A/HRC/14/30 delayed emergency intervention may actually lower the costs of the health system.25 In this context, the Special Rapporteur stresses the critical importance of providing migrants with essential primary health care, given that migrants may often have to self-medicate and use health services at a later stage in the progression of their ailments than members of the host community. C. The right to health for migrant women and girls 29. Article 12 of the Convention on the Elimination of All Forms of Discrimination against Women guarantees the right to access health-care services, including family planning services, on a basis of equality of men and women. This provision is particularly pertinent, as migrant women and girls face specific challenges in the field of health. They may be subject to sex- and gender-based discrimination, such as mandatory HIV/AIDS, pregnancy or other testing without their consent, as well as sexual and physical abuse by agents and escorts during transit.26 In host States, many female migrants are employed in relatively low-skilled jobs within the manufacturing, domestic service or entertainment sectors, often without legal status and little access to health services. They are often subject to exploitation and/or physical and sexual violence by their employers or clients. They may be particularly vulnerable to HIV and have few alternative employment opportunities.27 30. Female migrant workers engaged in domestic services are one of the most vulnerable groups of migrant workers. There appears to be a widespread pattern of physical, sexual and psychological abuses of migrant domestic workers,28 and they are also often exposed to health and safety threats without being provided with adequate information about risks and precautions. Further, their vulnerability is heightened by the lack of domestic legal mechanisms recognizing or protecting their rights. Consequently, they are often excluded from health insurance and other important social and labour protections.29 Given the lack of health care, they tend to seek care late. 31. Migrant women and girls also often experience different and more problematic pregnancy and gynaecological health issues, compared to the host population.30 Many arrive from countries with poor sexual and reproductive health services or information, including on family planning, or with little knowledge or experience in such services. Consequently, the rate of unwanted pregnancies among migrant women and girls may be high and they may be more exposed to risks of deportation or coercive abortion than women from the host country.31 Indeed, owing to the persistent discrimination against pregnant women, the number of requests for abortion in populations of migrant women and 25 26 27 28 29 30 31 GE.10-12615 See Global Health Advocacy Project, “Proposals to exclude overseas visitors from eligibility to free NHS primary medical services: a summary of submissions to a Department of Health consultation whose findings were never published” (Cambridge, 2008). Available from www.medsin.org/ downloads/page_attachments/0000/1939/Where_s_the_Consultation_-_FINAL.pdf. Committee on the Elimination of Discrimination against Women, general recommendation No. 26 (2008), paras. 12, 17 and 18. UNAIDS, “HIV and International Labour Migration”, Policy Brief, June 2008, first page. See United Nations Population Fund (UNFPA), State of World Population 2006: A Passage to Hope – Women and International Migration (New York, 2006). Available from www.unfpa.org/swp/2006/ english/introduction.html. UNICEF, briefing note (see footnote 5), p. 12. Manuel Carballo, “The challenge of migration and health”, International Centre for Migration and Health Feature Article (2007), p. 2. Committee on the Elimination of Discrimination against Women, general recommendation No. 26, para. 18. 9

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