The Australian Government prioritizes improving the wellbeing of those participating in the Pacific Australia Labour Mobility (PALM) scheme. However, significant obstacles persist for these participants regarding access to sexual and reproductive health (SRH) services and information, particularly support for survivors of sexual and gender-based violence (SGBV).
Based on insights from researchers, service providers, and educators, this article highlights key issues concerning the sexual and reproductive health and rights (SRHR) of PALM participants in Australia and proposes five actionable recommendations.
Firstly, it is essential to acknowledge that in many PALM sending countries, SRHR is a delicate and often taboo topic. Cultural, social, and religious norms significantly impact the accessibility of SRH care and information. Once in Australia, PALM participants confront multiple SRHR challenges.
Access to SRH services for PALM participants is frequently obstructed by issues such as lack of information, stigma, fear of judgment, limited access to technology or digital literacy, cost concerns, language barriers, and issues related to transport and confidentiality, especially when using translators. These hurdles are often magnified by geographical and social isolation, as well as cultural barriers.
Moreover, participants struggle to find information regarding which SRH services are covered by PALM health insurance, or which providers offer free or subsidized services. For instance, it remains unclear if abortion services are covered, resulting in varied experiences regarding costs and care among participants seeking abortion.
Inconsistencies around insurance coverage for pregnancy and childbirth also pose significant problems. Some PALM participants have experienced comprehensive prenatal and obstetric coverage, while others have faced exorbitant charges for delivery in hospitals. Furthermore, some participants have been directed by their employers to return to their home country to give birth despite having completed the 12-month insurance waiting period for maternity care.
Power imbalances within the scheme, with approved employers bearing responsibility for their employees’ welfare, can leave PALM participants vulnerable. Without independent support mechanisms, participants often feel compelled to disclose sensitive information, such as their pregnancy status, to employers.
Additionally, those who have encountered SGBV in Australia may hesitate to report incidents or seek assistance, particularly if they are uncertain about their visa entitlements or fear breaches of safety and confidentiality.
The ramifications of these challenges manifest physically, emotionally, and financially for PALM participants. Unintended pregnancies, including those resulting from sexual violence, have placed female participants in dire situations, leading them to conceal their pregnancies to avoid job loss. Many women face ostracism from family and communities back home due to pregnancy and struggle to find help. When they do seek pregnancy or abortion care, they often confront prohibitive medical costs that can lead to financial distress.
In response to these challenges, we offer the Australian Government several recommendations:
First, it is crucial to engage Pacific civil society organizations to provide standardized, comprehensive SRHR information to participants before departure. The International Planned Parenthood Federation has eight Member Associations in PALM sending Pacific countries, many of which conduct in-country pre-departure briefings and SRH screenings for PALM participants. However, the pre-departure process can be overwhelming, leaving little room for discussions about health-related issues. Collaborating with local organizations can ensure culturally sensitive SRHR conversations and establish points of contact for participants returning home.
Second, Australian health providers and organizations should expand programming to deliver culturally relevant SRHR education for PALM participants. True Relationships and Reproductive Health currently offers education sessions on SRHR and respectful relationships, led by bilingual educators in culturally safe environments. While over 1,500 participants in certain states have benefited from this program, the need for comprehensive education extends to the tens of thousands of PALM participants who have not yet received this critical information.
Third, it is vital to empower PALM-approved employers to provide better support for employees regarding their SRHR. Employers should be equipped with the tools, resources, and training necessary to guide participants in accessing SRHR services and information, particularly concerning reproductive health and SGBV.
Fourth, PALM participants need readily available, up-to-date information on SRH services and insurance coverage while in Australia. Participants must understand which services are covered regarding sexual health, pregnancy, termination of pregnancy, and childbirth, alongside where to access such services. The Australian Government has made resources available, but these require better context, emphasizing free or approved services specific to each state.
Finally, it is important to enhance protection mechanisms and establish confidential channels of support to help PALM stakeholders identify and respond to safeguarding violations. Implementing an independent, confidential reporting mechanism is critical for participants seeking to report SGBV, sexual harassment, and other forms of abuse. Increasing the engagement of Pacific Islander women in welfare and social support roles, alongside clear referral systems with approved service providers, is essential.
Australia’s Minister for Employment and Workplace Relations, Tony Burke, affirms the importance of the wellbeing of Pacific and Timorese people within the PALM scheme. Ensuring sexual and reproductive health and rights is crucial for overall wellbeing, and the Australian Government has the opportunity to address these pressing issues.
This article reflects ongoing research related to the safety and wellbeing of PALM participants, including contributions from SRHR service providers in the Pacific region. Discussions on this topic will take place at the Pacific Migration Workshop hosted by the Development Policy Centre on September 3.