- 5 hours ago
- #considerthis
The Covid-19 pandemic revealed just how strained and undervalued Malaysia’s care workforce had become. But several years later, have their conditions improved? A new study by the RE:CARE Project maps the pressures, inequities, and policy gaps surrounding Malaysia's care workforce, and what must change to protect it from burnout, mental health strain, and retention challenges. On this episode of #ConsiderThis Melisa Idris speaks with Anis Farid, Principal Investigator for the RE:CARE Project, and Shazana Agha, one of the projects Co-Principal Investigators. This report is a part of the RE:CARE Project (Endemicity, Care, and Gender: Towards Developing Resilience in Malaysia’s Essential Care Workforce and Infrastructure), an initiative led by researchers and personnel from Women’s Aid Organisation, University of Alberta, and Universiti Malaya, in collaboration with representatives of TalentCorp and the Ministry of Health.
----
----
Category
🗞
NewsTranscript
00:00Hello and good evening. I'm Melissa Idris. Welcome to Consider This. This is the show where we want
00:15you to consider and then reconsider what you know of the news of the day. The COVID-19 pandemic
00:21revealed just how strained and undervalued Malaysia's care workforce had become. But
00:27several years later now, have their conditions improved? A new study by the ReCare Project maps
00:35the pressures, inequalities and policy gaps surrounding Malaysia's care workforce and what
00:41must change to make it more resilient. Joining me on the show are the good folks from the ReCare
00:47Project, Anis Farid, who is the Principal Investigator and Shazana Agar, who is one of the Co-Principal
00:53Investigators. Both of you, welcome to the show. I'm very curious to know more about this
00:58project and the study, the recent report that you launched. So talk to me a little bit about
01:03what this project is, who's involved in it and why you decided to focus on the care workforce,
01:15particularly post-pandemic. Anis, if I may come to you.
01:19Yeah, okay. So first of all, thank you for having us here today. I'm really happy to have this
01:24opportunity to share more about this important study. So I think, to answer your question,
01:31what we know is that women are societally expected to be the primary caregivers of their families.
01:38And we know that during the COVID-19 pandemic, this burden increased a lot, the unpaid care
01:44responsibilities. Simultaneously, our care workforce, which undertakes the paid care work,
01:50and this encompasses those from health care, social care, and domestic care. This workforce
01:57is also primarily women. So what we saw during the COVID-19 pandemic was the demands on women who were
02:06undertaking paid care work increased a lot because of the nature of the COVID-19 pandemic.
02:11A lot of these women were frontline responders, for example. And this is the unique double burden
02:18that women in the paid care workforce carry. They have to manage their paid care responsibilities
02:23and their unpaid care responsibilities. And in times of crisis, especially like COVID-19,
02:31this burden increases. But we don't actually know about the experiences of these women. Like,
02:38what did they really go through? So what we wanted to look at, essentially, is how these paid care
02:44workers negotiated the balance between their paid care responsibilities at work and their unpaid
02:49care responsibilities at home. And also, more broadly, the impact that this has on their well-being
02:55because we believe that the resilience of Malaysia's care ecosystem hinges on the well-being of our
03:01care workers. Definitely. Yeah. So the ReCare project is essentially a collaboration. So you came
03:09together, researchers came together to say, hey, we suspect that the care workforce, particularly women,
03:17are under immense strain. And we want us to see whether the data reinforces that by talking to them,
03:25by documenting their experiences. Is that correct? Am I correct in raising that? Yeah, you're absolutely
03:32right. We had suspected, you know, that this was something that was being underestimated or not being
03:40looked into more thoroughly. And we felt that it was really important to bring this to the fore and for us
03:51to understand better what were the experiences of care workers during COVID. What are the experiences
03:57now? Yeah. Could I just get the both of you maybe to define the care workforce? Anis, you mentioned
04:07health, social and domestic. And sometimes I think maybe it would be beneficial if we understood who we
04:15mean when we say care workforce because sometimes people think, oh, is that just nurses or maybe
04:21domestic helpers. So when you looked at this study, who did you look at and how did you define them?
04:27Okay. Yeah, you're absolutely right. Our study takes a very broad approach to defining who a care worker
04:35is because we're taking a more ecosystems approach where we believe that all of these different sectors
04:41under care like health care, social care and domestic care have an important role to play
04:46in supporting Malaysia's care needs. So amongst our health care workers who we were looking at were
04:51doctors, nurses and hospital cleaners. For social care, we looked at social workers, particularly those
04:58within the social welfare department, JKM. And then we also looked at those who provide care for children,
05:04the elderly and people with disabilities. And for domestic care, we were looking at migrant domestic
05:10workers from Indonesia and the Philippines. And these are all paid care workers. So we haven't even
05:16touched on the unpaid care work. Right. So let's talk about the findings of the report. I want to delve
05:24deeper into that. I understand that this has been a labor of many years since the pandemic was officially
05:32over. So how long has it been? And maybe talk to us about what's changed, why you started to look at this at the start of the research
05:44and what has changed since and the findings of the report. I'll go to the both of you, but I need to see if we could start.
05:49Yes. Okay. So in terms of our findings, so broadly, this was a very large scale nationwide study.
06:00And it was also mixed methods, meaning we did both qualitative research. So things like interviews,
06:05focus group discussions, as well as quantitative research. So like surveys. So for us, we started with
06:11focus group discussions with over 140 women care workers across Malaysia to really understand what
06:17were the issues that they were facing during the pandemic and after. And then from there,
06:22we created a survey, which we, which was undertaken rather. Okay. The survey had 1500 respondents,
06:32care workers, men and women. And the survey was really assessing the wellbeing of the care workers,
06:38both not across time, essentially. So before, during and after the COVID-19 pandemic.
06:43I see. Okay. Yes. And I also want to give a bit of context as to what wellbeing is, because we're
06:50going to talk about it a lot. Sure. You're right. You're right. That's important to define it.
06:53Exactly. So for us, wellbeing is composed of four core aspects and we measured subjective wellbeing,
07:01which means that we allowed the care workers to assess how satisfied they were with these aspects of
07:05their lives. And so our four key aspects that we were assessing was how satisfied were care workers with
07:11their physical and mental health, their job satisfaction, their satisfaction with their work
07:15life balance. And finally, their satisfaction with the social support that they had for unpaid care
07:20work. So simultaneously, we also wanted to make the measure as holistic as possible. So we also
07:26considered contextual factors. So for example, how satisfied you are with your work life balance
07:30is going to depend on how much time you spend on your paid work and also how much time you have for
07:34your unpaid caregiving. So we really wanted to capture as holistic as possible, this idea of wellbeing.
07:43And for what we found, we saw that during the COVID-19 pandemic, three fourths of the care workers
07:49that we surveyed, they experienced a decline in their wellbeing. And what we're talking about here is
07:55over 1,100 care workers saying during the pandemic, my wellbeing declined. And what we're seeing also is that
08:02post pandemic, two thirds of them have not recovered to pre pandemic levels of wellbeing. So what this
08:09tells us is that the effect of the pandemic, it wasn't temporary, it's ongoing, and it's shaping the
08:14realities that care workers are facing day to day, even now. Wow, that's, that's really heartbreaking,
08:22isn't it? Because you, we knew the pressures put on care workers during the pandemic, but you would have
08:28thought that years after that conditions would have improved or things would have gone back. But it
08:34really, I think just deepened some of the vulnerabilities. Yeah. How do you view the findings?
08:40Do you, what was the most significant for you? Um, I think, uh, what was the most significant for me was
08:49how, um, care workers are intending to leave the workforce. And, uh, a lot of the times it's to do
08:59with, uh, wanting to spend more time with family, um, wanting to have that time to be able to do their own
09:07unpaid care work. And I think, um, while we emphasize the importance of, you know, um, uh, paid care work,
09:19we often forget or underestimate the, uh, the, the toll that unpaid care work can also take on an
09:27individual, including care workers themselves. So we're always looking to care workers as people who
09:33serve us, you know, as people who serve care recipients, but are we also looking into what
09:40their own personal care needs are? Um, yeah. So you're absolutely right. The number of people
09:49who were thinking about leaving, um, the care workforce was quite shocking to me from, from your
09:55study. One in three of Malaysian care workers intend to leave their current position within the next five
10:02years. I was so shocked when I saw that in your report, it's staggering. What do you think it could
10:11mean for the care industry, the care sector, if this comes true, if one in three, if 35%, 34 and a half
10:20percent say, I no longer want to do this because it's taken too much of a toll on my well-being.
10:26Anis? Um, yeah. Um, I think before we go into what the implications are, um, I want to emphasize
10:35that this statistic, this one in three statistic is, um, the number amongst Malaysian care workers,
10:42it's actually much higher amongst, um, migrant domestic workers. Oh, wow. It's, uh, over half want to
10:48return, uh, over half want to leave their current jobs within the next five years. And obviously,
10:54migrant domestic workers are under different pressures. Um, for example, like the long-term
10:58familial separation, things like that. They want to be reunited with their families. Um, but what
11:03this statistic, this one in three number really means for Malaysian care workers, uh, there's two
11:07things actually that it could mean. Um, the first is that they're thinking of changing their jobs in
11:12some way, whether it is, um, moving from the public sector to the private sector, um, or changing jobs
11:18altogether. Um, the second is that they want to drop out of the care workforce. Um, so, um, as, um,
11:25Shazana mentioned, one of the reasons that is most commonly cited is wanting to spend more time with
11:30family. Um, but the top reason that cited is actually job stress and burnout. Um, so, other commonly
11:38cited reasons also retirement. Uh, but when we're looking at those who say they want to retire and they
11:44want to spend more time with family, a lot of them are actually working age, meaning they're in their
11:49prime working age. They're under 50 years old. Um, which they're already talking about retirement.
11:53Yes. They're already thinking about retirement, which means that they want to drop out of the
11:57care workforce, essentially drop out of the workforce altogether. Yes. Um, so this is obviously
12:03really concerning because it shows that the structures that we have are not supporting women and the
12:08unpaid care responsibilities that they have, right? Like maybe workplaces are not flexible or
12:12supportive enough of the unpaid care responsibilities that these women have. Um, simultaneously, there's
12:18also this huge problem with the burnout that the care workers are facing. Um, those who say that they
12:23want to change their jobs because they're burnt out, um, you can see that they have higher levels of
12:28burnout than those who are citing other reasons. Shazana, is this concerning to you? This, this staggering
12:35statistic, which I have now learned that it's probably higher if you take into account, uh, the migrant domestic
12:41workforce. Um, yes, of course, um, you know, it's concerning and, um, it's also, uh, more concerning is what are we
12:49doing about it? You know, um, are we taking this seriously? Are we taking stock of, you know, uh, things that
12:56happened during the pandemic and, um, you know, uh, and responding to it through policy interventions and
13:03programs? So I think that's the bigger question. I have to say, I mean, I, you suspect it's the case and I've heard
13:10anecdotally of friends of friends who say, you know, they want to drop out of the healthcare workforce
13:17or, um, social care workforce, but when it's in, when there's data to support your suspicions,
13:24it's really quite worrying. Um, let's talk a little bit about the other shocking, important finding that
13:33came out from your survey, which was 52.6 hours was spent on paid care, a week was paid care. Actually,
13:43I bungled that up. So I'm going to leave it to you to, to share with us this important finding. Talk to me
13:49about what you learned about how much time was spent on, uh, paid care work and unpaid care work.
13:57Okay. Um, so the, uh, you're absolutely right about that. 52.6 hours per week. That is post pandemic.
14:06So on average, um, the care workers that we surveyed are reporting that they spend 52.6 hours
14:11per week on their paid care work. Um, and obviously this is, um, a very high number. It is above, um,
14:20the maximum hours that is outlined within the employment act of 45 hours per week. Um, and this is why
14:26we see such high rates of burnout amongst the care workers. Um, in our study, what, in our analysis,
14:32what we found is that there's a high correlation between those who spend, um, long hours working on
14:38at work, um, and facing burnout. So the long hours is contributing to the burnout that they're experiencing.
14:47But, um, it's not just that because the reality is that the work was really demanding and intense
14:52during the COVID-19 pandemic. Um, during the COVID-19 pandemic, in fact, like one in three
14:58care workers were reporting that they were spending over 70 hours a week working. Um, and it's obviously
15:04not just about the amount of hours that are being worked that's intense, uh, but it's also about how
15:10much is being done within those hours, right? Because COVID-19 was a crisis. It was an emergency.
15:15Um, and we saw how it affected the healthcare frontliners. What we saw less of was what was
15:21happening to our social care workers. Um, for example, a lot of them are managing clients who
15:27have, who are elderly, who have complex care needs. Um, and they needed to be able to meet those needs
15:33while also managing disinfection protocol, SOPs, less, less staff within like, for example, a nursing home.
15:40And you can imagine the toll on them was huge. And that's something that we didn't really,
15:45we didn't really know. We didn't really see. Right. It was all invisible work, wasn't it?
15:50Yeah. Yeah. Yes. So, I mean, to go back to, I guess, the bigger question of what the implications
15:57are, um, when we know the impact that the pandemic took on our care workforce and that they have not
16:04recovered to pre-pandemic levels of wellbeing, they're still facing burnout, things like that,
16:08um, is leading to this, uh, high intention to leave the care workforce, first of all, which then impacts
16:16not just, um, their wellbeing, right? Uh, it's also impacting the wellbeing of the nation because,
16:22as it is, we're an aging nation, um, we don't have enough care workers. And if our care workers don't
16:28want to continue doing their jobs because they don't feel supported enough, they don't feel valued,
16:31they don't feel appreciated, you can imagine the quality of care that Malaysians will receive is going
16:36to be compromised. Yeah. I mean, what a wake up call. It really is. Shazenna, can I ask you,
16:41so just now, Anis mentioned that, uh, in addition to the paid care work, the, the number of hours put
16:49in for paid care work, women especially have to put in more hours for unpaid care work at home.
16:56Yeah. Um, maybe talk to me a little bit about that, about that, because, um, unpaid care work is
17:03so often falls on women to carry, um, what that means for the care workers and caregivers, uh, when
17:15policies don't recognize the gendered dimension of it. Yeah. I think, um, you know, care workers own
17:24unpaid care work. That was something, uh, perhaps, uh, really was not seen. And, and through the study,
17:30we, we, we found, um, we got to know more about the struggles of care workers in navigating their
17:37own paid care work. A lot of them had to bring their children to work. Um, you know, some of them,
17:43uh, had to, uh, leave their children alone at home. Uh, and while they're at work, they're thinking about
17:49the children at home. Um, how is my 10 year old doing? Um, you know, not being at peace. Um,
17:56you know, having to bring three children along to work and navigating roadblocks, uh, you know,
18:03every day. So these are some of the, uh, stories that were shared and, you know, it, it, uh, I feel
18:10like there's, I've not seen a recognition of this, uh, anywhere. Sacrifice. Yeah. It's a sacrifice that
18:18they've, they've done. It's a sacrifice. And also, um, do they really have to go through this?
18:23You know, um, is there, is it possible to support them better? And how do we do this? So, I mean,
18:30one of our key recommendations actually is to talk about how we need to integrate care workers
18:37within our crisis preparedness, uh, plans and programs. Oh, um, yes. They're not.
18:44Uh, well, some of them are. So you see doctors and nurses, uh, these are the more, uh, uh, you know,
18:51uh, front of mind, uh, occupations that, you know, uh, are recognized. But when we talk about,
18:58for instance, hospital cleaners, uh, social workers, you know, uh, you know, here and there,
19:04uh, and then you talk about elderly care providers, child care providers, domestic care workers,
19:09they were all performing really essential functions during the pandemic, caring for us,
19:15whether within the hospital or out of the hospital. And the thing is, um,
19:19um, uh, so, so what we're saying is that if a pandemic were to happen again, we don't know,
19:26it could happen very well. Oh, it could be another crisis. Climate, uh, change is here. Um,
19:33or it could be, you know, uh, the, the simple idea that we are going towards an aging nation,
19:39you know, we, uh, need to prioritize care. And in doing so, we need to look into the well-being of our
19:46care workers. A hundred percent. Definitely. Tell me more about the other recommendations from your
19:52work because you've clearly, you've laid out the problem. You've, you have data to support, um,
19:59the hypothesis, but where do we go from here? We know that we need to build, um, we need to take
20:06better care of our care workforce, the way they've taken care of us. What, what were some of the
20:11recommendations that you put out? So, um, we've put forward five pillars of recommendation. So
20:18essentially, uh, these were derived together with care workers themselves. So some of these, uh, so,
20:25so under each pillar of recommendation, we have some sub-recommendations that were, that, uh, came
20:32directly from care workers themselves as well as researchers. Okay. Yes. Um, as we, as we sat down
20:39together to analyze the data, uh, through our participatory data analysis sessions. And so, um,
20:45the pillar one, for instance, is to enhance working conditions of care workers to ensure that, uh,
20:52care work is decent work. So what does that look like? It means fair wages, um, job security,
20:59ensuring there is adequate mental health support, um, you know, looking into representation of care workers
21:07in decision-making spaces. So these are all aspects of what we call decent work. And, uh,
21:14we want to make this happen for care workers because we cannot still, we can, we cannot continue to rely
21:21on care workers' individual resilience or individual coping mechanisms. We need structural
21:27support for them and we need them. We need structural change. Definitely. Okay. So that was one. Talk me
21:33through some of the other major pillars. I'm sure we can't go through in detail, um, every single,
21:39um, recommendation, but what do you think, uh, would be the, you would personally consider the most
21:46urgent reforms and most achievable. I might say some reforms take longer, take years, maybe a more
21:51political will, but are there low hanging fruit that you think we can win in terms of providing for our
21:58care workers, Josana? Um, I think, uh, uh, a low hanging fruit would of course be, uh, better mental
22:05health support. I think that's, we already have some structures. We already, already have some
22:11initiatives in place, but we need to improve them certainly. And one of the things that we found was
22:16that a lot of the time care workers don't access, uh, uh, mental health support that are available, uh,
22:23simply because they, uh, they have fear of, uh, confidentiality breaches. So, uh, what we are
22:31putting forth as a recommendation is to ensure that mental health services that are provided for
22:36care workers should be independent. They should be independent from the management and from
22:42administrative, uh, positions within the, uh, care institution. Um, and certainly, uh,
22:50uh, the other thing that we found from our study also was the significant impact of personal violence
22:57on care workers. And that's something perhaps Anis could maybe speak to a bit more. Tell me more.
23:03Okay. Uh, um, so in terms of violence, there were two measures of violence that we assessed,
23:09whether they were experiencing violence in the workplace. So these are things like bullying,
23:13harassment within the workplace. But we also asked if they were experiencing any violence at home,
23:17um, or in their personal lives. And, uh, when we were looking at those who said that they wanted to
23:23leave the care workforce within the next five years, we saw that generally those who experienced violence
23:27in the workplace, they reported, um, higher rates of experiencing violence at the workplace.
23:34Um, and then when you're looking at Malaysian women specifically, those who want to leave the,
23:39um, their current jobs within the next five years, they actually reported higher rates of experiencing
23:46personal violence. Um, we're not exactly sure why this is. This is definitely something that we want
23:51to look further into, but it shows that addressing the violence experienced by care workers, both in
23:56the workplace and at home, um, might be crucial for retention strategies and to support their well-being
24:03overall. Wonderful. Uh, in the few minutes that we have left, can I ask both of you for the audience
24:08watching at home? Um, you've put in years of work to put together this report. You've spent time talking
24:15to care workers, learning about their experiences. For many of us who often take for granted or don't
24:24value enough the, the work, the contribution of care workers, do you have a reminder for our audience? Um,
24:32just based on the work that you've been doing and your observations, what would you like the public,
24:37and who knows, maybe a policy maker or two who may be watching this, to bear in mind the next time we
24:43think about the well-being of our care workforce. Um, Shazana, may I begin with you? Um, actually,
24:49can we begin with Anna? Oh, sure. Have a think first and I'll come back to you, Anis. Okay. Um, okay. So,
24:56I think, um, what we see in the 13th Malaysia Plan, for example, is that the well-being of the Rakyat is one of the
25:03core pillars. Um, and I think what our study really shows is that we've really neglected looking into the
25:09well-being of our care workers and how they're doing post-pandemic. Um, I think at the same time,
25:15for most of us, the big tangible changes that need to happen might seem a bit like out of reach because,
25:22for example, maybe it's the policy makers that need to, um, make that change and make that difference.
25:27Yeah. Um, but what we know from having worked with the care workers for the past few years is that,
25:34um, valuing and appreciating the work that they do can go a long way. A simple thank you, um,
25:41in recognition of the sacrifice that the sacrifices that, um, they went through during the COVID-19
25:47pandemic, that is a good place to start for, I think, all of us. Yeah. We, we come across so many
25:54care workers in our daily lives and maybe we don't, you know, we don't, we take them for granted,
25:59right? Shazana, have you had a thought? Yes. So, uh, perhaps, I mean, uh, the idea of care as, uh,
26:06gendered, um, you know, we, we, we, we really should be challenging these, uh, stereotypical ideas that
26:14care work is a women's work, you know, um, that, uh, you know, uh, uh, you know, between a husband and a
26:20wife, you know, it's on, it's all on the wife's shoulders. Um, you know, we need to be challenging
26:26these gendered ideas because it's just not sustainable. It's not sustainable for the
26:30average woman and it's certainly not sustainable for the care workers. Absolutely. Both of you,
26:36thank you so much for coming on the show and sharing some of your work and for all the hard
26:40work that you've put in to put together this survey and this report. I appreciate you and the
26:44the whole of the ReCare team. Thank you. Thank you. That's all the time we have for you on this
26:49episode of Consider This. I'm Melissa Idris signing off for the evening. Thank you so much for watching
26:54and good night.
Be the first to comment