportation arrangements by the government, he had to travel back independently in a truck to his village. One of the social workers we interviewed described the desperate circumstances that the low-skilled workers had to face in Delhi due to the imposition of the sudden lockdown. He explained:

“Most of the workers stranded on the streets were from low-income groups and belonged to industries such as construction, restaurant, etc. Many workers were stranded on the streets with their families and were rendered jobless. Nobody was there to help them.”

There was an increased pressure from all the stakeholders as several petitions were filed in High Courts and the Supreme Court of India to rescue stranded migrants in various states/countries (Desai, 2020 ; NH Political Bureau, 2020 ). After one and a half month of the lockdown, the central government started Shramik (workers) special trains and local buses on the request of the state governments. From May 2020 onwards, 4621 Shramik special trains were operated for rescuing both stranded persons and migrants which transported 63.19 lakh (around 6 million) passengers to their origin states (Ministry of Railways, 2020 ). The Indian Railways allowed only those passengers to travel who were facilitated by the destination state governments. Given the lack of availability of latest data on internal migrants, the Indian government also launched the National Migrant Information System where details of the migrants commuting via the Shramik trains could be maintained for seamless communication between state governments and contact tracing if needed (Karthikeyan, 2020 ). There was widespread criticism against the central government for making the poor and distressed migrants pay for their ticket despite amassing huge amounts in the PM-CARES Fund established to provide emergency relief during the COVID-19 crisis. Following much confusion and a political tussle between the central and state governments regarding the sharing of travel expenses even when the special trains were running, the state governments later offered to cover their fare (Dhingra, 2020 ).

Interviews with migrants revealed the difficulties they faced while boarding the special train. Deepak, returning from Delhi to UP, reported that the passengers were not provided with food and water while other respondents reported that they were provided with one meal on a long journey. The train Deepak boarded left him at a place which was 84 kms away from his home. This experience was shared by a few other respondents where they had to cover the remaining distance on their own. Another complexity was related to the online ticket booking process since most of the migrants lacked access to and knowledge about digital technology. The information regarding the Shramik trains was advertised on digital media and the ticket could be booked only in online mode. One of the respondents highlighted how some migrants were unable to return due to their lack of awareness and inability to book the ticket online. Here it is important to emphasise the role played by NGOs and trade unions in the repatriation of migrants either by bus or special train. Yogesh, who returned from Karnataka to Chhattisgarh, described how the migrants who booked the tickets through exploitative agents paid an exorbitant fee:

“Some received help from their family members and friends. But a majority of the workers went back with the help of NGOs, trade unions and their employers. Those who went back with the help of travel agencies and dealers had to pay around 1500-2000 rupees in order to reach home.”

A number of senior academicians and civil society members had pointed towards the ineffective governmental efforts in spreading awareness about the contact details of the designated officials to help with the free online ticket booking and caution them against the exploitative third parties (Counterview, 2020 ). This resulted in a number of migrants being unable to return on their own or returning late or still walking on foot towards their origin state even when the trains were operating in comparison to those migrants who had the necessary resources and support.

Following appeals from various stakeholders and Indians stuck abroad, especially from the Gulf countries, the central government initiated the Vande Bharat Mission (VBM) on 7th May, 2020. As per the data provided by the MEA, until 11th September, 2020, over 1,385,670 Indian nationals stranded abroad had been repatriated under the VBM (MEA, 2020 ). MEA provided a list of country-wise and category-wise registration list of stranded Indians in foreign countries (MEA, 2020a ). As per this list, Indian workers stranded in the Gulf were the highest amongst other categories requesting for their repatriation . As per the latest statistics available on 10th March, 2021, 3.25 million workers had been repatriated from the Gulf (MEA, 2021 ). The Kuwait government helped in repatriating the undocumented migrants back to India by paying for their amnesty flights and allowing these migrants to re-apply for their visa at a later date (Dutta, 2021 ).

In order to board a special flight, returnees from Gulf countries under VBM had to afford their own high-cost flight tickets as per the central government guidelines. Kumar, who worked as a driver in Kuwait, discussed his experience of availing the VBM flight during a telephonic conversation with the Indian Embassy in Kuwait as follows:

“First they asked for details like my name, where I worked, whether I am willing to go back home, they asked about the nature of my problem and after gathering the remaining details, they asked me whether I have the money to purchase the flight tickets. If I say ‘yes’ only then they were proceeding the call, if ‘no’ then they (may) disconnect the call. If I say ‘yes’ then they will ask me to undergo a COVID-19 test and fourteen days quarantine. If we agreed, only then they will inform us about the procedure to book the tickets and our name will be noted. Based on this, we can either go home or not.”

The above narration reveals the plight and vulnerability of the stranded Indian workers awaiting repatriation. Further, the guidelines issued by the Ministry of Health & Family Welfare had prescribed 14 days of mandatory quarantine for all international arrivals with the first 7 days to be spent in institutional quarantine (Ministry of Health and Family Welfare, 2020 ). All the respondents of this study reported undergoing the COVID-19 tests and either institutional or home quarantine. It should be noted that for internal migrants, quarantine facilities and COVID-19 testing were state-sponsored. However, for international migrants, the expenses for institutional quarantine and COVID-19 testing had to be incurred by the passengers themselves (Srivastava, 2020 ). They could avail exemption from institutional quarantine but only by submitting a negative RT-PCR test result, which was also an expensive test. Thus, the international reverse migrants had to bear a major financial burden during the governmental repatriation and only those who could afford the high travel expenses could easily avail the VBM flights.

Process of economic reintegration of reverse migrants

Before discussing the experiences of the respondents with regard to their economic reintegration, we will mention the short-term and long-term measures taken by the central government to reintegrate the migrant workers in the post-COVID-19 economy. The central government announced a Rs 1.70 lakh crore (US$ 22.8 billion) relief package for the vulnerable sections which included categories of people who are migrants (Ministry of Finance, 2020 ). The central government urged the state governments to mobilize the Building and Other Construction Workers (BOCW) Welfare Fund which would benefit around 35 million construction workers registered under the Act (Ministry of Labour and Employment, 2020 ). However, it should be noted that there are an estimated 56 million workers in the construction sector (Nag and Afonso, 2021 ) .

Additionally, several state governments such as UP, Bihar, Andhra Pradesh and Rajasthan announced one-time immediate cash benefits of Rs 1000 to 5000 (USD 13.59–67.12) and free rations through the Public Distribution System (PDS) (Anand and Thampi, 2020 ). Subsequently, after immense media attention, another relief package was announced of Rs. 20 lakh crores (USD 270 billion approx.) to benefit the migrant workers, self-employed and small traders. (Ministry of Finance, 2020a ). The scheme ‘ One nation one ration card’ was announced to be implemented across India in 2021 to enable migrants to access ration from any fair price shop in India using a digital card. Between April 1 and May 20, 2020, there was a sudden increase in the registrations (around 3.5 million workers) for MGNREGA, a rural employment scheme promising 100 days of work, pointing to increased need for employment (Chauhan, 2020 ).

It should be noted that such short-term relief packages by the central government were absent in the case of international migrants. Kerala was the only state in India which provided a one-time cash benefit of Rs. 5000 to them (Mathrubhumi, 2020 ) Also, the Kerala government aimed to help around 5000 Non-Resident Keralites under the Non-Resident Keralites Affairs (NORKA) Department Project for Returned Emigrants (NDPREM) scheme by offering Rs. 50 lakhs (USD 67,123) to each expat to facilitate their own business ventures (ET Bureau, 2020 ). Acknowledging the huge amount of remittances from the international migrants which benefitted the economy, Kerala also launched an exclusive integration programme called the ‘Dream Kerala Project’. It provides a platform for the business sector to tap the expertise of skilled human resources returning to Kerala after losing jobs abroad (Press Trust of India, 2020 ). The role of Kerala government in caring for its migrant community from organising community kitchens for stranded migrants to introducing long-term reintegrative measures has been praiseworthy.

As a long-term measure for the labour market integration of both internal and international reverse migrants, the central government announced a Rs 50,000 crore (USD 6.9 billion) ‘Garib Kalyan Rozgar Abhiyan’ which involved skill mapping of migrant workers and connecting women with self-help groups for enhancing employment opportunities. (Ministry of Rural Development, 2020 ). In view of the lack of data on internal migrants, the government also announced to conduct an All India Survey on Migrant Workers and develop a National Database of Unorganised Workers (NDUW), which would include details of the migrants such as name, occupation, address, educational qualifications and skill type, etc. in order to secure employability and social security benefits for the inter-state migrant workers (Ministry of Labour and Employment, 2021 ).

SWADES (Skilled Workers Arrival Database for Employment Support), a joint initiative of the Ministry of Skill Development & Entrepreneurship, the Ministry of Civil Aviation and the MEA, aimed to create a database of migrant workers based on their skill set and experience to fulfil the demands of Indian and foreign companies (Ministry of Civil Aviation, 2020 ). For facilitating employment opportunities, details of SWADES registrations were integrated with Skill India’s ASEEM (Aatmanirbhar Skilled Employee Employer Mapping) portal. As per the latest data, i.e. January 25th, 2021, more than 30,500 workers have registered for the SWADES Skill Card, out of which more than 24,500 are returnees from GCC countries (Ministry of Skill Development and Entrepreneurship, 2021 ). Further, all data regarding Indians returning under VBM was shared with the state governments.

The internal migrants interviewed reported a sparse coverage of the government relief package as only a few respondents received immediate cash benefits. Only half of the respondents from UP and Bihar received a one-time cash benefit while the remaining did not. Sudesh, a construction worker, reported that he received free ration which would sustain his family only for 15–20 days of a month. A survey of 11,000 migrant workers conducted in April 2020, by SWAN (Stranded Workers Action Network) reported that none of the workers had received ration by the government during the lockdown period (Pandey, 2020 ). Our study (conducted between May – August, 2020) revealed that half of the respondents were able to avail rations at their native states even though its quantity and duration varied from within and across states included in our study. Those who did not receive free ration reported that they did not have a ration card, or their name was not included in the family’s ration card or were not present to provide a thumb impression to the biometric machine as they migrated to other states hinting at the non-portability of benefits. The data of the Ministry of Consumer Affairs indicated that the free ration scheme had failed because almost 11 states distributed less than 1% of food grains allocated to them (Sharma, 2020 ). Also, an RTI revealed that barely 10% of the Rs. 20 lakh crore stimulus package was distributed (The Tribune, 2020 ). Almost all the respondents reported not receiving work under MGNREGA. Ram, a construction worker and a registered MGNREGA worker, who returned to his native state Bihar in June stated that:

“It has been in news that people who have migrated to Bihar shall be provided with employment. But I did not get work under MGNREGA ever since I returned to my village.”

As a result, they were unable to find secure employment in their villages and were willing to remigrate to the urban areas or work under the same contractor/ employer who were unsupportive towards them when the lockdown commenced (Kumar, 2020 ). Amongst the international migrants interviewed, almost all of them were willing to remigrate abroad once the restrictions eased both in India and at the destination countries. Prem, one of the international migrants from MP, spoke about his desperation to remigrate to cover debts:

“After returning from UAE, so far I did not find any good job opportunities at par with the salary which I was earning abroad. Also our family has some debts which I can only settle if I work abroad for a high salary as the salary is very low here.”

Palani worked as a driver in Saudi Arabia and returned to UP after he was retrenched. However, he was willing to remigrate to any foreign country owing to the low level of wages in India in order to take care of his family. Thus, the data suggests that most of them are eager to remigrate than to stay back in their native states due to low wages, inability to find suitable employment opportunities and governmental support for integration. The remaining migrants, both internal and international, were uncertain about their return due to job losses, closing of the businesses where they used to work at or were willing to begin a new venture in their native states.

Analysis of the findings

Forced migrant mobility due to lack of protection by employers and the government.

As observed, the worst affected sections of the COVID-19 crisis were the migrant workers, both internal and international, who were pushed to the periphery. Due to the sudden and unplanned lockdown, shutting down of workplaces, hotels, construction work and other sectors which engaged migrant workers, where they earned hand-to-mouth wages, rendered them workless, wageless and homeless. Wage theft is an old phenomena, however the COVID-19-induced migrant crisis magnified this issue (Foley & Piper, 2021 ). The irresponsibility displayed by the employers, rampant wage thefts and forceful retrenchments in large numbers of both internal and international migrant workers added to their misery (Kuttappan, 2020 ; Sarkar, 2020 ). Although the Indian government issued an advisory promising the internal migrants food and shelter, payment of due wages and punitive action against landlords who forcefully evict them but it was rendered ineffective in protecting them.

There are several reasons which add to the precarious circumstances of both the categories of migrant workers. Firstly, they are informal workers with no enforceable contracts between the worker and the contractor. They are not united or backed by trade unions, are less educated, lack knowledge of the job market and good social networks to rely upon in urban areas and foreign countries. This makes them dependent on their contractors and contributes to their lack of bargaining power in case of exploitation (Srivastava, 2013 ). Describing the work condition of internal migrants , the Periodic Labour Force Survey (2017–18) revealed that for more than 70% of the workers in the non-agricultural sector with a regular salary, consisting of mostly migrants, lacked any written job contract and 50% were not enrolled for any social security benefits (Sengupta & Jha, 2020 ). Also there is unavailability of affordable housing or rental options for the migrants (Iyer, 2020 ). The exploitative relations between the migrant workers and the employers or sponsors in the kafala system, contract substitution and corruption by middlemen in the Gulf is well-known (Hussain, 2015 ). In cases of wage theft, most workers are unable to file complaints due to lack of awareness of their rights and costly judicial process. For the international migrants, it is even more complicated to file complaints against their foreign employers after their return to their origin country (Kumar & Akhil, 2021 ). Therefore, the lack of minimal social and economic protection afforded to migrant workers pushed them back to their village. It can be deduced from our findings that if workers received a safety cover such as a place to live with food, water, free electricity, payment of wages and job security, there is a possibility that they would have stayed back in their work destination. Or the proper arrangement of their return would have contributed to a relatively smoother process of their reverse migration and ensured control over the spread of the virus. However, the rampant unemployment even amongst the general population during the lockdown will further reduce the bargaining power of the migrant workers in the post-COVID economy.

Migrant experiences of stigmatization, hostility and discrimination

The ill-treatment of the respondents of this study, both internal and international migrants, in terms of being stranded without adequate facilities aggravated their feeling of being discriminated. At the destination state, they were treated as outsiders and a burden when calamity struck with neither the employer nor the government taking their responsibility. The primary findings showed how both the categories of workers were forcefully retrenched and reduced to unsanitary shelters which took away their ability to isolate and put their life at risk. Wage theft and abrupt termination of employment contracts added to the hopelessness of the migrants who incurred huge costs while migrating to Gulf countries in search of a better life (Kumar & Akhil, 2021 ) Lack of social networks and the hostility and isolation they experienced in the cities, which many migrants referred to as “foreign lands”, forced them to return to their villages (Kumar, 2020a ). However, they had to face the social stigma of spreading the virus from the afflicted urban areas by returning to their villages which were relatively protected from the virus at that stage. In the case of internal migrants, the unsanitary conditions under which they returned at a time when travelling was prohibited exacerbated the hostility against them in the form of police brutality and discrimination by villagers. There were instances of social tension among villagers fearing contagion who assaulted the government officials and migrants who were returning (Kumar, 2020 ; Manoj, 2020 ). Deplorable condition of health facilities in the rural areas, lack of awareness of the safety measures and proper transportation arrangements by the government also contributed to the fear of the spread of the virus resulting in stigmatisation of the returning migrants. Lack of awareness of government officials in dealing with the returnees was evident when the migrants were sprayed with disinfectants in UP (BBC, 2020 ). When the government initiated transportation, most of the trains were carrying migrants from COVID-19 hotspots which raised concerns about their isolation (Sheriff et al., 2020 ). The instances of non-cooperation by migrants needs to be viewed in a larger context of lack of awareness, hostility towards migrant mobility, lack of basic amenities in the destination states and quarantine facilities and a resulting sense of distrust. In order to avoid discrimination and stigma, migrants tend to hide their symptoms, avoid seeking immediate healthcare and observing healthy behaviour (WHO, 2020 ) . The governmental controls over migrant mobility in the name of containing the virus perpetuated discrimination against the migrants who were viewed as vectors of the virus (White, 2020 ).

High migration costs for international migrants

Though both the categories of Indian migrant workers faced problems while seeking help from the Indian government, there are some differences which can be pointed out. The international migrants had to incur huge expenses on their ticket, Covid tests and quarantine centres in contrast to the internal migrants whose fare was covered by the respective state governments, even though some internal migrants ended up paying due to exploitative agents, lack of awareness and confusion at the political level. This difference of treatment is due to inadequate media attention and, as a result, lack of governmental attention paid to the concerns of international migrants. It must be highlighted how Indians travelling to foreign countries have to pay an exorbitant recruitment fee especially when travelling through an agent (Migration News, 2008 ). Such high costs of migration especially amidst a crisis, has the potential to push the blue collar international migrants into major debt and make their reverse migration challenging.

Inadequate database and lack of inclusive legal and social security for migrants

There is lack of reliable data on internal migrants with the government, unlike international migrants, as the last time any official data was collected was as part of the National Sample Survey 2007–08 and the Census 2011 whose data was partially released in 2020. During the lockdown, the Indian government never collected data on the deaths of internal migrants during their reverse migration and their job losses (Paliath, 2021 ). The lack of data culminated in the lack of clear direction among the central and state governments on the handling of the migrant mobility and also resulted in their non-coverage of social security measures. The Inter-State Migrant Workmen (Regulation of Employment and Conditions of Service) Act, 1979 aimed to protect migrant workers during their recruitment and transportation against abuse and exploitation by unregistered contractors but it has been poorly implemented (Sen, 2020 ). Also, in 2020, it has been subsumed under the Occupational Safety, Health and Working Conditions Code, where it is applicable on establishments that employ five or more employees which renders migrants working in micro units outside the ambit of the law. Exclusion, poor implementation, lack of awareness and difficult application process of the governmental schemes providing affordable housing, food and cooking oil subsidies under the public distribution system, affordable public healthcare system renders the low-income migrant communities insecure (International Labour Organisation, 2020 ).

Positive role of the civil society

The civil society played a major role in supporting the migrants at all stages of their reverse migration. NGOs in India and in the Gulf countries were at the forefront during the distribution of food and medicines to stranded migrants, directing them to shelter homes, organising bus services, booking tickets of governmental transportation and facilitating undocumented migrants (Business & Human Rights Resource Centre, 2020 ; Som, 2020 ). They even conducted migrant surveys and compiled useful reports highlighting the tremendous problems they face generally and during the lockdown. The immense outreach of NGOs with the migrant workers at the grassroot level calls for a concerted effort between the civil society and the government in policy making for migrants.

Ineffective reintegration measures

Since labour is in the concurrent list, it is important for the central government to set a standard for the other states to follow. In this context, the non-inclusion of international migrants in the relief package was blameworthy. Though international migrants bring in huge remittances benefitting the Indian economy but amidst a crisis, they were left on their own instruments to cover their basic needs, travel fare during repatriation and survival in their origin country. This aspect did not receive enough media attention in comparison to the internal migrants. However, this was not enough to ensure the smooth reintegration of internal migrants as well, as more than 90% of India’s workforce is in the unorganised sector, which includes the low-income migrant workers, who are not registered under welfare schemes, lack wage protection and bank accounts (Express News Service, 2015 ). This, along with the faulty distribution of the stimulus packages, deprived them of its benefits. Even for those who managed to receive the one-time financial assistance, the amount was extremely small to meet the basic needs for even a month. The continuing pandemic and repeated lockdowns makes the situation for migrants difficult as they are unable to find jobs in their village and face travel restrictions which hinders their job search in urban areas simultaneously. Though skill mapping and maintenance of database are steps in the right direction, it has to be followed up with proper implementation and, most importantly, job creation in the origin states and under rural employment guarantee schemes like MGNREGA. In fact, renowned economist Jean Dreze has touted the idea of a state-sponsored urban employment scheme which will integrate the urban poor (Vij, 2020 ). A universal social protection cover, not only for the internal migrants but also international migrants upon their return, is important without which any reintegrative measure will remain futile.

This study highlighted the various aspects where the experiences of the internal and international migrants differed as well as converged especially during the pandemic. Some obvious differences were on account of them being separate categories in terms of their work destinations and migration process. However, as far as the differences in terms of the disparate media attention, share in relief package and reintegrative measures, high costs of migration, maintenance of proper database, all these can be commonly attributable to governmental neglect of migrants. The convergences drawn in this study are therefore important to highlight the general vulnerability of the migrants, irrespective of their category, even though both the origin and destination states benefit from migration. Their experiences converged in terms of the lack of planning and protection for the migrant community which led to them being stranded, economic challenges such as wage theft, retrenchments, survival on meagre savings, lack of social security protection, lack of governmental and employer accountability, social discrimination and hostility, mobility issues both before and after repatriation, difficulty in access to justice, ineffective reintegrative measures and vulnerability especially of the low-skilled workers. These commonalities reveal a general precarity of the Indian Migrant community and glaring caveats in migration policy making and implementation. There is a need to work on these aspects to make both internal and international migration a smoother process where all the stakeholders benefit especially in a post-crisis situation.

This study highlighted the involuntary and forced nature of reverse migration due to the sudden lockdown, lack of preparedness and planning among the government, the irresponsible behaviour of the employers and social hostility against the migrants. Lack of migrant data and registration in welfare schemes excluded most of them from the relief package benefits. The COVID-19 crisis has magnified several pre-existing problems faced by the migrant communities which led them to suffer invariably at different stages of their reverse migration. This crisis, therefore, should be used as an opportunity to bring positive measures and requires strong political will to implement them. The effective reintegration of the internal and international migrants in the post-COVID economy is an important policy issue which would entail collecting latest data, job creation which matches their skill set, inclusion in welfare schemes, portability of social security benefits taking into consideration the mobile nature of migrant communities. The Indian Community Welfare Fund should be mobilized not only in times of crisis but also in reducing the migration costs for international migrants. For better policy making, government must integrate with the civil society which has good outreach with the migrant communities at the grassroot level.

Availability of data and materials

This research includes primary data collected through interviews of migrant workers and social workers which is available with the authors. This data is not publicly available to protect the privacy of the respondents and only their real occupation, origin and work destination state has been reported in the manuscript. Some of the other data used for supporting key arguments are as follows. These links also feature in the reference list:

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According to Emigration Act, 1983 “person whose educational qualification is below matric (10th class) are categorized as ECR passport holders”. They have to obtain an “Emigration clearance” from the concerned office of Protector of Emigrants (POE) before travelling to any of the 18 ECR countries which includes the GCC countries.

Abbreviations

Emigration Check Required

Gulf Cooperation Council

Madhya Pradesh

Ministry of External Affairs

United Arab Emirates

United Nations Department of Economic and Social Affairs

Uttar Pradesh

Vande Bharat Mission

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Acknowledgements

We would sincerely like to appreciate the help of the migrant workers and the social workers interviewed in this study. We are extremely grateful to S Irudaya Rajan, Chairman at The International Institute of Migration and Development, for his valuable insights on various aspects of the migration crisis during COVID-19. We would also like to thank Dr. Arsala Nizami, who works on issues related to South Asian Migration, for her views on the role of the civil society in assisting the migrants during the crisis.

The APC charges were covered by IMISCOE – Erasmus U Rotterdam through a SpringerOpen Membership. They did not influence the findings of this research in any way.

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AK worked on the internal migration aspect and carried out a comparative analysis of the internal and international migration. AH worked on the international migration aspect and wrote the sections pertaining to the same. All authors read and approved the manuscript.

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Khan, A., Arokkiaraj, H. Challenges of reverse migration in India: a comparative study of internal and international migrant workers in the post-COVID economy. CMS 9 , 49 (2021). https://doi.org/10.1186/s40878-021-00260-2

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DOI : https://doi.org/10.1186/s40878-021-00260-2

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• Economic reintegration
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Asian Education and Development Studies

ISSN : 2046-3162

Article publication date: 25 February 2020

Issue publication date: 23 December 2020

The purpose of this paper is to ascertain the major characteristics of contemporary migrant workers in Japan. In order to illustrate their actual situations in relation to the socio-economic conditions and government policies, data have been gathered from relevant government sources and several surveys conducted by Japanese researchers.

Design/methodology/approach

The paper discusses social background, socio-economic factors and the public response to migrant workers in Japan. The focus is placed upon Japanese policy context and recent trend which demonstrates an increase in foreign workers. The main method is statistical analyses of the government macro data. In addition, some data from the relevant research outcomes are systematised.

The inflow of migrant workers has consistently augmented, and this has fostered the public debate. Some observers indicate that government deceitfully accepts migrant workers through the “backdoor” and the “side doors”. There has been some criticism, relating to the fact that increasing numbers of foreign employees include many workers with no formal qualifications, such as technical internships and international students who take on part-time jobs.

Originality/value

This article provides some factors for certain migration patterns, featuring contemporary Japan's migration issues. In conclusion, some uniqueness of contemporary migrant workers in Japanese community has been depicted, and the implications of these findings can contribute to prospective research, Japan's policy and practice in this field.

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Acknowledgements

The author wishes to thank the JSPS KAKENHI for financial support. The research Grant No. is Grant-in-Aid for Scientific Research (C) 18K01805.This paper forms part of a special section “Migrant Workers in Seven Destinations: Perspectives from East and Southeast Region”, guest edited by Eric Fong and Hua Guo.

Hosogaya, N. (2021), "Migrant workers in Japan: socio-economic conditions and policy", Asian Education and Development Studies , Vol. 10 No. 1, pp. 41-51. https://doi.org/10.1108/AEDS-02-2019-0032

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Migrant workers occupational health research: an OMEGA-NET working group position paper

Emine aktas.

1 Florence Nightingale Faculty of Nursing, Department of Public Health Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey

2 Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium

Barbara Bergbom

3 Finnish Institute of Occupational Health, Helsinki, Finland

Lode Godderis

4 External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium

Bertina Kreshpaj

5 Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden

Mario Marinov

6 South-West University “Neofit Rilski”, Blagoevgrad, Bulgaria

7 The National Institute of Public Health, Bucharest, Romania

Damien M. McElvenny

8 Institute of Occupational Medicine, Edinburgh, UK

9 University of Manchester, Manchester, UK

Ingrid Sivesind Mehlum

10 National Institute of Occupational Health, Oslo, Norway

11 Institute of Health and Society, University of Oslo, Oslo, Norway

Valentina Milenkova

Evangelia nena.

12 Medical School, Democritus University of Thrace, Alexandroupolis, Greece

Deborah C. Glass

13 MonCOEH, Monash University, 553 ST Kilda Road, Melbourne, 3004 Australia

The aims of the study were: (1) to clarify the definitions of “migrant” used in occupational health research; (2) to summarize migrant workers’ industry sectors, occupations and employment conditions; (3) to identify the occupational health and safety services available to migrant workers; (4) to summarize work-related health problems found among migrant workers; (5) to identify the methodological challenges to research into occupational health of migrant workers; and (6) to recommend improvements in migrant occupational health research.

This position paper was prepared by researchers from several European countries and Australia, working within the EU COST Action OMEGA-NET. The paper drew on two recent systematic reviews on the occupational health of international migrant workers and other literature, and also identified uncertainties and gaps in the research literature. Migrants may, for example, be temporary or permanent, moving for specific jobs migrants or other reasons. Their ethnicity and language capabilities will affect their work opportunities.

The occupational health literature seldom adequately identifies the heterogeneity or characteristics of the migrant group being studied. Migrants tend to work in more physically and mentally demanding environments with higher exposures than native workers. Migrants tend to have an increased risk of physical and mental ill health, but less access to health care services. This has been demonstrated recently by high rates of COVID-19 and less access to health care. There have been a number of cross-sectional studies of migrant health but few long-term cohort studies were identified. Other study designs, such as registry-based studies, surveys and qualitative studies may complement cross-sectional studies. Mixed-methodology studies would be valuable in research on migrants’ occupational health. Language and lack of trust are barriers to migrant research participation.

Targeted research, especially longitudinal, identifying how these economically important but often-vulnerable workers can be best assisted is needed. Researchers should identify the characteristics of the migrant workers that they are studying including visa/migration circumstances (temporary, permanent, undocumented), racial and ethnic characteristics, existing skills and language abilities.

Introduction

Migration is a global phenomenon playing an essential role in the socio-economic development of many countries. Using 2017 data from the United Nations, the International Labour Organization (ILO) has estimated that globally 164 million people (4.7% of all workers) are migrant workers (International Labour Organization (ILO) 2018 ). Migrant workers contribute to the economies of both the host country, often meeting needs that are not met by the native population; and the country of origin, by remitting financial support to families. Host countries for international migrants are typically high-income countries in North America, Europe, the Middle East and Australia (Hargreaves et al. 2019 ; Kennedy et al. 2015 ).

This paper resulted from OMEGA-NET, an EU-funded Network on the Coordination and Harmonization of European Occupational Cohorts ( http://omeganetcohorts.eu ), COST (European Cooperation in Science and Technology) Action CA16216 (Bodin et al. 2020 ; Guseva Canu et al. 2021 ).

Many migrants work in precarious jobs, in difficult and dangerous conditions, perhaps resulting in adverse physical and/or mental health outcomes, such as injury or more recently high rates of COVID-19 (Ahonen et al. 2007 ; Hargreaves et al. 2019 ; Moyce and Schenker 2018 ). Researchers in OMEGA-NET recognized that the occupational health of migrant workers is under-researched.

This paper has the following aims:

• To clarify definitions of “migrant” used in the occupational health research.
• To summarize migrant workers’ industry sectors, occupations, and employment conditions.
• To identify the occupational health and safety services available to migrant workers.
• To summarize work-related health problems found among migrant workers.
• To identify the methodological challenges to research into occupational health of migrant workers.
• To recommend improvements in migrant occupational health research.

OMEGA-NET enabled researchers from across Europe and elsewhere to form interest groups to share knowledge and expertise about occupational health research. The Migrant Worker task group consisted of researchers from several European countries and Australia.

We drew on published literature, particularly on two recent systematic reviews of the occupational health of international migrant workers (Hargreaves et al. 2019 ; Sterud et al. 2018 ). We identified the types of studies that had been carried out and the major findings in respect of migrant workers’ work sectors and what is known about migrants’ physical and mental health risks related to occupation. This included a summary of migrant workers’ experience of COVID-19.

We situated the available data in the context of the occupational health services typically available to migrant workers and identified gaps in the research. We then systematically evaluated the strengths and weaknesses of the types of study available to investigate the occupational health of migrant workers and made recommendations to strengthen research in this field. The findings of the current position paper were discussed and refined via several virtual meetings by the authors.

Heterogeneity and lack of definition for “migrant” in research

There have been a variety of studies of migrant occupational health around the world, but the literature lacks a consensus in terminology. The legal status of migrants varies between countries and between migrant groups within a country. However, papers seldom characterize the migration status (reason for migration and legal/visa status) of the individuals under study. In some studies, the definition of ‘migrant’ derives from data collected for purposes other than the research. Understanding migration status is crucial to the interpretation of migrant occupational health studies, as well as for comparison of the findings between studies.

The work circumstances of the migrant population should be made clear. Migrants may be permanent or temporary (seasonal or perhaps for a few years). Black miners, e.g. from Botswana, may work for many years at the same site in South Africa but were not permanent migrants (Steen et al. 1997 ). Temporary migrants, often experience employment precarity. Some migrants are employed on short-term visas, perhaps tied to specific jobs, for example unskilled domestic workers (Phillipine Statistics Authority 2018 ). In addition, documented and undocumented (“official vs unofficial”) migrants have very different experiences and vulnerabilities at work (Ahonen et al. 2009 ).

Within a host country, the migrants’ country of origin and language skills significantly affect the employment experience (Daly et al. 2019 ; Sole et al. 2013 ). Skilled and educated workers, such as trained medical practitioners, may migrate and take up suitably skilled jobs (Kizito et al. 2015 ; Marusic and Markovic-Denic 2018 ). The skill status of the migrants under study should therefore also be made clear.

Migrants’ ethnic origin, skin colour and religion affect their employment opportunities and work experiences. Some groups encounter more discrimination than others (Balidemaj 2017 ; European Union Agency for Fundamental Rights 2017 ). Race and ethnicity are often used interchangeably in the literature, and without being sufficiently defined (Zagefka 2009 ). Papers from the USA often distinguish risks separately for Black and Caucasian workers and may identify Hispanic or Latino ethnicity (Bahrami et al. 2017 ; McCurdy et al. 2014 ). Papers from Europe seldom report on ethnicity or race although this may affect their work experience.

Some papers use a definition of migrant based on language. However, a person’s first language may or may not indicate that the person is a migrant. A definition based on language spoken at home, or the need for an interpreter may result in the inclusion of second-generation migrants rather than first-generation. (Daly et al. 2019 ).

The term “migrant worker” has also been used to refer to natives moving within a large ethnically and culturally diverse country, perhaps from the countryside to the town (Al-Ayyadhi and Akhtar 2018 ; Fan and Qian 2017 ; Zeng et al. 2014 ). Such internal migrants may or may not experience language and cultural differences; however, if they do, they would be in a comparable situation to many international migrants (Bergbom and Vartia 2021 ). South African mines relied on a “migrant labour system” which provided employment for men from neighbouring countries as well as from within South Africa (Steen et al. 1997 ). In a paper on South African miners, it was not always clear whether study participants came from within the country or were international migrants, the term “migrant” was not used (Naidoo et al. 2005 ). Workers commuting between countries who return home on days off, e.g. Swedes in Norway, have more in common with domestic fly-in-fly-out workers such as Australians traveling to mines in remote areas of Australia than they do with other international migrant workers.

Other terms used in the literature are seasonal, guest or foreign-born worker (Ahonen et al. 2007 ; Frank et al. 2004 ; Rebecca Smith 2012 ). The terms “refugee” or “asylum seeker” identify the reason for the migration. These people are particular subsets of migrants, who have not moved specifically for employment opportunities, but to escape, for example, war or persecution.

Occupational health research should identify the migration status, skills including language skills, and other circumstances of the migrant workers under study, so that readers have a better understanding of the findings of the research, how they should be interpreted and where they can be generalized.

Characteristics of international migrants’ work

International migrants are commonly employed in construction, agriculture, hospitality, cleaning, transportation, healthcare and personal care sectors (Philippine Statistics Authority 2018 ; Maji et al. 2020 ; Ruhs and Anderson 2010 ). Worldwide studies of migration have shown that the male migrant workers are employed in agriculture, construction, the food sector, transport and material moving occupations, while the majority of migrant women workers are employed in the service sectors, such as domestic work, cleaning, catering, hospitality, and the healthcare and manufacturing sectors (Foley and Piper 2020 ; González and Irastorza 2007 ; U.S. Bureau of Labor Statistics 2019 ).

Migrant workers often display commitment, availability and flexibility, and may accept lower wages and so may be a preferred source of employees. This is notably the case where there are rapid fluctuations in demand and high turnover of unskilled employees for example in seasonal farm work (Chartered Institute of Personnel and Development (CIPD) 2013 ; Janta et al. 2011 ).

Migrant workers commonly work in what are known as the 3-D jobs “dirty, dangerous and demanding or demeaning” often characterized by lower pay, longer working hours, more exposure, e.g. to chemicals and no work training (Moyce and Schenker 2018 ). Many of the industries where migrant workers are employed, have hazards, such as extreme temperatures, noise, vibrations, heavy loads, or fast work speeds (Ronda Pérez et al. 2012 ). Within an industry or job, migrants may be more highly exposed than native workers (Reid et al. 2018 ).

Immigration status may affect employment quality, and migrants may be constrained by host country requirements e.g. dependent on a temporary work permit (McDowell 2008 ). Migrant workers, especially those who have recently arrived, are more likely than their native counterparts to find themselves in short-term, agency and precarious employment. Precarious employment is an important social determinant of health and typically includes employment insecurity, inadequate income and limited rights and protection (Kreshpaj et al. 2020 ; Siegmann and Schiphorst 2016 ). They may have limited access to legal expertise, collective bargaining agreements and union representation. Labour market deregulation has particularly affected sectors commonly employing migrant workers, such as construction, agriculture and services (Pajnik 2016 ). Migrant workers typically have poorer social networks limiting opportunities to find work (Salvatore et al. 2013 ). Migrant workers are more likely to work in unregulated sections of the labour market and are consequently exposed to social segregation and are vulnerable to exploitation and abuse (Alberti et al. 2013 ; Bretones et al. 2020 ; Thornley et al. 2010 ).

Migrant workers’ employment security, immigration status and labour market policies have a bearing on occupational health and should be identified as well as the industry sector and specific job being researched.

Migrant access to health and safety services

Migrant workers contribute to the economy of both their origin and host countries, sometimes at a very high personal cost (Moyce and Schenker 2018 ). It is in the interest of both the receiving country and the country of origin to keep this population healthy, to provide healthy working and living conditions and to allow access to health care.

The healthy migrant effect has been reported in relation to permanent migrants (Kennedy et al. 2015 ). Migrants, the majority of whom are from developing countries, tended to be healthier than the average of people in the country they migrate to. They were also healthier than those remaining at home perhaps as a result of health screening or selection for skills and education by host country (Kennedy et al. 2015 ). In some cases, such as Australia, pre-migration health checks are required. Over time, permanent migrants’ health has been shown to deteriorate (Claussen et al. 2009 ). Some of this change is likely lifestyle-related, for example, metabolic syndrome, alcoholism and diabetes affect the health of recent migrants and are more common among male migrant workers than the native male population (Mucci et al. 2019 , 2020 ). Much is likely to be a result of poor working conditions and less access to health care. The extent to which these changes affect the health status of temporary migrants is unclear.

Interventions to ensure the good health of migrants encompass both occupational health and safety, and primary health care. This includes access to safe and healthy working conditions, targeted medical surveillance, vaccination programs and referral for treatment. Information on hazards, good working practices and control measures, such as ventilation and personal protective equipment, should be provided by the employers in migrants’ language (Hargreaves et al. 2019 ).

The current literature has little information on what occupational health services are provided to migrants, the quality of the services or the ease of access. The range and quality of services will vary from country to country (or jurisdiction to jurisdiction). Further research is needed to support evidence-informed policy-making to identify which types of health insurance/health provision are best for migrant workers.

A study of the policies/interventions to improve migrant health showed that only 11 of the 25 included EU countries had established specific national actions to improve migrant health beyond statutory legal entitlements (Peiro and Benedict 2009 ). The report showed that the health services targeting migrant workers usually cover primary health care and occupational health and safety. Preventive services and long-term care did not receive sufficient attention. In particular, the neglected areas were: infectious diseases (including vaccination/immunization), mental health, dental health, sexual and reproductive health, and family health (paediatric services). Migrant workers may receive these services from government authorities (health, labour, immigration or law enforcement) and/or from private or non-governmental organisations (Simon et al. 2015 ).

Many migrant workers, particularly undocumented workers and those in the black economy, are likely to experience health care inequalities. Entitlement to health care and to effective preventive measures does not necessarily ensure equality of access because there may be other barriers, such as language, physical accessibility, lack of information on how to navigate the health care system, financial cost, etc.

The heterogeneous composition of the migrant worker community, in terms of legal status, qualifications and skills, cultural background, language abilities, labour market integration and work experience leads to a variety of health care needs. A much richer picture of these needs in relation to the sectoral distribution of migrant employment is needed (Ambrosini and Barone 2007 ). For example, unskilled personnel working in tourism (hotels and restaurants) and household services may need health care to prevent infectious diseases and to control exposure to cleaning materials and disinfectants. For employees in the construction sector, access to emergency health care is necessary. Maternity health services should be considered for all female migrant employees, and child health services may be needed by all migrant workers. Health care services for migrant sex workers are usually restricted to the prevention of sexually transmitted diseases. However, these migrants may also need emergency, reproductive, nutrition and dental care (Global Network of Sex Work Projects NSWP 2018 ).

Occupational health outcomes for migrant workers

In the last decade, there has been a significant increase in the number of studies of work-related health problems suffered by migrant workers. Studies in different European countries, and outside Europe showed that migrant workers have high risks of workplace injury, occupational disease, work-related disease and ill health (Abubakar et al. 2018 ; González and Irastorza 2007 ; Hargreaves et al. 2019 ). Although, providing a comparison of work-related health problems between migrant and native workers is often difficult, it has been stated that migrant workers have more absenteeism and sickness leave than native workers. This may be related to higher stress and poorer working conditions (González and Irastorza 2007 ). They may also exhibit more presenteeism, not taking time off when they are unwell, especially when they have recently migrated. This may be related to the perceived precarity of their work situation. (Agudelo-Suárez et al. 2010 ).

Physical and chemical exposures can affect the health of migrant workers and lead to respiratory and occupational skin diseases (Arici et al. 2019 ; Moyce and Schenker 2018 ). More work-related disease was found among migrant farmworkers, hairdressers, nail salon workers, domestic and healthcare workers and asbestos miners, suggesting perhaps more exposure than for native workers in the same industry (González and Irastorza 2007 ; Moyce and Schenker 2018 ; Reid et al. 2018 ). Ergonomic risks factors, low back pain and work-related musculoskeletal disorders have also been associated with ethnicity and country of origin (Aung et al. 2019 ; Hoppe et al. 2014 ; Sterud et al. 2018 ). Cancer and long-term chronic diseases, such as pneumoconiosis, are difficult to study in migrant populations (Arici et al. 2019 ; Naidoo et al. 2005 ) because long-term follow-up is lacking.

Recent research has highlighted the mental health and social well-being problems of migrant workers and shows that migrant workers are more likely to suffer from psychosocial problems and mental disorders than the native workers (Bretones et al. 2020 ; Daly et al. 2019 ; Liu et al. 2020 ). These mental health problems include depression, anxiety, stress, burnout, daytime sleepiness, insomnia, chronic fatigue, and violence (Capasso et al. 2018 ; Font et al. 2012 ; Sole et al. 2013 ). Factors affecting mental health include personal attributes, such as nationality/ethnicity, culture, language barriers; perceptions, such as perceived health risk at work and perceived job satisfaction; and external factors, such as the job demands/stress, working hours, income, working conditions, stress management strategies, a supportive work environment and social inclusion (Capasso et al. 2018 ; Clouser et al. 2018 ; Hargreaves et al. 2019 ; Sterud et al. 2018 ). A number of studies have found that separation from the family is an important risk factor for poor mental health. (Mucci et al. 2020 ) Deficient language skills and non-transferability of education and training can also give rise to occupational stress (Ahonen et al. 2007 ; Daly et al. 2019 ). A higher education level may have positive effects on health outcomes for migrants but highly educated migrants employed in jobs for which they are overqualified, have poor self-reported health (Espinoza-Castro et al. 2019 ).

A study in Australia identified that migrants and native workers had largely the same psychosocial job characteristics; but the severity of the job stressors was higher for migrants (Liu et al. 2020 ). Moreover, migrant and ethnic minority employees have been shown to be more exposed to workplace bullying and social exclusion than native and ethnic majority employees (Bergbom and Vartia 2021 ; Rosander and Blomberg 2021 ). Studies have shown that migrants who were living in shelters or barracks had increased mental health problems (Clouser et al. 2018 ; Moyce and Schenker 2018 ).

Less research has been identified on occupational biological risks and related health outcomes in migrant workers. There is, however, literature about workers bringing disease with them when they migrate (Arici et al. 2019 ). Communicable diseases such as TB in health care workers can spread in the work environment, so it is crucial to assess biological health risks particularly in health care setting.

A study in 14 European countries identified that many migrants had a less healthy lifestyles characteristics than natives, e.g. higher smoking rates (Arsenijevic and Groot 2018 ). Unhealthy behaviours of migrant workers were more likely to be linked to socio-demographic characteristics and cultural background. However, some migrants had a healthier lifestyle, e.g. workers who are practising Muslims avoid unsafe sexual behaviour and alcohol consumption (González and Irastorza 2007 ; Shaw et al. 2017 ). Lifestyle behaviours should be considered in future studies of migrant workers’ occupational health.

Migrant workers and Coronavirus (COVID-19)

Migrant workers have been studied during the COVID-19 pandemic; they are concentrated in high-risk people-facing industries; hence, there is an inequality in workers’ risk of contracting COVID-19 (Maji et al. 2020 ). During the first wave of COVID-19, health care professionals and transportation workers were found to be at the highest risk in many countries. In addition, in the second wave, food delivery workers, waiters, bartenders, and taxi drivers were found to be at a higher risk than people in other jobs, in all age groups (Magnusson et al. 2021 ). These industry sectors have high rates of precarious employment and informal work and migrants are over-represented, so they have experienced more layoffs or reductions in working hours (International Labour Organization (ILO) 2020 ). On the other hand, some workers in sectors, such as healthcare, transportation and warehousing, and social assistance, faced increased workloads exacerbated by high work turnovers (Papadimitriou and Cseres-Gergelyne Blasko 2020 ).

Also, migrants are over-represented in these industry sectors. Further, migrant workers who live in dormitories or work in crowded workplaces are at increased risk of COVID-19 infection (Gorny et al. 2021 ; Koh 2020 ).

During the COVID-19 lockdowns, closed borders, uncertainties about work life, poor working conditions and job insecurity were reported by migrant workers (Greenaway et al. 2020 ; Roy et al. 2020 ; Suresh et al. 2020 ). They faced poorer access to health care; job and wage loss, accommodation insecurity, difficulties in finding basic food and hygiene needs and anxiety about family members living in different countries (Adhikari et al. 2020 ; Kluge et al. 2020 ). Migrant health care professionals had a high level of mental distress and poor general health associated with limited access to personal protective equipment (Attal et al. 2020 ).

Migrants were more likely to be infected with COVID-19 (Koh 2020 ) and in the UK, the mortality rate for those infected was also higher, especially at the early stage of the outbreak (Aldridge et al. 2020 ). In addition, migrant workers may be less likely to adhere to protective measures, perhaps increasing the risk of COVID-19 infection (Skogberg et al. 2021 ). In the current COVID-19 health emergency, migrants need equal access to health care including to vaccination/immunization programs. If they are in people-facing occupations, it is arguable that they should be a high priority in these programs.

Methodological challenges

Studying the occupational health of migrants poses a variety of methodological challenges. The majority of studies conducted on migrants’ occupational health have been cross-sectional survey studies (Hargreaves et al. 2019 ; Sterud et al. 2018 ). Cross-sectional studies can be vulnerable to the Healthy Worker Effect (Fox and Collier 1976 ). Long-term follow-up is needed to identify excess risk for long-latency occupational diseases, such as cancer or silicosis. Some longitudinal studies were identified including among South African mine workers. Even here authors identify a likely bias “Black miners, upon retiring, return to their distant homes, and are unlikely to have autopsies performed on them.” (Naidoo et al. 2005 ). This will lead to underestimation of risks. Longitudinal (prospective) studies on migrants present significant logistical problems of follow up especially when studying undocumented, seasonal or temporary migrant workers.

Registry-based studies, surveys and qualitative studies complement each other, each has their own weaknesses and strengths. Table ​ Table1 1 systematically evaluates the strengths and weaknesses of these three study types of study in relation to migrant workers. Because of the different strengths and weaknesses of different research methodologies, mixed-methodology studies would be valuable in research on migrants’ occupational health. Some intervention studies identifying effective strategies to improve migrant health have also been carried out (Sterud et al. 2018 ).

Strengths and weaknesses of different types of studies in respect of migrant workers: Registry-based, survey and qualitative studies

Prospective surveys of migrants may be hard to successfully conduct because of low response rates and attrition particularly of temporary workers. Registry-based studies are helpful in this context. The strengths of registry-based studies are that they can be conducted using a longitudinal design, using objectively collected data, which enables causal inferences (Thygesen and Ersbøll 2014 ). Moreover, registry-based studies are less likely than surveys or qualitative studies to suffer problems of language and cultural barriers. Some Scandinavian countries have national registers which include data on migrants. The shortcomings of registry-based studies include that researchers cannot influence the data that are collected and there is limited ability to control for confounders and they are unlikely to include undocumented migrants. The strength of survey and qualitative studies, are that data collection can be tailored to the research questions of the particular study.

A common and serious problem in surveys of migrants is a low response rate. This can lead to systematic under-representation of migrants or of some migrant groups, resulting in bias and lack of generalizability of findings (Moradi et al. 2010 ). One obvious cause of low response rates is the language barrier. Poor proficiency in the survey language may lead to misunderstanding of questions and response scales. Thus, survey studies should ideally be translated and back translated to the required language(s). A study by Moradi et al. ( 2010 ) showed that translation of the questionnaire increases migrants’ response rates, not only by removal of the language barrier but importantly, because it gives a sense of inclusion to migrant respondents. Translation of surveys must ensure the equivalence of questions and scales in different languages and that they are culturally valid. Construction and translation of good survey instruments for occupational health research around migrant populations, can be time-consuming and costly (Mladovsky 2007 ). Guidance has been provided for translation of key EU surveys collecting health information (European Commission 2020 ). Lack of trust in confidentiality may lead to both low participation and an increase in socially desirable responses (Janus 2010 ). Thus, building of trust is of paramount importance in surveys and in most qualitative studies. Overlooking these reliability and validity issues may seriously affect the quality of survey studies and their findings.

A particular strength of qualitative studies is the increased ability to study marginal groups including undocumented migrants, migrant sex workers and those in the black economy. In qualitative studies, it is possible to build rapport and trust, which may allow studying sensitive issues. Qualitative studies may give deeper and more nuanced understanding of the phenomena being studied but a weakness may be the difficulty of generalizing to other groups.

Finally, it should be emphasized that migrants are not a homogenous group, and so the occupational health of migrants from all relevant groups should be investigated. This would include permanent, temporary and undocumented migrants and migrants from different countries and ethnicities.

Concluding remarks and recommendations

Many migrant workers experience precarious work, work in hazardous industries and in the least desirable jobs. They are at increased risk of a variety of mental health and social well-being problems, as well as increased risk of workplace accidents, hazardous exposures, discrimination, workplace bullying and, in some circumstances, violence. Indeed, they may be subject to multiple stigmatizations. Recently, healthcare and domestic workers have been working at increased risk of COVID-19; this is sometimes exacerbated by dwelling in dormitory-style accommodation and perhaps by having multiple jobs.

Migrants are not a uniform entity, they can be permanent or temporary, documented or undocumented, tied to specific jobs or not and may regularly return to the same place for seasonal work. The term “migrant” has used in the literature for both domestic and international migrants.

Researchers should provide a clear definition of the migrant population under study, to enable better understanding and future evidence synthesis. At present, demographic information, such as age, sex, etc., is reported, but for migrants, the visa/migration circumstances (temporary, permanent, undocumented), racial and ethnic characteristics, existing skills and language abilities are seldom reported. A description of the health and safety support available in the workplace(s) would be helpful. These factors can affect migrants’ ability to get work, the type of work obtained and experiences encountered at work. It is often unclear which are the most important factors resulting in migrant physical or mental ill health. Mixed methods and intervention studies for these workers, could provide good evidence of factors that might improve their situation.

Sharing improved and translated survey instruments which take cultural considerations into account could improve the research effort.

The largest challenge in studying this group of workers is the ability to do longitudinal research. It is unclear how much ill health is exported when migrant workers return home. Little is known about the rates of cancer and long-term chronic diseases, such as pneumoconiosis, in returning migrant populations. This is an important gap in the evidence base and should be a research priority.

Further research across the globe is urgently required to understand long-term health and safety outcomes and their causes in this often-vulnerable subgroup of the working population to bring about changes in organizational culture to reduce the risks to their health.

Acknowledgements

This paper was written within the scope of OMEGA-NET, supported by COST (European Cooperation in Science and Technology), project CA16216: Network on the Coordination and Harmonisation of European Occupational Cohorts.

Author contributions

All authors have participated sufficiently.

Declarations

The authors declare that they have no conflict of interest.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Emine Aktas, Email: rt.ude.cui@kaenime .

Deborah C. Glass, Email: [email protected] .

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• DOI: 10.1016/j.lisr.2024.101316
• Corpus ID: 271580070

Factors affecting the cultural information needs of Chinese migrant workers and their role in the acculturation: A descriptive framework

• Peng Xiao , Shuxian Liu , Andrew Madden
• Published in Library &amp; Information… 1 July 2024
• Library &amp; Information Science Research

113 References

Are adaptation challenges relevant to the location choices of internal migrants evidence from china, regional informal institutions, local governance and internal migration in vietnam, heritage as an affective and meaningful information literacy practice: an interdisciplinary approach to the integration of asylum seekers and refugees, ceo–tmt congruence in growth‐need strength and firm growth, advantages of being bicultural: acculturation and mental health among rural-urban migrants in china, "so many things were new to us": identifying the settlement information practices of newcomers to canada across the settlement process, linking internal and international migration in 13 european countries: complementarity or substitution, cultural information needs of long-settled immigrants, their descendants and family members: use of collective and personal information sources about the home country, return or not return: examining the determinants of return intentions among migrant workers in chinese cities, making regional citizens the political drivers and effects of subnational immigrant integration policies in europe and north america, related papers.

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