Maternal care of undocumented pregnant women under the Fees Act (Medical) for Foreigners 1951. Perspectives of health and non-health actors

Abstract

With the unprecedented international migration around the world, policies that restrict immigrants' health care access have become prevailing. In 2014, the amendment to The Fees Act (Medical) for Foreigners 1951 had further hindered the health care access of undocumented pregnant women. This qualitative study aimed to obtain perspectives of health and non-health actors regarding the implications of the amendment to the undocumented pregnant women. Ten semi-structured interviews were conducted in Kuala Lumpur, Malaysia. The findings show that Malaysians perceive as a threat when the competition for public health care access rises with the growing number of immigrants. The amendment was used to save the health care budget and to control the immigrant population. Scapegoating immigrants has nonetheless masked the weak governance and poor development of the health care system that has stretched the health care budget. The amendment is likely to show immediate cost saving. However, women are highly prone to various pregnancy complications without adequate maternal care, and may eventually result in increased hospital fees. The high medical cost will increase the difficulty in public health control as any outbreak of infectious disease can cost the government massive amounts of money. Also, provision of family planning services among the immigrants can directly improve maternal and child survival and extend women's work productivity from unwanted pregnancy. Stemming the undocumented immigrant pool not only can reduce job competition for Malaysia’s bottom 50%, the collected levy among the newly documented immigrants can in turn subsidies the health care services for immigrant group themselves. The presented findings are based on the perspectives from health and non-health actors in Malaysia. To conclude, this study shows a profound need for health and immigration policy reform. The effort is not just for the health of undocumented pregnant women, but most importantly for the economic and health benefit of Malaysians in general.