Not all migrant workers in Korea are getting access to healthcare services in the Covid-19 pandemic situation, a study showed.

They earned Covid-19 related information quite easily, but only 48.1 percent of them subscribed to the national health insurance.

JW Lee Center for Global Medicine at Seoul National University College of Medicine released the study's outcome on migrant workers’ health literacy and access to medical care.

The center conducted individual interviews with 528 migrant workers, including 250 undocumented workers in Seoul and Gyeonggi Province and 278 who obtained an E-9 work visa for two months from February to March.

The study showed that while migrant workers had easy access to health information and high health literacy, they had low access to health services.

Almost all respondents -- 98 percent and 94.1 percent of them – were aware of measures to prevent Covid-19 infection and self-isolation rules, respectively.

About 69 percent of the migrant workers knew exactly what the rules were for each stage of social distancing.

Also, 28.4 percent said it was easy to follow the quarantine guidelines, which was more than 19.7 percent who said it was difficult.

The overall health literacy level related to Covid-19 was high at 3.88 points out of 5. Health literacy refers to “the ability to understand basic health information and process information to make appropriate decisions about health problems.”

Undocumented migrants scored 3.93 in health literacy, 0.9 points higher than 3.84 by documented ones. As undocumented migrants have had a longer stay in Korea, their higher Korean language proficiency seemed to have yielded better results in health literacy, the research team said.

Despite the high health literacy in Covid-19 information, many migrant workers had difficulty in using healthcare services.

Only 48.1 percent of the total respondents subscribed to the national health insurance program. Among the subscribers, 76.4 percent were employer-provided policyholders, and 20.5 percent, locally provided policyholders. Only 3.1 percent subscribed to a private health insurance policy for foreigners.

Among uninsured migrants, 88.7 percent said they could not join the health insurance program because they did not qualify. Another 6.4 percent said they were uninsured because they could not afford high insurance premiums.

Only 1.7 percent said they could not see a doctor or get treatment since the Covid-19 outbreak. However, most of them said they gave up receiving healthcare services on their own.

Among the respondents, 16.5 percent had a Covid-19 test, but none of the undocumented migrants had it.

Migrant workers preferred visiting a pharmacy to a clinic or a hospital when they were sick. The largest proportion of the respondents, about 42 percent, chose a pharmacy as the first place to visit when feeling unwell.

A pharmacy was the most preferred medical facility, with 47.5 percent choosing it, followed by a neighborhood clinic with 33.9 percent. Only 12.9 percent said they preferred a free clinic for foreigners, and 1.3 percent, a public health center.

“Expatriates who failed to join the national health insurance program due to illegal employment status are in a blind spot of healthcare services,” the research team said.

"In the Covid-19 situation, the government should allow them to subscribe a locally provided health insurance policy temporarily so that they can get access to health services.”

Thirty-two percent said they had lost the main source of income because of Covid-19 and 65.3 percent said their average monthly income went down by 768,000 won.

Kim Woong-han, director of the JW Lee Center who led the study, said migrant workers were experiencing extreme stress due to social discrimination and job insecurity sparked by Covid-19.

“We need structural measures and interventions to embrace, rather than exclude, medically vulnerable groups such as migrants,” he said.

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