All over the world women are perceived as care takers. * Throughout history women have taken on this role. Mothers, grandmothers, daughters, all providing personal- and professional care. More than eighty percent of caregivers are female, who spend fifty percent more time on providing care than the average male. Within this group we can see women with a migration background. How do these migrating women shape and pursue this role when changing their familiar environments?

Family and Community Caregivers

Over the years the number of individual women migrating for work, education or as the head of a household has grown drastically. The integration of these women shows to be a complex process in most cases. Due to underestimation of one’s previous education and work experience, these women end up ‘filling the gaps’ in the labour market. Nevertheless, these women tend to play a vital role for their family and community in their country of origin. By sending parts of their own income as financial support to family members through remittances, some research shows the positive development on economic wellbeing of the receiving persons.

The experiences of migrant women in the destination country also contribute to social development of the family and community in the country of origin. This process can be called social remittance. Experiencing other social standards, norms or identities and possibly learning new skills can contribute to the personal development of migrant women. This new or different knowledge can transfer on to family and community members.

Women’s Jobs: Easy and of Low Value?

Female migrant workers play a big role in the labour market of the destination country. A growing demand for domestic care, domestic housework and professional health care has been a trigger for more female migration over the last decade. With the aging of most western countries, female migrant workers play a vital and irreplaceable part in the labour market. They also maintain the employment system of the country.

However, migrant workers face daily misperceptions about their abilities and knowledge – perceived as taking other people’s jobs and only being able to provide low value work. Female migrant workers also face sexist attitudes that contribute to these ideas. These attitudes push migrating women into jobs that are perceived as easy and of low value, such as domestic and health care work, both professional and informal. Domestic and health care work is seen as a natural extension of a women’s role in daily life.

A Profession in Health Care

The health care sector is globally experiencing a worker shortage and it is dependent on migrating health care workers to play a part in resolving this problem. However, research shows that in most western countries this is not a sustainable solution. Some western countries are actively recruiting foreign health care workers. In return these workers are offered training and education in combination with a job. These offers do not seem to be made to other migrating women, who migrated because of other reasons or by their own initiative. These women enter the labour market in the destination country without these types of support. 

When entering the health care field migrant women can face a range of challenges due to legislation, recognition of previous education and work, cultural differences, discrimination, and language barriers. As a result of these factors, migrating health care workers mostly end up working with the elderly either through home care or assisted living organizations. This field of health care work is often perceived as non-challenging and predictable.

Domestic Workers

Migrating women also find their place of employment in domestic work, being care takers for young children, the elderly or domestic housework. When working in an informal domestic setting migrant women face a risk of abuse due to a dependent relationship between the worker and the employer. Dependence based on a residence permit, income, housing, and security of work opportunity as well as isolation from social settings and lack of accurate information due to language and cultural differences heighten the vulnerability of these women.

The three takeaway points to future-proof the Dutch healthcare system are financial sustainability, social sustainability, and personnel sustainability. Financial sustainability focuses on expenses the Dutch government makes in the healthcare sector. Considering the demographics and technological developments, it is expected that healthcare expenditure will increase faster than economic growth in the future. So predicts the Dutch government (RIVM) in a preliminary study. It is predicted that healthcare expenditure will continue to rise by an average of 2.8 percent per year until 2060, compared to the 1 to 1.5 percent volume growth for the economy as a whole. This is mainly because of the stagnation of the productivity in the Dutch healthcare sector.
According to the Dutch government (Ministerie van Algemene Zaken, 2022) there are only 3 solutions available on how to subsidize these increasing expenditures:

– (1) reducing the share of other public expenditure by the government
– (2) increasing the collective tax burden
– (3) increasing the national debt

The “TAZ” programme focuses on personnel sustainability. “TAZ” has been started in 2022. “TAZ” is short for “Toekomstbestendige Arbeidsmarkt Zorg & welzijn” which translates to “Future-proof Labor Market Healthcare & Welfare”. The percentage of people working in the Dutch healthcare system has increased since the early
1970s from 7 to more than 15 percent.

Momentarily about one out of every seven employees in the Dutch labour force works in the healthcare sector. In about forty years this should be one in three employees to be able to meet the healthcare demand. It is therefore imperative that the people that work in the healthcare sector stay as employees in the healthcare sector. Personnel sustainability focuses on this point (Ministerie van Algemene Zaken, 2022).

To keep healthcare workers within the Dutch healthcare system some changes for healthcare workers have been proposed. These are, for example, that employees are already involved in healthcare innovations during the training, that there is good internship guidance and an attractive (learning) work program that allows them to do what they have been trained to do they are given the opportunity to develop further, so they spend less time on it administrative burdens, that they have access to new working methods and technology to increase job satisfaction and that they have a say in the way the work is done equipped. All this contributes to ensuring that the healthcare and welfare sector is, and remains, a good sector to work in.

Social sustainability focuses on the views the Dutch population have about the healthcare system and how much they are willing to pay for their healthcare. In the Netherlands insurance is mandatory. If insurance prices rise people are forced to pay the fees and will be dissatisfied. Social sustainability is the general opinion about the healthcare (e.g., accessibility and quality) and the financial support the Dutch population can (and wants to) give to their healthcare system.