Over-Qualification / Under-Qualification of Care Work in Ageing Asia: Towards Regional Framework of Care Provision Regime

Skills harmonization is one of the urgent challenges in international migration of healthcare workers. This is significantly due to the increase number of de facto care worker migration within Asia in the forms of domestic work, care work, nursing and even nuptiality corresponding to ageing. The complexity of care worker migration is because of absence of equivalent qualifications of care workers between the sending and receiving countries. This absence in migration trigger in a dual sense. One is under-qualification of care work, such as a domestic worker engaging in a skill-required home care such as suction, NGT, stoma and so forth. The belief of domestic work as naturalized among women is also another factor in the facilitation of the under-qualification and hence legitimate familialism of care provision from the viewpoint of welfare regime. On the other hand, over-qualification is overt especially in institutional care to avoid skills shortages or to secure qualified care. This is why nurses in the sending countries are recruited to destination countries. More than 20% in Taiwan and surprisingly more than 90% of care workers in Singapore are nurses from the sending countries. This is not merely a deskilling of individual nurses but also creating insufficient allocation of nurses in the region even though most of sending countries run short of nurses especially in the rural area. Since the current bilateral agreement basis of care work migration is not endowed with a sustainable migration system, multi-lateral or regional framework for the management would be necessary.