A/HRC/41/38 G. Specific human rights concerns related to migrant women 1. Access to decent work and social protection 59. The intersection of gender norms and market economies has diverse consequences for migrant women. Migrant women who are working in unskilled, undervalued and lower paid sectors, often as domestic workers or caregivers, are in spaces that are difficult to regulate, such as private homes. In 2013, it was estimated that around 75 per cent of the 11.5 million domestic workers worldwide were women and girls. Despite the fact that there is a high demand for domestic workers in many countries, the job is less socially valued than other types of work, which is reflected in the lower pay, fewer labour regulations and a lack of social protection. 2. Migration and access to health care, including sexual and reproductive health, and education 60. Migrant women and girls often do not have reliable access to health care or reproductive health-care services in transit and destination countries. Their lack of access is due to factors such as the lack of information or health-related education, isolation, or the inability to gain access to services based on legal status, for fear of deportation or other repercussions, particularly for migrants in irregular situations. The Special Rapporteur has affirmed on numerous occasions that States should ensure that there is a strict separation (“firewall” protections) between public services and immigration authorities, allowing migrants to exercise and enjoy their rights without fear of being reported to the immigration authorities (see A/73/178/Rev.1). 61. As asserted by the Committee on Economic, Social and Cultural Rights in its general comment No. 22 (2016) on the right to sexual and reproductive health, the right to sexual and reproductive health is an integral part of the right to health enshrined in article 12 of the International Covenant on Economic, Social and Cultural Rights. The Committee recognizes that the right to sexual and reproductive health is indivisible from and interdependent with other human rights, while it is also affected by the social inequalities in society and unequal distribution of power based on gender, ethnic origin, age, disability and other factors. The Committee emphasizes that migrants may be disproportionately affected by intersectional discrimination in the context of sexual and reproductive health. States are therefore obliged to take particular steps to ensure that migrants have access to sexual and reproductive health information, goods and services, and to ensure that individuals are not subjected to harassment for exercising their right to sexual and reproductive health. 65 62. Migrant women may acquire HIV while in transit or in their country of destination and are often particularly vulnerable to the virus owing to their status as a migrant. Reports have shown that migrant women in transit may be forced to engage in transactional sex to facilitate their border crossing. 66 Migrant women, especially those employed in lower skilled jobs such as domestic service work, often have limited access to preventive reproductive and sexual health services, gynaecological and obstetric care and antiretroviral therapy, because of their migration status and lack of access to insurance or national health schemes (A/HRC/32/44, para. 51). 63. Research has also demonstrated that migrant women seek less antenatal care than non-migrant women, even when their economic and socioeconomic background is similar. That is particularly the case when their status in a given country is unclear, or when they feel that local policies and social attitudes towards them are hostile. 67 In some countries, migrant women face discrimination based on pregnancy or their maternity status. They may be subjected to mandatory pregnancy tests upon arrival; if the test is positive, they are dismissed and/or deported. That fear, together with the fear of losing their job, may lead pregnant migrant women to try and terminate their pregnancy, sometimes using dangerous 65 66 67 See UNFPA, State of World Population 2006. Joint United Nations Programme on HIV/AIDS, The Gap Report (Geneva, 2014), p. 165. See Manuel Carballo, “Female migrants, reproductive health, HIV/AIDS and the rise of women” (2006). 15