Pre-departure psychological distress and associated factors among migrant workers of Nepal

Introduction Foreign employment is the most significant motivation for international migration in Nepal. However, migrant workers are vulnerable to many exploitations that lead to psychological distress during the pre-departure phase and at the destination. The study aimed to identify the prevalence and associated factors for psychological distress among migrant workers during the pre-departure phase. Methods This was a cross-sectional study based on the representative sample of 445 migrant workers. A 21-item Depression Anxiety Stress Scale (DASS-21) and Pre-Departure Risk Factors Perception Scale (PD-RFPS) at the workplace were self-administered to migrant workers selected randomly attending the pre-departure orientation program. Bivariate and multivariate logistic regression was performed to identify the associated factors. Results Prevalence of psychological distress (Depression, Anxiety and Stress) was identified as 20.9% and female (AOR=2.02, p-value=0.041) and perception of bad working conditions (AOR=2.44, p-value=0.046) were found significantly associated with pre-departure psychological distress. Conclusion Data suggests the presence of symptoms of psychological distress among migrant workers during the pre-departure phase and perception of risk factors at the workplace were found significantly associated with pre-departure psychological distress. Concern bodies should provide in-depth orientation on possible risk factors at the destination and coping skills for psychological distress during the pre-departure orientation program.


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The number of international migration has continued to grow and estimated to around 272 41 million in 2019. Among these migrants, most of them were of the working age group (20-64 Pre-departure and in-service at the destination are the two major stages where migrant workers 60 are vulnerable to exploitation like manipulation of contract, hiring for non-existent jobs, poor 61 working conditions, wages below standard, health and safety risk, and prolonged debt period that 62 results in psychological distress [7]. Therefore, instead of focusing only on tertiary prevention, 63 targeting the pre-departure determinant of the problem would be the most appropriate approach 64 as primary prevention to improve the psychological well-being of the migrant workers. For that 65 reason, the objective of this study was to identify the prevalence of psychological distress and its 66 associated factors among migrant workers of Nepal departing to GCC countries.

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This was a cross-sectional study conducted among migrant workers attending a pre-departure 69 orientation program. A total of 445 migrant workers were included from eight randomly selected

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Symptoms of psychological distress were experienced by 20.9% of migrant workers during the 106 pre-departure phase. Symptoms of psychological distress were more prevalent among females 107 compared to males. Nearly one-fourth of younger age groups less than 25 years were found with 108 the symptoms of psychological distress, which was higher than the older age group migrant 109 workers. Similarly, it was high among those who had smoked in the last month compared to 110 those who had both smoked and consumed alcohol. Likewise, nearly one-third of unskilled 111 manual workers were found with symptoms of psychological distress and it was less among the 112 professional jobholders.

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Psychological distress was high among those who were traveling for the second time compared 114 to the first time travelers. Those who were traveling due to poverty, family pressure, and to pay 115 back debt were found with a higher prevalence of symptoms. Similarly, it was high among those 116 who had not discussed with their family about foreign employment, had a loan, had not pre-117 arranged for employment, had not pre-arranged accommodation, had no family member at the 118 destination, and who did not understand the language of the destination country.
119 In bivariate logistic regression, none of the socio-demographic and foreign employment related and not getting rest at work (OR=1.81) were significantly associated with psychological distress.

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Final multivariate analysis showed psychological distress significantly associated with the 128 female (AOR=2.01) and perception of a bad working condition at work (AOR=2.44).
129 in different phases of migration in recent national and international studies [6,14]. Poor mental 151 health was reported by 23% of returnee migrant workers in Nepal [6]. Likewise, a 22% of non-152 domestic migrant workers in Singapore were found at higher risk of psychological distress [14].

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Psychological distress reported in this study was also found similar with the depression and 154 anxiety among migrant workers reported in the systematic analysis of the studies conducted 155 globally, which was 20% and 21% respectively [15].

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From the multivariate analysis, females and those who had a perception of the bad working